Cholera – Causes, Symptoms and Treatments!

Cholera – Causes, Symptoms and Treatments  we should know. In addition,  cholera is an acute diarrhea caused by some strains of enterotoxin-producing bacteria of virulent Vibrio cholerae. These toxins are capable of altering the functioning of the intestines, causing great loss of water and electrolytes such as sodium bicarbonate , chloride and potassium .

Cholera is usually acquired from drinking contaminated water, diarrhea , and in severe cases, it is more intense than the images of diarrhea that most people tend to experience occasionally.

In cholera, the amount of fluid lost in the stool is so great and occurs so quickly that if the patient does not receive timely treatment, symptoms of severe dehydration and hypovolemic shock can develop within 12 to 24 hours.

In this article, we will explain what cholera , Vibrio cholerae bacteria like can be acquired, what its symptoms are, what kind of treatment should be instituted and what are effective ways of prevention.

Cholera Transmission:  The route of transmission of cholera is fecal-oral, that is, a healthy person needs to have contact with the feces of a sick person to acquire the bacteria. This infection is usually done through contaminated water, which is common in very poor places with inadequate sanitation. Regions hit by war or natural disasters also experience cholera epidemics.

But it’s not just the consumption of contaminated water that can cause the transmission of Vibrio cholerae. Contaminated hands are a common source of contamination, either when preparing food or through direct contact with others. If the infected patient is not in the habit of disinfecting his hands properly after each evacuation, the risk of contamination of people who live close by is very great.

Studies show that every liter of diarrhea eliminated by the patient is not a release to the atmosphere of about 1 billion Vibrio cholerae bacteria. The concentration of bacteria in water that is generally sufficient to cause infection is 100,000 per liter, that is, more than 1 million times less than that eliminated in feces.

Main Symptoms of Cholera:  After an incubation period that usually lasts for 1 or 2 days, but can range from a few hours to 5 days, most patients infected with cholera had symptoms ofmild to moderate diarrhea , which is the same as any other type. diarrhea , including viral gastroenteritis. Vomiting and abdominal pain may occur, but fever is an abnormal symptom. There are also completely asymptomatic cases where the patient is still suspected of being infected.

In 5 to 10% of cases, however, cholera can occur as profuse watery diarrhea . Cholera diarrhea is  very characteristic, with a slight fishy smell and looks like “rice water” because of its whitish color . Diarrhea symptoms usually last for 4-6 days, being more intense in the first 48 hours.

The massive loss of fluids, which can become more than 1 liter per hour, often leads to severe dehydration within hours. Symptoms of dehydration include excessive thirst, dry mouth, prostration, sunken eyes, weight loss, and reduced urinary volume.

The loss of water is so intense that the patient may lose the equivalent of his weight in liquid. It is no wonder, therefore, that severe rabies, if not treated in time, the patient invariably leads to hypovolemic shock and, consequently, death. The mortality rate is 70% for severe cases that do not receive medical treatment.

The large loss of electrolytes in the stool is also responsible for some of the symptoms, including cramping, hypoglycemia, seizures, and a reduced level of consciousness.

Diagnosis of Cholera:  Diagnosis of cholera is made by isolating V. cholerae in stool culture. However, as cholera is an image that can lead to death in a few hours, treatment must begin even before any laboratory results. Diagnosis confirmation is therefore more important from an epidemiological surveillance point of view for patient care.

Treatments For Cholera:  What makes an image of cholera potentially fatal is the severe onset and rapid dehydration. Therefore, the mainstay of cholera treatment should always be aggressive hydration to compensate for the large volume of fluid lost in the stool. The elderly and children are the groups most at risk for complications from dehydration.

If the patient is not vomiting, hydration may be orally, preferably with oral rehydration salts, containing amounts of glucose and electrolytes suitable for the treatment of diarrhea. If no rehydration solution is available, imaging can be treated initially with homemade rehydration solution until you can purchase oral rehydration salt at a pharmacy or clinic (Lee: Home Treatment of Diarrhea).

In children with diarrhea, maintaining breastfeeding along with the rehydration solution is essential. And older children and adults should try to eat normally, just avoiding fatty foods or milk.

People traveling to areas where cholera is common should always carry, preventively, envelopes to prepare rehydration salts. Eight envelopes per person is the suggested number.

In severe cases, when the patient is vomiting, thus preventing rehydration, or when it is not possible to hydrate orally in proportion to the severity of the diarrhea , hospitalization for the administration of intravenous fluids is most indicated.

Antidiarrheal agents such as loperamide (Imosec) which act by inhibiting peristalsis (movement) of the intestines, are contraindicated in the treatment of cholera . The reasons are two:

  • 1- One of the functions of diarrhea is to eliminate bacteria and toxins from the body. If the patient takes a medication that inhibits diarrhea , it prevents this cleansing process, which facilitates the proliferation of V. cholerae in the intestine and delays the healing of the disease.
  • 2- The fact of contracting intestines does not prevent the loss of water. The difference is that instead of passing liquid stools, they accumulate in the intestinal tract. Antidiarrheal, therefore, only masks the symptoms and it becomes more difficult to assess the amount of fluid the patient loses each hour.

Although not the most important element of treatment, the use of antibiotics can help reduce the duration of illness, especially if it starts within the first 24 hours of diarrhea . The most recommended regimens are Azithromycin 1 g single dose or doxycycline 300 mg single dose, too.

In non-severe cases, the use of antibiotics is not justified because they do not change the course of the disease or interfere with the spread of V. cholerae.

In patients who fail to stay hydrated during the acute phase of cholera, the mortality rate from cholera is less than 0.5%.

Cholera Prevention:  From a public health point of view, the most effective way to prevent cholera is through the widespread implementation of basic sanitation and running water. From an individual’s point of view, washing hands frequently and avoiding suspicious food and drinking water sources is important.

Useful links: 

Cholera Vaccine:  Existing cholera vaccinesthat can be administered orally. The vaccine is effective for epidemics and for people traveling to endemic areas. Duration of efficacy, however, begins to remain engaged after 6 months, requiring reinforcement if the patient stays longer in high-risk areas.

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