Video:Cholera

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Overview

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

Cholera bacteria SEM.jpg

Symptoms

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

Cholera feces.jpg

Other symptoms

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

Symptoms-vomiting.jpg

Dehydration

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

Symptoms-diarrhea-nonbloody.jpg

Signs of dehydration

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

Adult cholera patient.jpg

Timing of symptoms

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

2 hours to 5 days.png

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]

Vibrio cholerae.jpg

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]

Unsafe disposal of faecal sludge or sewage in Haiti (6458176073).jpg

Poorly cooked food

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

Cooked fish vendor in Hargeisa, Somaliland (5850895870) (2).jpg

Risk factors

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

Drain in Kalibari community (3682826791).jpg

Effect of global warming

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

Flooding in Mumbai, India 2017.jpg

Diagnosis

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

Agar plate with colonies.jpg

Prevention

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

A SOIL EkoLakay toilet customer. (15921409131).jpg

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]

Poliodrops.jpg

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]

Cholera rehydration nurses.jpg

Zinc

Zinc supplementation is useful in children.[7]

Zinc pills.jpg

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]

Hospitalized child with IV.JPG

Epidemiology

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

Distribution of the cholera.PNG

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]

Cholera hospital in Dhaka.jpg

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]

Africa cholera2008b.jpg

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]

Cholera.jpg

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]

Chol an.gif

References

  1. Finkelstein, Richard. "Medical microbiology". Archived from the original on 1 September 2017. Retrieved 14 August 2016. CS1 maint: discouraged parameter (link)
  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. CS1 maint: discouraged parameter (link)
  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. CS1 maint: discouraged parameter (link)
  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. CS1 maint: discouraged parameter (link)
  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. CS1 maint: discouraged parameter (link)
  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. CS1 maint: discouraged parameter (link)
  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. CS1 maint: discouraged parameter (link)
  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. CS1 maint: discouraged parameter (link)
  11. "Cholera's seven pandemics". CBC. 9 May 2008. Retrieved 15 July 2018. CS1 maint: discouraged parameter (link)