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Cholera: More about this deadly disease

Cholera is a bacterial disease (caused by the bacterium Vibrio cholerae) that is spread through contaminated water and food due to unhygienic living conditions especially during the monsoons and flood like situations. Cholera leads to acute and severe diarrhoea and dehydration. Although, cholera can be easily treated, if left unattended, the dehydration due to cholera can lead to life-threatening conditions.

Symptoms of Cholera:

Cholera leads to watery diarrhoea which contains flecks of whitish material which contains mucus and epithelial cells. These cells are almost the size of pieces of rice. This kind of watery diarrhoea is termed as rice-water stool. This diarrhoea has a fishy smell to it.

Apart from the watery diarrhoea, people with cholera may experience the following symptoms:

  • Nausea
  • Vomiting
  • Rapid heart rate
  • Severe abdominal muscle cramps leading upto watery diarrhoea
  • Abnormal thirst
  • Headache
  • Loss of skin elasticity which makes your hands look like those of a washerwoman
  • Dry mucous membrane

All these symptoms are indications that person is soon going to develop a severe attack of dehydration and that he/ she needs immediate restoration of the lost bodily fluids.

Severe dehydration can lead to the following:

Sunken eyes, irritability, dry mouth and lethargyAcute renal failure

Severe electrolyte imbalance leading to muscle cramping

Coma

If this is left untreated, a person might collapse with shock and this could lead to untimely death.

Dire consequences of cholera:

The other problems caused by the loss of vital nutrients from the body are:

Low blood sugar (hypoglycaemia): This condition can lead to seizures, unconsciousness and even death if it is not monitored.

Low potassium levels (hypokalemia): It is a known fact that potassium regulated the heart rate and extremely low levels of potassium could lead to interference in the heart and nerve function and this in turn could lead to sudden death.

Renal failure: Kidney failure is a condition that accompanies shock during dehydration.

Causes of Cholera:

The potent toxin CTX produced by Vibrio cholera in the small intestine is the real cause of the disease cholera. As CTX binds to the intestinal walls, it interferes with the normal exchange of sodium and chloride. Thus the body begins to secrete copious amounts of water leading a loss of the vital nutrients and bodily fluids. This results in diarrhoea and ultimately dehydration.

Contaminated water and food is the main cause of the spread of infection. Apart from this, cholera bacterium can also thrive on raw foods and fruits, vegetables and raw shellfish.

Hence maximum cholera cases are observed during the monsoons and a flood-like situation where the level of hygiene and sanitation is extremely poor.

Diagnosis:

Initial personal history taking is followed by microscopic examination of the diarrhoea fluid in which the motile comma-shaped bacteria are visible.

Treatment:

Immediate treatment initiation is necessary in the case of cholera. The various treatment methods are as follows:

Antibiotics:

Antibiotics are not a really necessary part of the treatment options for cholera. But a single dose of doxycycline or azithromycin can prove to be beneficial. Antibiotics could help reduce the amount and the duration of cholera-related diarrhoea.

Oral rehydration:

It is necessary to replace the lost fluids and electrolytes using simple oral redhydration solutions. These salts are available in powdered form and need to taken with boiled water. Once the lost fluids are replenished, the person begins to show an active reaction to the medications.

Intravenous fluids:

Most of the times, oral rehydration solutions are enough to bring the patient back to normal, but in the cases of extreme and severe dehydration, it is necessary to provide the lost electrolytes in the form of an intravenous injection. This is done when there is a case of a cholera epidemic outbreak.

Zinc supplements:

In children with cholera, zinc is known to decrease or shorten the duration of the diarrhoea.

Prevention:

These are some simple precautionary measures that one can take in order to not contract the disease:

  • Wash hand before meals, after using the washroom and after touching a person with cholera.
  • Drink filtered and boiled water
  • Avoid eating outside food and fruits
  • Eat food that hot and freshly cooked
  • Do not consume dairy products bought from outside.