What to eat to prevent cholera: A Guide to Safe Food and Drink

According to the World Health Organization (WHO), a primary cause of cholera outbreaks is the consumption of contaminated food and water. Therefore, knowing what to eat to prevent cholera is a crucial step in protecting your health, especially when traveling or living in an at-risk area.

Quick Summary

Proper food and water safety are essential for avoiding cholera infection. This guide details which foods are safe to consume, which ones to avoid, and the necessary preparation techniques to minimize your risk.

Key Points

• Eat Hot, Cooked Food: Only consume food that is thoroughly cooked and served hot to ensure harmful bacteria are killed.

• Peel Your Fruits: Stick to fruits and vegetables that you can peel yourself, such as bananas, to avoid contamination from the outer skin.

• Drink Safe Water: Opt for bottled water with an unbroken seal, or water that has been boiled or disinfected.

• Avoid Raw Seafood: Stay away from raw or undercooked fish and shellfish, as these are common carriers of cholera bacteria.

• Practice Proper Hygiene: Frequently wash your hands with soap and safe water, especially before handling food.

• Beware of Street Food: Exercise caution with street vendors unless food is cooked in your presence and served hot.

• Avoid Cross-Contamination: Use separate utensils and cutting boards for raw and cooked food.

The Foundation of Food Safety: "Boil It, Peel It, Cook It, or Leave It"

Preventing cholera through diet relies on safe food handling and preparation, rather than specific foods. The guiding principle, particularly in high-risk areas, is "Boil it, peel it, cook it, or leave it," emphasizing the consumption of demonstrably safe food and drinks. The risk of ingesting the Vibrio cholerae bacteria is highest from food or water contaminated by feces from an infected individual.

What to Eat and Drink to Stay Safe

Adhering to these principles significantly lowers the risk of infection by eliminating harmful bacteria through heat or preventing contamination.

Cooked Foods and Meals

• Eat freshly cooked meals: Food that is thoroughly cooked and served hot is generally safe.
• Properly handle leftovers: Leftovers should be cooled rapidly (below 10°C/50°F), stored safely, and completely reheated to at least 70°C (158°F) before eating.
• Soups and stews: These are safe because high cooking temperatures kill bacteria.

Fruits and Vegetables

• Choose peelable items: Fruits and vegetables you can peel yourself, such as bananas, are safe as the skin protects the inside from contamination.
• Cook other vegetables: All other vegetables should be thoroughly cooked and served hot, avoiding raw options like salads.

Safe Water and Beverages

• Drink bottled beverages: Only consume sealed bottled water, canned, or bottled drinks, ensuring the seal is intact.
• Boil water: If bottled water is unavailable, boil water for at least one minute. Store boiled water in a clean, covered container.
• Hot drinks: Coffee and tea made with boiled water are safe.
• Use safe water for everything: This includes brushing teeth, making ice, and washing hands.

Foods and Practices to Strictly Avoid

Ignoring these precautions increases the risk of exposure to the cholera bacterium.

Raw and Undercooked Foods

• Raw seafood: Raw or undercooked fish and shellfish, especially from coastal waters, are a major source of cholera. Avoid dishes like sushi.
• Salads and raw produce: Unpeeled or uncooked fruits and vegetables, particularly salads, can be contaminated.
• Street vendor food: Avoid food and drinks from street vendors unless you witness them being freshly cooked and served hot.

Recontaminated Foods

• Moist grains: Cooked grains left at room temperature for several hours can harbor bacteria.
• Cross-contamination: Prevent raw and cooked foods from touching. Use separate cutting boards and utensils.

Improper Water Use

• Ice: Do not use ice unless it is confirmed to be made from safe water.
• Tap water: Avoid drinking tap water in areas with poor sanitation.

Safe Food Preparation vs. Unsafe Preparation: A Comparison

Safe Food Preparation Practices	Unsafe Food Preparation Practices
Use boiled, treated, or bottled water for all cooking and washing.	Use untreated or tap water for washing or rinsing food.
Cook food to a high temperature and serve immediately while hot.	Leave cooked food at room temperature for hours.
Store leftovers in a refrigerator (below 10°C) and reheat thoroughly.	Store cooked food improperly or at unsafe temperatures.
Wash hands with soap and safe water frequently.	Fail to wash hands, especially after using the toilet.
Use separate utensils and cutting boards for raw and cooked items.	Use the same utensils and surfaces for raw and cooked food.

The Importance of Kitchen and Hand Hygiene

Beyond dietary choices, hygiene in preparation and personal habits is crucial. Handwashing with soap and safe water for at least 20 seconds is a primary defense, especially before food preparation, before eating, and after using the toilet. If soap and safe water aren't available, an alcohol-based hand sanitizer (at least 60% alcohol) can be used. Maintaining clean kitchen surfaces and using separate utensils for raw and cooked foods prevents cross-contamination. For more information on preventing cholera through hygiene, consult resources like the U.S. Centers for Disease Control and Prevention(https://www.cdc.gov/cholera/prevention/index.html).

Conclusion: A Proactive Approach to Health

Preventing cholera through diet involves rigorous food safety and hygiene practices. By consuming only thoroughly cooked food, peeling your own fruits, and using safe water and beverages, you significantly reduce the risk of Vibrio cholerae infection. This proactive strategy, combined with diligent hygiene, is the most effective protective measure in cholera-prone areas.

Frequently Asked Questions

Can I eat salads to prevent cholera?

No, you should avoid salads and other raw vegetables, as they are a frequent source of cholera infection, particularly in regions where irrigation or washing water may be contaminated.

Is it safe to drink fruit juice in a cholera-prone area?

Only if the juice is canned, bottled, and has an unbroken seal. Fresh juice from street vendors or unknown sources should be avoided as it may have been prepared with contaminated water or ice.

What kind of water should I use for drinking and food preparation?

You should use only bottled, chlorinated, boiled, or properly filtered water for drinking, brushing teeth, and preparing food.

Are leftovers safe to eat if they were properly cooked originally?

Only if they were cooled quickly, stored properly in a refrigerator (below 10°C/50°F), and then reheated thoroughly to at least 70°C (158°F) before consumption.

Why is it important to peel my own fruit?

Peeling your own fruit ensures that the edible part has not been handled by potentially contaminated hands or washed with unsafe water, a key step in preventing infection.

Is it safe to eat at a restaurant in an area with cholera?

Choose restaurants that appear clean and have a good reputation. Stick to freshly cooked dishes that are served steaming hot. Avoid raw foods, salads, and drinks with ice.

Can cholera spread from person to person through casual contact?

Cholera does not spread through casual contact, coughing, or sneezing. It is spread by ingesting contaminated water or food.

What is the primary way cholera is spread through food?

Cholera is often spread through food that has been prepared with contaminated water, handled by an infected person, or tainted by contact with infected feces.