Cholera

An Overview

Cholera is a bacterial disease caused by the bacterium ‘Vibrio Cholerae’. This type of bacteria is usually present in contaminated foods. It is also found in places where there is a lack of sanitation facilities. This disease was first discovered in the US during the 1800s. Cholera disease has been causing severe issues to people for hundreds of years.
If this disease is left untreated, it might cause severe diarrhoea and would lead to dehydration in the body. Sometimes it might lead to a fatal condition.

Vibrio cholerae is the causative agent of the disease. It is a curved and comma-shaped, Gram-negative bacterium. It is present in coastal saltwater areas and in the sewage. They attach themselves to the shells of shell-fish, crabs, etc. Drinking of contaminated water leads to various diseases including cholera.
This bacterium lives in the small intestine of the human body which releases an exotoxin thus causes a flow of water and certain electrolytes such as the sodium bicarbonate, chloride etc, into the small intestine.

Symptoms for Cholera

Most people exposed to the cholera bacterium (Vibrio cholerae) don’t become ill and don’t know they’ve been infected. But because they shed cholera bacteria in their stool for seven to 14 days, they can still infect others through contaminated water. Most cases of cholera that cause symptoms cause mild or moderate diarrhea that’s often hard to tell apart from diarrhea caused by other problems. Others develop more-serious signs and symptoms of cholera, usually within a few days of infection.
• Diarrhea. Cholera-related diarrhea comes on suddenly and can quickly cause dangerous fluid loss — as much as a quart (about 1 liter) an hour. Diarrhea due to cholera often has a pale, milky appearance that resembles water in which rice has been rinsed.
• Nausea and vomiting. Vomiting occurs especially in the early stages of cholera and can last for hours.
• Dehydration. Dehydration can develop within hours after cholera symptoms start and range from mild to severe. A loss of 10% or more of body weight indicates severe dehydration.

Signs and symptoms of cholera dehydration include irritability, fatigue, sunken eyes, a dry mouth, extreme thirst, dry and shriveled skin that’s slow to bounce back when pinched into a fold, little or no urinating, low blood pressure, and an irregular heartbeat.
• High fever.
• Weight loss.
• Increased thirst.
• Feeling of Nausea.
• Vomiting sensation.
• A kind bloating in the belly.
• Blood pressure becomes low.
• The elasticity of the skin is lost.
• Develop cramps in the muscles.
• A rapid increase in the heart rate.
• Dryness in the mouth, nose, and eyelids.
• Formation of blood or mucus or sometimes undigested materials in the stool.

Causes of Cholera

• Surface or well water. Contaminated public wells are frequent sources of large-scale cholera outbreaks. People living in crowded conditions without adequate sanitation are especially at risk.
• Seafood. Eating raw or undercooked seafood, especially shellfish, that comes from certain places can expose you to cholera bacteria. Most recent cases of cholera in the United States have been traced to seafood from the Gulf of Mexico.
• Raw fruits and vegetables. Raw, unpeeled fruits and vegetables are a frequent source of cholera infection in areas where there’s cholera. In developing countries, uncomposted manure fertilizers or irrigation water containing raw sewage can contaminate produce in the field.
• Grains. In regions where cholera is widespread, grains such as rice and millet that are contaminated after cooking and kept at room temperature for several hours can grow cholera bacteria.

Diagnosis

Although signs and symptoms of severe cholera can be unmistakable in areas where it’s common, the only way to confirm a diagnosis is to identify the bacteria in a stool sample.
Rapid cholera dipstick tests enable doctors in remote areas to quickly confirm a cholera diagnosis. Quick confirmation helps to decrease death rates at the start of cholera outbreaks and leads to earlier public health interventions for outbreak control.

Treatment

The treatment for cholera includes replacement of lost fluid and electrolytes. Drinking plenty of ORS (Oral rehydration solution) is advised to prevent dehydration. If the condition worsens, intravenous fluid replacement may be required. Doctors may prescribe antibiotics and Zinc supplements to check diarrhea.
• Rehydration. The goal is to replace lost fluids and electrolytes using a simple rehydration solution, oral rehydration salts (ORS). The ORS solution is available as a powder that can be made with boiled or bottled water.
Without rehydration, approximately half the people with cholera die. With treatment, fatalities drop to less than 1%.
• Intravenous fluids. Most people with cholera can be helped by oral rehydration alone, but severely dehydrated people might also need intravenous fluids.
• Antibiotics. While not a necessary part of cholera treatment, some antibiotics can reduce cholera-related diarrhea and shorten how long it lasts in severely ill people.
• Zinc supplements. Research has shown that zinc might decrease diarrhea and shorten how long it lasts in children with cholera

Prevention

The most important thing that one could do to avoid the disease is to prevent it. Cholera could be prevented by:
• Wash your hands with soap and water frequently, especially after using the toilet and before handling food. Rub soapy, wet hands together for at least 15 seconds before rinsing. If soap and water aren’t available, use an alcohol-based hand sanitizer.
• Drink only safe water, including bottled water or water you’ve boiled or disinfected yourself. Use bottled water even to brush your teeth.
Hot beverages are generally safe, as are canned or bottled drinks, but wipe the outside before you open them. Don’t add ice to your drinks unless you made it yourself using safe water.
• Eat food that’s completely cooked and hot and avoid street vendor food, if possible. If you do buy a meal from a street vendor, make sure it’s cooked in your presence and served hot.
• Drink water which is boiled.
• Avoid consumption of raw foods.
• Avoid dairy products as much as possible.
• Wash fruits and vegetables before you eat.
• Washing your hands before you eat is a good way to keep the disease away.
• Drink plenty of water and it is recommended to drink about 8 ounces of water every day.

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