The Ministry of Health and Social Protection of the Population of Tajikistan (MoHSPP) has placed strict control over water quality in the border areas of the Panj River and in districts of Khatlon province bordering Afghanistan. 

Mr. Navrouz Jafarov, Deputy Head of the MoHSPP State Sanitary and Epidemiological Supervision Service says this is in response to reported cases of cholera in Afghanistan.  “The primary reason for these inspections is the cholera outbreak in Afghanistan, which reached a dangerous level last year.  The disease affected the regions of Balkh, Kunduz, Takhar, and Badakhshan, as well as areas bordering Tajikistan. As a result, water in the Panj River in the border areas is under strict supervision by specialists from the Republican Center for Combating Quarantine Diseases," Jafarov told Asia-Plus in an interview.

He specified that since June 3, a comprehensive inspection of open water sources in the border areas of the Khatlon province has been underway.  Specialists are taking water samples and conducting analyses to prevent the possible spread of infection.

"We have five rivers that cross the border with Afghanistan.  In the event of floods or the discharge of wastewater from Afghan villages into the rivers, there is a risk of the disease spreading," the Tajik health officials noted.

He further noted that they will monitor cases of hospitalization due to various intestinal diseases in districts of Khatlon province.   

At the same time, Mr. Jafarov emphasized that there is no need for undue concern, as the ongoing work is part of regular preventive measures.  Similar measures will also be taken in open water bodies in Dushanbe, districts subordinate to the center and Sughd province. 

The epidemiologist recommended that residents of border areas adhere to hygiene rules: wash hands thoroughly with soap, boil water for drinking and cooking. These measures are aimed at preventing the possible spread of cholera and other intestinal infections.

Recall, the MoHSPP and Rospotrebnadzor (the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing of the Russian Federation) have worked together to combat the risks of spread of cholera in Tajikistan.

Despite the fact that cholera has not been registered in the country, the Health Ministry has turned to Rospotrebnadzor for assistance in organizing preventive monitoring of this disease as well as in increasing preparedness for possible complications of the epidemiological situation, including in border areas.  

Russian specialists reportedly arrived in Tajikistan in late March for the joint work, which includes training of specialized specialists.  

It is to be noted that negotiations on this subject took place between Rospotrebnadzor head Anna Popova and Tajik Deputy Minister of Health and Social Protection of the Population Abdukholiq Amirzoda via videoconferencing on March 15.   

Cholera is an infection of the small intestine by some strains of the bacterium Vibrio cholerae.  Symptoms may range from none, to mild, to severe.  The classic symptom is large amounts of watery diarrhea lasting a few days.  Vomiting and muscle cramps may also occur.  Diarrhea can be so severe that it leads within hours to severe dehydration and electrolyte imbalance.  This may result in sunken eyes, cold skin, decreased skin elasticity, and wrinkling of the hands and feet.  Dehydration can cause the skin to turn bluish.  Symptoms start two hours to five days after exposure.

Cholera is caused by a number of types of Vibrio cholerae, with some types producing more severe disease than others.  It is spread mostly by unsafe water and unsafe food that has been contaminated with human feces containing the bacteria.  Undercooked shellfish is a common source.  Humans are the only known host for the bacteria.  Risk factors for the disease include poor sanitation, insufficient clean drinking water, and poverty.  Cholera can be diagnosed by a stool test, or a rapid dipstick test, although the dipstick test is less accurate.

Prevention methods against cholera include improved sanitation and access to clean water.  Cholera vaccines that are given by mouth provide reasonable protection for about six months, and confer the added benefit of protecting against another type of diarrhea caused by E. coli.  In 2017 the US Food and Drug Administration (FDA) approved a single-dose, live, oral cholera vaccine called Vaxchora for adults aged 18–64 who are travelling to an area of active cholera transmission.  It offers limited protection to young children.  People who survive an episode of cholera have long-lasting immunity for at least three years (the period tested).