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Cholera epidemic: How to prevent, treat disease

By Chukwuma Muanya, Assistant Editor
29 September 2016   |   2:39 am
Worldwide, cholera affects three to five million people and causes 100,000-130,000 deaths a year as of 2010. Due to severe dehydration, fatality rates are high when untreated, especially among children and infants.
Cholera epidemic

Cholera epidemic

Worldwide, cholera affects three to five million people and causes 100,000-130,000 deaths a year as of 2010. Due to severe dehydration, fatality rates are high when untreated, especially among children and infants. Death can occur in otherwise healthy adults within hours. Those who recover usually have long-term immunity against re-infection.

The cholera epidemic in parts of Africa has been ongoing for more than 30 years, due to inadequate sanitation and water treatment systems.

Cholera was one of the earliest infections to be studied by epidemiological methods.

People with blood type O more susceptible to severe cholera – researchers from Massachusetts General Hospital, Harvard University and the Broad Institute of Massachusetts Institute for Technology (MIT) reported in Science Translational Medicine that people with blood type O are more likely to develop severe cholera.

What are the symptoms of Cholera?
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.

Most infections are not severe, with 75 per cent of infected people not showing any symptoms.

Within six hours to five days of exposure, symptoms of cholera range from being mild or asymptomatic to severe disease, characterized by huge volumes of explosive watery diarrhea (sometimes called “rice water stools” because of the similarity of appearance to water that has been used to wash rice), vomiting, and leg cramps. Due to rapid loss of fluids up to 20 liters daily, severe dehydration and shock can occur in these individuals.

Signs of dehydration include loss of skin plasticity, sunken eyes, fast heart beat, low blood pressure, and rapid weight loss. Shock occurs as a result of collapse of the circulatory system.

What are the causes of Cholera?
Cholera is a diarrheal illness caused by the bacteria Vibrio cholerae. This species is not endemic to humans, and its presence in the human digestive system is not part of the natural life cycle of the bacteria. Normally found in an estuary ecology, the Vibrio cholerae bacteria life cycle naturally shifts between various reservoir species such as small snails and crustaceans, free-floating planktonic forms and static forms resident in the silt and muck of the estuary.

Vibrio cholera bacteria enter the human ecosystem through a variety of routes. The most common entry is through contaminated food or water. When humans eat seafood–in particular shellfish native to estuary environments such as oysters or crabs–and fail to cook them completely or even eat them raw, they can ingest the large amounts of bacteria necessary to cause a case of cholera.

Poorly cleaned vegetables irrigated by contaminated water sources are another common source. In situations where sanitation is severely challenged, such as in refugee camps or communities with highly limited water resources, a single affected victim can contaminate all water for an entire population.

What are the treatment options for Cholera?
Because death from cholera is a consequence of dehydration, the disease is treated using oral rehydration therapy (ORT), which consists of large volumes of water mixed with a blend of sugar and salts.

Prepackaged mixtures are commercially available, but wide distribution in developing countries is limited by cost. Therefore, homemade ORT recipes using common household ingredients and materials have been developed. Severe cases of cholera require intravenous fluid replacement.

Antibiotics can shorten illness, but ORT is still necessary even when antibiotics are used. Do not use anti-diarrheal medicines, since they prevent flushing of the bacteria out of the body.

In many areas of the world, antibiotic resistance is increasing. In Bangladesh, for example, most cases are resistant to tetracycline, trimethoprim-sulfamethoxazole, and erythromycin.

Preventing Cholera
Eat only fruit you have peeled and avoid salads, raw fish and uncooked vegetables.

…Street foods should be avoided because they are known to cause not only cholera but other diseases as well. The exposure to dust and other contaminants make it unsafe to eat street foods.

*Culled from Medical News Today

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