Introduction
It is an acute infectious disease caused by the bacteria Vibrio cholerae. This bacteria releases toxins in the small intestine, causing the body to secrete an enormous amount of water resulting in rapid loss of water and electrolytes. It is caused by the ingestion of contaminated food and water. It is a highly virulent disease that causes watery diarrhea. If the bacteria are in a small amount in the body, it is killed by acid in the stomach; however, bacteria remain in stool for seven to fourteen days. Therefore, proper maintenance of sanitation and hygiene helps in the prevention of this infection.
What Are the Causes of Cholera in a Child?
Vibrio cholerae bacteria cause cholera. It is found in contaminated food and water and spreads to the feces of an infected person. The bacteria release a toxin in the small intestines that causes severe diarrhea. The child may get infected by water or eat raw uncooked food contaminated with bacteria.
Following are the various modes of transmission.
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Food and drink items are sold outside with improper hygiene.
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Consumption of vegetables grown with the help of human waste.
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Raw and undercooked seafood from polluted sewage.
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Water supplies from municipal sources.
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Unsanitary disposal of stool.
What Are the Clinical Features of Cholera?
The signs and symptoms of cholera begin after six days of the infection. Most commonly, symptoms range from mild to moderate, but sometimes, it gets severe. The most common clinical manifestation is acute diarrhea and vomiting, resulting in severe dehydration. The infected child with mild or without symptoms can spread the infection.
The bacteria is present in feces for ten days, approximately after the infection. The bacteria typically have an incubation period of one to two days. The characteristic symptom of this infection is stool presenting with a fishy odor, also known as cholera gravis. If it is not treated correctly, it can lead to hypovolemic shock. Children who have weak immune systems are at significant risk of severe complications.
Following are the various signs and symptoms found in this infection.
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There is the presence of severe watery diarrhea known as "rice-water stools."
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There is the presence of recurrent vomiting.
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Severe dehydration due to water and electrolyte loss.
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The heart rate of the child is rapid.
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The blood pressure of the child is low.
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The mucous membrane appears to be dry.
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There is the presence of muscle cramps.
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There is a loss of skin elasticity.
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The stool output can reach one liter per hour.
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There is the presence of abdominal discomfort.
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There is a presence of low urine output.
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The child appears to be irritable.
What Are the Treatment Plans for Cholera?
The infection needs immediate care and treatment as it can cause severe dehydration. The primary goal of the treatment is to manage dehydration and treat fluid and electrolyte loss. For mild to moderate symptoms, fluid intake is advised for hydration; however, if there is a severe infection, the child is recommended to get intravenous fluid. In addition, the adjunctive therapy of antibiotics is indicated in children suffering from severe diseases.
Following are the various treatment plans for the treatment of cholera.
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Assessment of Loss of Fluid - It can be assessed by physical examination of skin, mouth, eyes, and pulse rate. According to the world health organization, the degree of volume loss is categorized as mild to severe according to the physical findings. For estimating the volume loss in stools, cholera clots are used. There can be a loss of ten milliliters per kilogram of fluid in each stool or vomiting episode.
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Oral Rehydration Solution - Most infected children can be treated with the help of an oral rehydration solution. The oral rehydration solution is administered as a standard sachet dissolved in one liter of clean water. The recommended dose for children suffering from mild to moderate dehydration is approximately five liters of oral rehydration solution. It helps in replacing fluid and electrolyte loss caused by vomiting and diarrhea.
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Intravenous Fluid - Intravenous fluid is indicated in children suffering from severe volume depletion and hypovolemic shock. There is immediate administration of fluid to restore circulation rapidly. Initially, the fluid volume administered is 100 milliliters per kilogram gram every three hours. The most commonly used intravenous fluid is ringer lactate solution.
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Antibiotic Solution - Antibiotics are used as an adjunct to the hydration treatment of the child. It is indicated in moderate to severe volume depletion. Antibiotic therapy shortens the duration of diarrhea and reduces volume loss by up to fifty percent. The choice of antibiotics depends upon the availability and pattern of the resistance. The commonly used antibiotics are tetracycline, furazolidone, chloramphenicol, doxycycline, and sulfaguanidine. The doxycycline is given at a dose of 300 milligrams.
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Zinc - It is a necessary adjunctive therapy for children under the age of five years. It reduces the duration of diarrhea. In addition, it helps in the prevention of fluid loss in children.
How Can Parents Prevent the Spread of Cholera in Their Children?
Parents can practice a few measures to prevent cholera in their children.
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Parents should ensure a clean water supply and proper sanitization to prevent cholera.
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If the child travels with their parents, boiled and chemically disinfected water should be used.
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The children's hands should be adequately cleaned before eating food.
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The eating utensils should be washed properly.
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The fruits and vegetables should be washed properly before eating.
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The surface of tins or cans containing food and beverages should be adequately cleaned.
Conclusion
It is a bacterial infection that causes acute diarrhea. Diarrhea caused by this infection can range from mild to moderate. This infection is severe because it causes water and electrolyte loss. It is a global threat to public health and indicates a lack of social development. If left untreated, it can cause severe consequences. Proper sanitation, disinfection, and safe water can prevent this infection. Oral cholera vaccines can help in controlling cholera outbreaks. In case of extreme conditions, rapid treatment with antibiotics and intravenous fluid is indicated. Parents should take care of the hygiene and environment of the child.
