Cholera is a deadly infectious disease that is common in developing and underdeveloped countries. Many people do not know about it since it does not get enough attention.
The following is list of some facts you need to understand about Cholera.
1. What is Cholera?
Cholera is a diarrheal Disease caused by an infections bacteria called Vibrio Cholerae ( V.Cholerae). It commonly affects adults and children above 5 years, but can affect all ages. It is known for causing a very severe diarrhea that leads to death within 24 to 48 hours if untreated due to severe dehydration and Electrolyte imbalance in the body.
2. Cause and Transmission
The cause of Cholera is V.Cholerae Bacteria. It is a bacteria that lives in water, especially salt water in the sea and areas of poor sanitation and also in humans. It has not been found in animals.
In humans, it infects small intestines and produce a toxin that causes hyperstimulation of the walls of intestines leading to severe diarrhea. Large intestines are not infected by the bacteria
Transmission of cholera is through ingestion of infected water or food. The incubation Period of V.Cholerae is 24-48 hours before symptoms begin to appear. The Bacteria passes the acidic environment of the stomach with the help of the fact that large quantities of the bacteria are ingested all at once when a person is drinking water or eating food (about 10³-10⁶ organisms).
The two main strains of V.Cholerae that are known to cause Cholera are V.Cholerae O1 and O139 variants. There are more than 200 variants, but of them are not pathogenic.
3. Symptoms and Signs of Cholera
The main Symptom of Cholera is diarrhea. The diarrhea is described as very large and watery. It may have some stools in the early stages but within few hours it changes to becoming “rice watery” since its color resembles that of a boiled or washed rice.
The person usually becomes very dehydrated quickly and combined with loss of Electrolytes, they also have acidosis. There may be vomiting and some abdominal cramps, but they are mild. The person becomes weak with time, have sunken eyes, dry mouth and skin and later loses consciousness.
Some signs include rapid weak pulse, low blood pressure and hypovolemic shock. In places where there is an outbreak of cholera, anyone above age of 2 years that has sudden onset diarrhea must be investigated for cholera.
4. Treatment and Prevention
Cholera was discovered in 1883 (organism causing Cholera), even though there are several vaccines for Cholera, multiple outbreaks in many countries have been reported including South Africa recently.
Cholera is treated with antibiotics such as:
- Ciprofloxacin 1g orally single dose. OR
- Azithromycin 1g orally single dose. OR
- Doxycycline 300mg oral single dose.
The above mentioned drugs can be used to all adults above 12 years including pregnant women, except for doxycycline.
Fluid Replacement with Oral Rehydration Solution (ORS) while still awaiting transport to health facility is very important and is recommended by World Health Organization (WHO). In Hospital care is with fluid replacement via IV fluids calculated for age and weight.
Prevention of Cholera includes:
- Boiling water before drinking in places where there is epidemic
- Thoroughly cooking food especially sea food and vegetables
- vaccination before travel to endemic areas
Remember Live attenuated monovalent vaccines last about 3 to 6 months while others last up to 5 years. It is important to enquire about the vaccine you are receiving.
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