Cholera

Cholera

Cholera which is an infection of a bacterium called Vibrio cholera is characterized by diarrhea and dehydration which may be fatal if a person infected does not get proper medical attention at once. ^[1] Although it is highly preventable and treatable, outbreaks still occur and the disease is still a major concern in some areas in the world. ^[2]

Epidemiology

The exact incidence is unknown since most cases are under reported. Adults are less likely to manifest symptoms while breastfed children are less vulnerable to get the disease. The disease is said to have been eliminated in the United States. Some individuals do get it thru travel. ^[3]

Causes

The causative organism is a bacterium named Vibrio cholera which thrives on saltwater. The bacteria cause release of toxins that eventually leads to water release from intestinal cells with painless, watery diarrhea as the upshot. Death occurs when there is severe dehydration due to diarrhea. Primary infection is frequently incidental. Secondary mode of transmission is mostly thru contact with an affected person or to contaminated water and food. ^{[3] [4] [5]}

Signs and Symptoms

The infected person may experience abdominal cramps, fatigue, nausea, vomiting, rapid heart rate and watery diarrhea. Signs of dehydration include dry mouth, dry skin, low urine output and sunken fontanelles in infants.  Some may feel thirst and may look irritable especially younger patients. The type of diarrhea is often termed "rice-water stool" with fishy odor. Severe dehydration may occur in a span of four to eight hours following the initial liquid stool. Death may go after if not treated accordingly. ^{[4] [6]}

Diagnosis

After a careful history taking, a physician often examines the patient and look for signs of dehydration. Laboratory examinations include stool examination, blood tests and metabolic panel assessment such as serum sodium, potassium, glucose and bicarbonate. ^[3]

Treatment

The main objective is to prevent dehydration thru fluid and electrolyte replacement. Fluids may be given orally or intravenously depending on the severity of the condition. Antibiotics such as tetracycline or doxycline may be administered. Most patients recover fully if given proper and timely medical intervention. ^[4]

References:

1.      http://www.mayoclinic.com/health/cholera/DS00579

2.      http://www.cdc.gov/cholera/index.html

3.      http://emedicine.medscape.com/article/962643-overview#a0156

4.      http://www.nlm.nih.gov/medlineplus/ency/article/000303.htm

5.      http://www.who.int/topics/cholera/about/en/index.html

6.      http://www.medicinenet.com/cholera/page2.htm#what_are_cholera_symptoms_and_signs

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