Video:Cholera

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Overview

Cholera is an infection of the small intestine by the bacterium Vibrio cholerae.[1][2]

Symptoms

Symptoms may range from none, to mild, to severe, but the classically include a large amounts of watery diarrhea, that lasts a few days.[2][3]

Other symptoms

Vomiting, and muscle cramps may also occur. .[2]

Dehydration

Diarrhea can be so severe, that it leads to severe dehydration, and electrolyte imbalances within hours.[3]

Signs of dehydration

Severe dehydration can give the person sunken eyes, cold skin, decreased skin elasticity, and wrinkling of the hands and feet.[4] Dehydration can cause the skin to turn bluish.[5]

Timing of symptoms

Symptoms typically start two hours, to five days after exposure.[2]

Cause

Cholera can be caused by different types of Vibrio cholerae, with some types producing more severe disease than others, which can make some outbreaks more severe than others.[3]

Spread

The main cause of Cholera is drinking unsafe water, that has been contaminated with human feces containing the bacteria, or unsafe food contaminated by infected water.[3]

Poorly cooked food

Undercooked seafood is a common source for the disease.[6], and humans are the only animal affected.[3]

Risk factors

Risk factors for the disease include poor sanitation, not enough clean drinking water, and poverty.[3]

Effect of global warming

There are concerns that rising sea levels, caused by global warming, will increase rates of disease.[3]

Diagnosis

Cholera can be diagnosed by a stool test.[3]

Prevention

Prevention methods against cholera include improved sanitation, access to clean water, and good hygiene.[4]

Vaccination

Cholera vaccines that are given by mouth, provide reasonable protection to the disease for about six months[3], and, they have the added benefit of protecting against another type of diarrhea, caused by E. coli.[3]

Treatment

The primary treatment is oral rehydration therapy—the replacement of fluids with slightly sweet and salty solutions.[3] Rice-based solutions are preferred.[3]

Zinc

Zinc supplementation is useful in children.[7]

IV fluids and antibiotics

In severe cases, intravenous fluids, such as Ringer's lactate, may be required, and antibiotics may be beneficial.[3] Testing to see which antibiotic the cholera is susceptible to, can help guide the choice.[2]

Epidemiology

Cholera affects an estimated 3–5 million people worldwide and causes 28,800–130,000 deaths a year.[3][8]

Developing nations

Although it is classified as a pandemic disease as of 2010, it is rare in the developed world,[3]and affects mostly the children of developing countries.[3][9]

Outbreaks vs chronic disease

Cholera occurs as both outbreaks, and chronically in certain areas.[3] Areas with an ongoing risk of disease, include Africa, and Southeast Asia.[3]

Risk of death

The risk of death among those affected is usually less than 5%, but can be as high as 50%.[3] Not having access to treatment dramatically increases the risk of death.[3]

History

Descriptions of cholera are found as early as the 5th century BC in Sanskrit.[4] The study of cholera in England by John Snow, between 1849 and 1854, led to significant advances in the field of epidemiology.[4][10] Seven large outbreaks have occurred over the last 200 years, with millions of deaths.[11]

References

  1. Finkelstein, Richard. "Medical microbiology". Archived from the original on 1 September 2017. Retrieved 14 August 2016.
  2. 2.0 2.1 2.2 2.3 2.4 "Cholera – Vibrio cholerae infection Information for Public Health & Medical Professionals". Centers for Disease Control and Prevention. January 6, 2015. Archived from the original on 20 March 2015. Retrieved 17 March 2015.
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 "Cholera vaccines: WHO position paper" (PDF). Wkly. Epidemiol. Rec. 85 (13): 117–128. March 26, 2010. PMID 20349546. Archived (PDF) from the original on April 13, 2015.
  4. 4.0 4.1 4.2 4.3 Harris, JB; LaRocque, RC; Qadri, F; Ryan, ET; Calderwood, SB (30 June 2012). "Cholera". Lancet. 379 (9835): 2466–76. doi:10.1016/s0140-6736(12)60436-x. PMC 3761070. PMID 22748592.
  5. Bailey, Diane (2011). Cholera (1st ed.). New York: Rosen Pub. p. 7. ISBN 978-1-4358-9437-2. Archived from the original on 2016-12-03.
  6. "Sources of Infection & Risk Factors". Centers for Disease Control and Prevention. November 7, 2014. Archived from the original on 12 March 2015. Retrieved 17 March 2015.
  7. "Cholera – Vibrio cholerae infection Treatment". Centers for Disease Control and Prevention. November 7, 2014. Archived from the original on 11 March 2015. Retrieved 17 March 2015.
  8. GBD 2015 Mortality and Causes of Death, Collaborators. (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  9. "Cholera – Vibrio cholerae infection". Centers for Disease Control and Prevention. October 27, 2014. Archived from the original on 17 March 2015. Retrieved 17 March 2015.
  10. Timmreck, Thomas C. (2002). An introduction to epidemiology (3. ed.). Sudbury, MA: Jones and Bartlett Publishers. p. 77. ISBN 978-0-7637-0060-7. Archived from the original on 2016-12-03.
  11. "Cholera's seven pandemics". CBC. 9 May 2008. Retrieved 15 July 2018.