Cholera is a potentially dangerous infectious disease that leads to severe watery stools, which can quickly progress to dehydration and death if left untreated. Read about its causes, symptoms, diagnosis, and treatment options.
Cholera is an acute bacterial infection caused by the bacteria Vibrio cholera (V. cholera), which spreads by drinking contaminated water. It causes watery and loose stools, severe loss of body electrolytes, and dehydration, which can be fatal. If left untreated, it rapidly progresses to dehydration and death within hours, commonly in infants and children. People who survive this infection have long-term immunity against this bacteria.
V. cholera bacteria were discovered by the German bacteriologist Robert Koch in 1883. While he was studying an epidemic in Egypt, he found these bacteria inside the intestines of people who died of cholera. But he was unable to isolate the bacteria. Later when he went to India, he successfully isolating the bacteria. These bacteria live in damp and moist clothes and soil and are present in the stools of infected people. Diarrhea is triggered by the poison produced by toxic strains of cholera.
In the US, cholera was prevalent in the 1800s, but now due to modern sewage and water treatment, cholera is virtually eliminated in the US and other industrialized countries. But in other underdeveloped countries, such as Southeast Asia, Africa, and Haiti, around 3 to 5 million get cholera every year, and around 100,000 people die of cholera in the world every year.
Cholera outbreak results when war, poverty, or natural calamity forces people to live in crowded and unsanitary conditions. Administration of oral rehydration salts can easily prevent dehydration and death in cholera patients.
Mild cases of cholera do not cause any symptoms, and the individual might not even know they are infected with the bacteria. But such people can be contagious and can contaminate water, as they shed the bacteria in their stools for up to two weeks. Most cholera cases only result in mild symptoms, and only 1 in 10 adult individuals develop severe symptoms.
Diarrhea - Loose and frequent stools start suddenly and can lead to severe fluid loss. The stools have a rice-water appearance, as they are pale and milky in appearance.
Nausea and vomiting.
Dehydration develops within hours of the onset of diarrhea and vomiting. Severe dehydration is when a loss of 10 % or more of total body weight. The signs of dehydration are irritability, fatigue, sunken eyes, severe thirst, dry mouth, dry skin, no urine output, and hypotension.
Electrolyte imbalance - It is when minerals are lost from the body due to dehydration. It can result in symptoms like:
Muscle cramps due to loss of salts (sodium, chloride, and potassium).
Shock is when hypotension results from a loss in blood volume, which drops the amount of oxygen circulating in the body. Shock can cause death if left untreated.
Children also show the same symptoms as adults do. The point to remember is that children get dehydrated faster and can go in hypovolemic shock much quicker than adults. The symptoms of shock in children are seizures, altered consciousness, and coma.
The bacteria Vibrio cholerae causes this infection. The severe symptoms that are seen in this infection results from the toxin CTX, which the bacteria produce in the intestine. This toxin interferes with the exchange of sodium and chloride in the intestinal walls, which makes the body release excess amounts of water. This leads to watery stools, fluid, and mineral loss. You can get infected by drinking contaminated water, eating raw shellfish and uncooked fruits and vegetables.
The Life Cycle of Cholera Bacteria:
This bacterium has two distinct life cycles:
Life cycle in the environment - Cholera bacteria are found naturally in coastal waters. In the water, they attach to microscopic crustaceans and travel with them.
Life cycle in people - On ingesting contaminated water, not all humans show signs of infection, but they shed the bacteria in their stools. These feces can contaminate food and water supplies, which is how cholera spreads.
Cholera is usually diagnosed based on the signs and symptoms in endemic areas. To confirm the diagnosis, cholera bacteria are identified in the stool sample. For quick diagnosis, rapid cholera dipstick test is available.
The treatment options include:
Oral rehydration salts (ORS).
These help in adding fluids to your body, and prevent dehydration and other complications.
As previously mentioned, this infection can become fatal within hours. The other less severe complications of cholera include:
Hypoglycemia (low blood sugar) - The blood sugar levels fall dangerously, which can result in seizures, loss of consciousness, and death in children.
Hypokalemia (low potassium levels) - As large amounts of minerals, such as potassium, are lost in stools, it results in hypokalemia. This can also cause fatal complications as it interferes with heart and nerve functioning.
Kidney failure - In shock, the kidneys are unable to filter out waste, which results in the buildup of excess fluids, electrolytes, and wastes in the body. This can also be fatal.
Follow these preventive tips to reduce the risk of cholera infection:
Frequently and properly wash your hands with soap and water. Especially before cooking or touching food, and after using the toilet.
Eat fruits and vegetables that can be peeled and eaten, such as banana, orange, etc.
Ice creams and other dairy foods are often contaminated.
Only drink bottled water or water that has been boiled or disinfected.
Avoid eating raw seafood (like sushi) and cook your food completely.
Avoid eating foods from street vendors.
The cholera vaccine, called Vaxchora, is now available in the US. Adults traveling to countries affected by cholera can take this vaccine 10 days before they travel. It is a liquid vaccine, which has to be taken orally.
The chances of you getting cholera are very less even if you travel to a country where there is a threat of cholera. You can prevent this infection by following the preventive measures. For more information on ways to prevent or treat this infection, consult a doctor online.
Last reviewed at:
20 Jan 2020 - 4 min read
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