Symptoms
Cholera manifests as severe, watery, milky-white diarrhea (“rice water“) that leads to a large loss of fluids and electrolytes and dehydration and dehydration within hours. Other possible symptoms include nausea and vomiting. The massive fluid loss can lead to shock, renal failure, convulsions, coma and, if left untreated, death in up to half of cases. However, the infection is often asymptomatic and may cause only mild diarrhea that is indistinguishable from other causes.
Causes
The cause of the disease is colonization of the small intestine with the gram-negative, comma-shaped rod bacterium of serotypes O1 and O139. The bacteria are transmitted mainly by fecal-oral route through contaminated water and food. A high dose is required for infection. The incubation period is a few days. The bacteria produce the cholera toxin, which inhibits the absorption of electrolytes and at the same time promotes their secretion, which leads to the massive diarrhea because it causes a lot of water to enter the intestine. Cholera has been virtually eradicated in Western industrialized nations, but is endemic, particularly in Asia and Africa. Outbreaks following humanitarian disasters, such as the severe earthquake in Haiti in 2010, are feared. Poverty, a lack of water treatment, no sanitary facilities and purification of water, and inadequate health care all promote the emergence of epidemics. It is estimated that cholera kills more than 100,000 people worldwide each year.
Drug treatment
It is important to get patients to treatment as soon as possible, as the disease can take a severe course within hours. With proper therapy, mortality can be greatly reduced. Oral rehydration solution (ORS) is used to replace lost fluids and electrolytes and to correct metabolic disturbances. In a severe course, intravenous administration is necessary. Antibiotics such as macrolides (azithromycin), tetracyclines (doxycycline), quinolones (ciprofloxacin), and cotrimoxazole shorten the duration of the illness, lessen its severity, and reduce the risk of infection. They are also administered for chemoprophylaxis. One problem is the development of resistant pathogens. Zinc supplements also shorten the duration and reduce the symptoms of the disease, which has been demonstrated especially in children. The drugs used are also combined with other medications such as vitamin A and antihelminthics to treat deficiencies and diseases present at the same time. Vaccines are available for prevention. In many countries, the suspension Dukoral is approved, which contains inactivated bacteria and is taken orally. It protects adults for up to 2 years.
Prevention
Key Points:
- Drink and use clean water
- Wash hands frequently with soap and water
- Use toilets, do not defecate into the water
- Cook food well
- Good hygiene in the living rooms and toilets
- Rapid treatment of the sick
