• Cholera

    Definition

    Cholera is an infectious disease that affects the intestinal tract. It is rare today in developed countries. However, it has caused severe epidemics in the past. It continues to be a major public health problem throughout the world in underdeveloped countries. If left untreated, it may cause death within hours.

    Causes

    Cholera is caused by the bacterium Vibrio cholera. This bacterium secretes a toxin that causes rapid loss of fluids from the small intestines. Cholera is spread by ingesting food or water contaminated by fecal waste. It is common in countries that lack adequate sewage disposal.
    Small Intestines
    Small intestines
    Copyright © Nucleus Medical Media, Inc.

    Risk Factors

    Factors that increase your risk of getting cholera include:
    • Eating contaminated food or fluids
    • Eating raw or undercooked shellfish
    • Living or traveling in areas where cholera is present
    • Having blood group O—nine-fold increase in risk
    • Having a compromised immune system
    • Having low levels of stomach acid

    Symptoms

    Symptoms of cholera begin quickly and can be severe. They include:
    • Sudden onset of painless, watery diarrhea without blood or pus
    • Vomiting
    • Dehydration
    • Thirst
    • Muscle cramps
    The severity of symptoms ranges from mild, short-lived diarrhea to shock and death due to extreme fluid loss. Most symptoms occur one to three days after exposure.

    Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. It is important to tell your doctor about any recent travel to areas where cholera is common. If cholera is suspected, stool and blood samples will be tested.

    Treatment

    Fluid Replacement

    The first priority in treating cholera is to replace fluids and electrolytes lost through diarrhea. In severe cases, uncorrected dehydration can be fatal. Hydration solutions can be given orally or through an IV.

    Antibiotics

    Antibiotic medications may help shorten the course of the disease. They may also be given to the people you live with to prevent them from becoming ill.

    Prevention

    Careful Eating Habits

    You can prevent cholera by avoiding contaminated food and fluids in areas where cholera occurs. Currently, these areas include parts of these countries and continents:
    • Asia
    • Africa
    • India
    • South America
    • Central America
    When traveling in these areas, you are advised to:
    • Eat only well-cooked foods that are served hot
    • Avoid all raw or undercooked shellfish
    • Avoid salads
    • Avoid raw vegetables that you have not peeled yourself
    • Carry oral rehydration solution (ORS) and know how to use it if you develop severe diarrhea

    RESOURCES

    Centers for Disease Control and Prevention http://www.cdc.gov

    World Health Organization http://www.who.int/en

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Manitoba HealthCommunicable Disease Control Unit http://www.gov.mb.ca/health/publichealth/cdc/index.html

    References

    Cholera. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/cholera/index.html. Updated May 3, 2012. Accessed January 7, 2013.

    Cholera. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated October 9, 2012. Accessed January 7, 2013.

    Farmer P, Almazor CP, et al. Meeting cholera's challenge to Haiti and the world: a joint statement on cholera prevention and care. PLoS Negl Trop Dis. 2011;5(5):e1145.

    Harris JB, Khan AI, et al. Blood group, immunity, and risk of infection with vibrio cholerae in an area of endemity. Infection and Immunity. 2005;73:7422-7427.

    Ryan ET. The cholera pandemic, still with us after half a century: time to rethink. PLoS Negl Trop Dis. 2011;5(1):e1003.

    Sack DA, Sack RB, et al. Cholera. Lancet. 2004;363:223-233.

    World Health Organization, Cholera: 2010. 2011 Weekly Epidemiological Record. Jul 29;86(31):325-39. Available at http://www.who.int/wer/2011/wer8631.pdf. Accessed January 7, 2013.

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