Close look on cholera

Cholera is a severe diarrheal illness that can be deadly if not treated. With the advancements in modern hygiene such as clean drinking water and sanitation systems, the disease is considered rare in developed countries.

Even though cholera can be prevented and treated, it is still considered as a public health issue in countries where sanitation systems and hygienic practices are not properly established.

How cholera spreads

The transmission of the disease occurs via consumption of water that has been contaminated by feces from an infected individual. Take note that being infected with cholera can occur via drinking contaminated water or eating foods that have been washed with or made with contaminated water.

This form of water-borne diffusion is prevalent in areas with meager sewage systems and impure drinking water. The foodborne transmission can also occur once an individual eats raw or poorly cooked shellfish.

Who are at risk?

Cholera

Within 6 hours up to 5 days of exposure, the symptoms can range from minor or asymptomatic to a severe disease that is characterized by substantial volumes of explosive watery diarrhea, leg cramping and vomiting.

There are several reported cases of outbreaks of cholera is various parts of the globe. The outbreaks are oftentimes replaced to displacements of individuals who do not have access to toilets or safe sources of water.

Most cases are often triggered by outbreaks. Individuals who live or travel to emerging countries including South America, Asia and Africa might be at risk for cholera.

Signs and symptoms

Within 6 hours up to 5 days of exposure, the symptoms can range from minor or asymptomatic to a severe disease that is characterized by substantial volumes of explosive watery diarrhea, leg cramping and vomiting.

Due to the rapid fluid loss, severe dehydration and shock can set in. The indications of dehydration include sunken eyes, loss of skin plasticity, low blood pressure, rapid heartbeat and weight loss. Shock occurs due to the collapse of the circulatory system.

Diagnosis

The clinical indications of copious watery diarrhea are used to come up with a diagnosis. A “cholera cot” is a cot built with an opening to let fecal matter drain into a bucket. This is utilized to determine the volume of stool that is lost and fluid replacement requirements.

The laboratory tests include stool PCR, stool gram strain culture and dark field microscopy. An individual with cholera must start treatment even before diagnostic work-up.

Treatment

Since death from cholera is due to dehydration, the condition is managed with oral rehydration therapy which involves large volumes of water mixed with a blend of salts and sugar. There are prepacked mixtures available in the market.

In severe cases of cholera, administration of intravenous fluid is required. Antibiotics can shorten the conditions but oral rehydration therapy is still needed even if they are used. Anti-diarrheal medications are not used since they prevent flushing out of the bacteria from the body.

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