Cholera is an acute epidemic infectious disease that is characterized by watery diarrhea, extreme loss of fluid and electrolytes, and severe dehydration. If not treated fast, it can be fatal.
It is caused by the bacterium Vibrio cholera (V. cholera) and can lead to dehydration, which can and even death if untreated. It is gotten by eating food or drinking water contaminated with a bacterium called Vibrio Cholerae.
Despite being easy to treat, cholera affects between 3 and 5 million people each year and causes over 100,000 deaths worldwide. Fatality rates are high when untreated, especially among children and infants, and death can occur in otherwise healthy adults within hours. Providentially, those who recover usually have long-term immunity against re-infection.
Key Facts on Cholera
- Cholera can kill within hours if left untreated.
- It is estimated that each year, 1.3 million to 4.0 million cases of cholera and 21 000 to 143 000 deaths worldwide due to cholera occur.
- Most of those infected can be successfully treated with oral rehydration solution.
- Severe cases of cholera will need rapid treatment with intravenous fluids and antibiotics.
- Provision of safe water and sanitation is critical to control the transmission of cholera.
- A universal strategy on cholera control with a target to reduce cholera deaths by 90% was launched in 2017.
- It is not likely you will catch cholera just from casual contact with an infected person.
Vibrio Cholerae is the bacterium that causes cholera and is usually found in food or water contaminated by feces from a person with the infection. Common sources include:
- Municipal water supplies or Ice made from municipal water
- Foods and drinks sold in the streets
- Vegetables that are grown with water containing human wastes
- Raw or undercooked fish and seafood caught in waters polluted with sewage
When a person ingests the contaminated food or water, the bacteria release a toxin in the intestines that produces severe diarrhea.
Symptoms of Cholera
Cholera is an extremely potent disease that can cause severe acute watery diarrhea. Cholera affects both children and adults and can take between 12 hours and 5 days for a person to show symptoms after ingesting contaminated food or water. It can kill within hours if untreated.
Among people who develop symptoms, the majority have mild or moderate symptoms, while a minority develops acute watery diarrhea with severe dehydration, which can lead to death if left untreated.
If symptoms appear, they range from mild or asymptomatic to severe, and they typically include:
- large volumes of explosive watery diarrhea,
- leg cramps
- Severe dehydration and shock can occur: A person with cholera can quickly lose fluids, up to 20 liters a day. Signs of dehydration include loose skin, sunken eyes, dry mouth, decreased secretion, fast heartbeat, low blood pressure, dizziness or lightheadedness, and rapid weight loss.
It can easily become a life-threatening condition and a medical emergency, as shock can lead to the collapse of the circulatory system.
Treatment of Cholera
Dehydration is the main culprit that leads to death from cholera, so the most important treatment is to give oral hydration solution (ORS), also known as oral rehydration therapy (ORT).
The treatment consists of large volumes of water mixed with a blend of sugar and salts, and there are also repackaged mixtures that are commercially available. Homemade oral rehydration therapy (ORS) recipes are often used, with common household ingredients.
However, severe cases of cholera require intravenous fluid replacement.
Antibiotics can shorten the duration of the illness, but experts do not recommend the mass use of antibiotics for cholera, because of the growing risk of bacterial resistance.
Anti-diarrheal medicines are not used because they prevent the bacteria from being flushed out of the body, and mass administration of antibiotics is believed to contribute to increasing antimicrobial resistance.
Rapid access to treatment is essential during a cholera outbreak, and oral rehydration should be available in communities. There should also be larger treatment centers that can provide intravenous fluids and 24-hour care.
Zinc is an important adjunctive therapy for children under 5 years of age, which also reduces the duration of diarrhea and may prevent future episodes of other causes on acute watery diarrhea, and with early and proper treatment, the fatality rate should remain below 1%.
Breastfeeding should also be promoted, and as already stated, with proper care and treatment, the fatality rate should remain very low (around 1%).