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By Adrienne Loerzel

HAGÅTÑA, Guam (December 27, 2000 - Pacific Daily News/PINA Nius Online)---The Marshall Islands government has restricted travel from Ebeye because of the cholera outbreak that has claimed five lives.

The Marshall Islands is also getting help from the recent experience of Pohnpei, Federated States of Micronesia, in fighting the cholera outbreak there.

The Marshalls had never experienced an outbreak of the contagious bacterial disease until the first case appeared in mid-December on Ebeye, an island in Kwajalein Atoll, said Donald Capelle, Secretary of Health.

Since the first suspected case, Ebeye's health-care workers have treated 143 cases of the diarrheal disease, including five patients who died, Capelle said.

An epidemiologist who was in Pohnpei during that island's outbreak has traveled to Ebeye to assist local health officials, Capelle said.

The doctor also brought about 4,000 doses of an oral cholera vaccine that will be given to high-risk residents on Ebeye, which has a population of about 10,000, he added.

Capelle said: "We have restricted travel out from Ebeye to protect the other islands. In order for people to leave Ebeye, they have to have a certificate signed by the medical doctors."

In an effort to halt the spread of the disease, the government is requiring travelers from Ebeye to take antibiotics to ensure they do not spread the cholera bacteria, Capelle added.

Cholera, usually spread through contaminated food or water, causes profuse diarrhea and vomiting. The disease is treated with antibiotics and rehydration solutions, but it can be fatal in patients who do not seek help early enough.

Capelle said the Marshallese government is trying to determine the source of the outbreak, which was confirmed by laboratories in Guam and Hawai‘i last week.

"We're still looking ... tracing it to try to see where the bacteria started," he said.

The island of Pohnpei, in the Federated States of Micronesia, has been battling cholera since April, but health care workers on that island said the disease has been largely contained.

"I'm not overwhelmed with cholera cases right now. On and off, we have cases that come," said Dr. Rally Jim, who works in Pohnpei's hospital. "But the numbers have decreased -- not like the last few months."

Jim added that the office in charge of the epidemic's statistics was closed yesterday, so he did not have the exact figures for the disease.

About 3,000 people on Pohnpei suffered through cholera and 19 people have died from the disease since the first case was identified in April.

Capelle said Pohnpei's experience is helping the Marshall Islands.

Capelle said officials are still trying to determine exactly how the disease is being spread.

Ebeye's water has not shown bacterial contamination, so physicians suspect the disease may be spread through food, he said.

Capelle said health workers have contacted the World Health Organization to ask for more vaccines.

He said the islands are taking strict measures to prevent the spread of the disease to other island.

"We haven't received any suspected cases in any of the other islands. We're hoping we can contain it in Ebeye," Capelle said.

What Is Cholera?

Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae. The infection often is mild or without symptoms, but sometimes it can be severe. Approximately one in 20 infected people has severe disease characterized by profuse watery diarrhea that may resemble "rice water," vomiting and leg cramps. In these people, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.

As a precaution, the Department of Public Health is asking residents to see a doctor if they have cholera-like symptoms, including watery diarrhea and vomiting. The disease usually is easily treated with oral or intravenous fluids and antibiotics, but a delay in treatment may be fatal.

If you are traveling to at-risk areas, you can follow a few simple precautions to reduce your chance of getting cholera:

Drink only water that you have boiled or treated with chlorine or iodine. Other safe beverages include tea and coffee made with boiled water and carbonated, bottled beverages with no ice.

Eat only foods that have been thoroughly cooked and still are hot, or fruit that you have peeled yourself.

Avoid undercooked or raw fish or shellfish.

Make sure all vegetables are cooked.

Avoid foods and beverages from street vendors.

A simple rule of thumb is: "Boil it, cook it, peel it or forget it."

For additional reports from the Pacific Daily News, go to PACIFIC ISLANDS REPORT News/Information Links: Other News Resources/Pacific Daily News (Guam).

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