Cholera is an infectious disease that is characterized by profuse watery diarrhoea and dehydration which could lead to death when left untreated. It is caused by a pathogenic bacteria known as Vibro cholerae. Cholera is a virulent infection that affects the small intestines and symptoms may not occur in some people while others may experience mild symptoms but in most cases symptoms are usually severe and can kill within hours without seeking medical care. According to the United States Centre for Disease Control and Prevention, cholera affect an estimated 2.9 million people and kill about 95,000 every year globally.
How can a person be infected with cholera?
Cholera is most prevalent in places with poor sanitation and hygiene, unclean water and foods. Vibrio cholera which is the bacteria that causes cholera is usually found in the feces of people that are suffering from the infection. Cholera spreads rapidly when people consume water and foods that have been contaminated with the bacteria (Vibro cholerae) that is responsible for the disease.
The risk factors of developing cholera include drinking unclean and untreated water, eating unwashed or unpeeled fruits and vegetables, consuming raw fish and seafoods such as shellfish (especially those that have been contaminated with cholera bacteria) and residing in an area with poor sanitation.
It is important to acknowledge that cholera do not usually spread through direct contact with an infected person rather they spread through food poisoning i.e the ingestion of food and water contaminated with bacteria (Vibrio cholerae).
Symptoms of cholera
People infected with cholera may not develop any symptoms while that may show mild or severe symptoms. Symptoms typically appears hours to 5 days after exposure to the infection and it can last for days. People who develop symptoms from cholera disease may experience:
- Severe watery diarrhoea
Dehydration that occurs in people with diarrhoea are usually severe and the signs and symptoms include:
- Rapid loss of body fluids
- Dry mouth
- Sucken eyes
- Increased heartbeat
- Unexplained weight loss
- Low blood pressure
- Dried and wrinkled skin
- Extreme fatigue
- Low urine volume
Severe dehydration causes excessive loss of body fluid which often lead to electrolyte imbalance. Electrolyte imbalance occurs when there is no balance between fluid and minerals in the body. The symptoms of electrolyte imbalance include muscle cramps and shock which can lead to death when left untreated.
Diagnosis of cholera
The diagnosis of cholera depends on the symptoms you are experiencing. If you develop the symptoms of profuse watery diarrhoea, vomiting, tiredness and dehydration, it is very important that you seek immediate medical care. To diagnose cholera disease your doctor will take your stool sample and send it to the laboratory for analysis in order to detect Vibro cholerae which is the causative agent of the infection.
Treatment of cholera
The treatment of cholera should commence immediately after its diagnosis. In most cases treatment usually starts even before laboratory test result comes out positive because of the severe impact of dehydration. The treatment of cholera involves replacing the fluids that were excessively lost and administration of antibiotics.
- Fluid replacement: this involves the use of oral rehydration therapy (ORT) to replace the fluids that are lost during diarrhoea. In severe cases of dehydration, intravenous fluid replacement are usually recommended to prevent the incidence of shock. The World Health Organisation (WHO), recommends that oral rehydration solution sachet should be dissolved in a litter of clean water before drinking.
- Antibiotics administration: this treatment involves the use of medications that fights the bacteria that causes cholera. The use of antibiotics helps to reduce the symptoms of diarrhoea and severity of the cholera disease.
How can cholera be prevented?
Cholera is an infection that is caused by poor hygienic practices and it can only be prevented by observing the following precautionary measures:
- Drink clean and treated water only
- Avoid consuming raw or undercooked foods
- Avoid eating unpeeled or unwashed fruits and vegetables
- Ensure proper cooking and reheating of foods at appropriate temperature
- If you fall sick from cholera disease you should avoid handling food so as to prevent spreading the infection
- Practice regular hand washing with soap and water especially when handling foods
- Keep a tidy and clean environment
- Avoid eating raw fish and seafoods
Is there a vaccine for cholera?
Yes, there are 3 oral cholera vaccines that are currently prequalified by the World Health Organization (WHO) and they include Dukoral, Shankol and Euvichol. Each of these vaccines have different recomendations for use by WHO. Dukoral is recommended for people above the age of 2 and it is mainly for those that are travelling to countries or places where cholera is common. Shankol and Euvichol can be given to individual above 1 year old. According to WHO, two doses of Dukoral can protect you against cholera for up to 2 years while two doses of Shankol and Euvichol will protect you from being infected with cholera for about 3 years.
In the United States, there is also a vaccine that have been approved to protect you against cholera disease. In 2016, the United States food and Drug administration FDA approved a cholera vaccine called “Vaxchora”. This vaccine is recommended to be taken orally 10 days before traveling to places where cholera is prevalent.
Cholera is a life-threatening disease and it can kill within hours without treatment. The best way to prevent cholera infection is to maintain hygienic practices and ensure other precautionary measures such as treating and boiling of water, proper hand-washing and good handling of foods. If you are travelling to countries where cholera is prevalent it is advisable to take cholera vaccine and maintain other precautionary measures to prevent the disease.