What is Cholera?

Cholera is a bacterial disease spread primarily through contaminated water. It is caused by consuming contaminated food or water containing the bacterium Vibrio cholera [1]. Cholera causes severe diarrhea and dehydration. Even in previously healthy people, untreated cholera can be fatal within hours.

 

What Causes Cholera?

Vibrio Cholerae, a comma-shaped gram-negative bacteria, is the causative agent of cholera [2].

V. cholerae binds to the intestinal walls and disrupts the normal flow of sodium and chloride. When V. cholerae attaches to the small intestine walls, the body secretes a large amount of water, resulting in diarrhea and rapid fluid and salt loss.

Common sources of Cholera include:

1. Food or water contaminated with human waste as a result of poor sanitation and hygiene.
2. Vegetables that have been improperly cleaned and irrigated with contaminated water
3. Raw or partially cooked seafood, particularly shellfish, such as oysters or crabs.
4. A single affected victim can contaminate all of the water for an entire population in situations where sanitation is severely compromised, such as in refugee camps or communities with severely limited water resources.

Cholera is rarely passed from person to person through casual contact.

 

What are the Symptoms of Cholera?

The vast majority of cholera patients have no or only minor symptoms. According to the CDC, only about 10% of cholera patients have severe symptoms.

Even though the vast majority of people who are exposed to Vibrio cholerae do not become ill and are unaware that they have been infected. It is interesting to note that because they shed cholera bacteria in their stool for seven to fourteen days, they can still infect others through contaminated water.

 

The symptoms of cholera include [3];

1. Large volumes of explosive watery diarrhea, also known as "rice-water stools" because they can look like water used to wash rice
2. Thirst
3. Restlessness or irritability
4. Leg cramps
5. Vomiting

 

A cholera patient can lose up to 20 liters of fluid per day, leading to dehydration and shock.

Dehydration symptoms include

• Sunken eyes and dry mucous membranes.
• Decreased secretion, as evidenced by less sweating
• Loss of skin elasticity.
• Rapid weight loss
• Rapid heart rate
• Dizziness or lightheadedness
• Hypotension (low blood pressure)

 

Treatment Options for Cholera:

Cholera requires immediate treatment because it can lead to death within hours.

Common cholera treatment methods include [4]:

·         Rehydration Therapy

Because dehydration is the most common cause of death from cholera, the most important treatment is to administer oral rehydration solution (ORS), also known as oral rehydration therapy (ORT).

The goal is to replace electrolytes and fluids that have been depleted. The ORS solution is available as a powder that can be mixed with boiled or bottled water.

The majority of cholera patients can be treated with oral rehydration alone, but severely dehydrated patients may require intravenous fluids as well.

·         Antibiotic Therapy

While not required for cholera treatment, some antibiotics can reduce and shorten the duration of cholera-related diarrhea in critically ill patients.

It is used to reduce fluid requirements in severe cases of cholera.
Because of the growing risk of bacterial resistance, the WHO does not recommend the widespread use of antibiotics for cholera.

·         Zinc Treatment

Reduced water and electrolyte absorption in cholera is linked to zinc deficiency. As a result, zinc plays an important role in symptom relief [5]. The use of zinc with oral rehydration solutions has been shown to improve cholera treatment.

 

 

 

References:

1. https://www.ncbi.nlm.nih.gov/books/NBK470232/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761070/#:~:text=Cholera%20is%20an%20acute%2C%20secretory,to%20much%20of%20the%20world.
3. https://www.ncbi.nlm.nih.gov/books/NBK470232/#:~:text=Common%20symptoms%20include%20diarrhea%2C%20abdominal,laced%20with%20bile%20and%20mucus.
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6492228/#:~:text=Effective%20antibiotics%20to%20treat%20cholera,L%20to%208%20L%2023.
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3845954/

 

 

 

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