A Simple Guide to Cholera

A Simple Guide to Cholera
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What is Cholera?
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Cholera is an acute infectious illness caused by the Vibrio cholorae bacteria.

What is the cause of Cholera?
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The bacteria which causes Cholera is the Vibrio cholorae which is an extremely hardy bacteria able to live in polluted water and contaminated food.

There are 2 main types of cholera bacteria:

1.the Classic short slightly curved Gram negative aerobic rods

2.The El Tor strain which is hardier,persists longer in nature and is more likely to cause carrier states in humans.

Incubation period is 12 hours to 6 days.

What are symptoms of Cholera?
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The main symptoms of Cholera are

1. Vomiting after 12 hours of ingestion of bacteria

2. abrupt painless rice water diarrhoea

3. abdominal pain

4. prostration and muscle cramps

Severe cases may have dehydration leading to:

1.hypotension

2.cardiovascular collapse

3.tachycardia

4.difficulty in breathing and cyanosis

5.weak peripheral pulses

6.delirium and disorientation

7.lassitude and tiredness

8.convulsions in small children

Symptoms usually appear within 12 hours after exposure to the germ and last up to 1 week.

How is Cholera transmitted?
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Most epidemics are water borne espcially after severe flooding.
The germs can also be transmitted by food handlers.

How is the diagnosis of Cholera made?
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Doctors generally diagnose Cholera based on the symptoms and a physical examination.
Confirmation is by blood tests and stool cultures.

What are the complications of Cholera?
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Cholera is a disease which can kill espcially through its complications:

1.Severe dehydration especially in young children and the very old patients

2.Hypovolemic shock

3.uncompensated metabolic acidosis

4.renal failure

How is Cholera treated?
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Cholera is an infectious disease which can spread to other people through contaminated food and water.
It is therefore advisable to quarantine the patient in hospitals.

1.The most important complication in Cholera is dehydration so prompt replacement of fluids and electrolytes intravenously is necessary.

WHO diarrhea treatment solution consists of
a.4gms of sodium chloride
b.6.5gms of sodium acetate
c.1 gm of potassium chloride
d.10gms of glucose
in 1 liter of sterile distilled water.

Where intravenous administration of diarrhea solution is not available, isotonic drinks and even coconut water may act as replacements.

2. Careful monitoring of the patient as 1 liter of fluid may be lost in the stools in one hour.

3.Antibiotics is the main treatment against cholera.
The best antibiotic is tetracycline or deoxycline.

Symptomatic treatment includes:

1.Paracetamol for relief of fever and headache

2.antispasmodic drug to stop abdominal cramps

3.medicine to harden the stools such as kaolin

4.slow down the intestinal movement (lomotil or loperamide).

Gradually reintroduce food, starting with bland, easy-to-digest food, like porridge or soups.

Get plenty of rest.

How is Cholera prevented?
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Prevention of Cholera can be by vaccination with the cholera vaccine.
However the success rate of immunisation against Cholera is only 20-30% so most doctors do not recommended it.

You can avoid infection by:
Avoid eating or drinking foods or liquids that might be contaminated
Good food hygience

What is the prognosis of Cholera?
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Prognosis is excellent with prompt treatment of rehydration treatment.
After replacement symptoms usually clear within 48 hours with tetracycline treatment.