Cholera is a state of infectious acute inflammation of the intestines characterized by vomiting, stooling, muscle cramps and prostration. It is a highly fatal illness (with mortality of 25-50%) and should be treated as an emergency.
Causes and Risk Factors
It is caused by a bacterium known as Vibrio cholerae which grows in salt and fresh water and can survive and multiply in brackish water by infecting copepods.
It is transmitted feco-orally. This occurs when the feces of an infected person contaminates the water supply in unsanitary conditions.
An important risk factor for cholera is low gastric acid level (especially due to prolonged use of antacids)
Children and the elderly are more susceptible to cholera.
People with blood type O are also more susceptible.
Characterized by nausea, vomiting, profuse diarrhea (characterized by stool resembling rice water, containing mucus, epithelial cells and a large number of organisms), abdominal cramps, fever (maybe uncommon), dehydration, circulatory collapse, anuria.
Diagnosis is by stool microscopy (smears and culture) and/or serology.
In treating cholera, fluid and electrolyte replacement is important. This is often done using oral rehydration salts and ringers lactate solution.
Tetracycline and doxycycline reduce the stool output in cholera and shorten the period of excretion of organisms.
Prevention is by proper sanitation and waste disposal, appropriate hand hygiene, avoiding raw vegetables, food from street vendors, uncooked seafood and by vaccination. Any case of cholera diagnosed should be reported to the ministry of health.