Cholera is a bacterial infection. It is caused by drinking water that is contaminated with bacteria, or by eating food that has been in contact with contaminated water.
Many people who are infected with cholera bacteria do not develop any symptoms. However, cholera can cause: severe, watery diarrhea, nausea, vomiting, and muscle cramps.
Without prompt treatment, about half of people with the most severe symptoms will die within a few hours, usually due to a combination of dehydration and shock (a sudden and massive drop in blood pressure that starves the body of oxygen).
If cholera is promptly treated with a combination of antibiotics, fluids and oral rehydration solution, the outlook is much better: only 1% of people will die from the disease.
Cholera is an acute, diarrheal illness caused by an infection with the bacterium Vibrio cholerae, in the intestines. The infection is often mild or without symptoms, but sometimes it can be severe. Although the illness can be life-threatening, it is easily prevented and treated.
An infected person experiences severe vomiting, explosive diarrhea and severe dehydration. Without immediate medical treatment, cholera may result in death within four to twelve hours after symptoms begin. Due to a large loss of body fluids, cholera is gruesome in the way that it leaves survivors in their physical appearance, as well as in the biological toll it takes on the body.
Cholera is very contagious. It is spread by the unintentional consumption of infected feces that contaminate food and water. It can also be spread through human to human contact. Some people have been infected with cholera by eating raw or undercooked shellfish.
Cholera is easily treated with fluids and antibiotics. When antibiotics are unavailable, which is commonly the case in areas that are plagued by cholera, a simple mixture of water and glucose for rehydration is life saving. Cholera usually resolves itself after a period of time; the danger is the severe dehydration that quickly causes death.
Similar to the bubonic plague which has showed its face time and again, cholera is a plague that is suspected to be an ancient disease. It has unquestionably reoccurred in seven pandemics since 1817, including in Europe and the United States. The most recent pandemic began in Asia in 1961 and continues to the present day in Africa.
In developing countries, cholera is prevalent in areas that do not enjoy sanitary living conditions because of poverty and a lack of resources. In pandemic regions, even sanitary conditions may not prevent further outbreak. Many people do not receive information on how the disease is spread, fear seeking medical help or simply do not have access to any kind of treatment.
Cholera is not common in developed countries due to the availability of medical treatment, regulated heath standards, clean water and effective sewage systems. Cases of cholera in developed countries are the result of raw shellfish or people who have contracted the illness while traveling. Those traveling to countries that have cholera epidemics should take careful precautions to prevent infection.
Precautions for travelers include boiling water before drinking or washing. Water can also be treated with chlorine or iodine. Frequent hand washing with clean water, especially after using the toilet, is imperative. Travelers are also advised to ensure their food is fully cooked and hot, peeling their own fruit and avoiding raw vegetables, including salads. Raw and undercooked shellfish should also be avoided.
Cholera is a disease that causes social stigmas and stereotypes in epidemic areas. Indigenous peoples who commonly fall victim to cholera fear the status of social outcast more than the disease itself. Throughout history, communities that have had outbreaks of cholera are marked as diseased and dirty even after they are no longer at risk for spreading the disease.
Although the causes of cholera are generally well known, it continues to be a problem in some parts of the world. Cholera is an intestinal disease caused by the Vibrio cholerae bacteria that can contaminate water, uncooked fruits and vegetables and raw shellfish. It is spread by the unintentional consumption of infected feces that contaminate food and water. It can also be spread through human to human contact. Infection can cause serious diarrhea, which in turn can lead to potentially lethal dehydration. Cholera bacteria occur naturally in coastal waters and spread via their host crustaceans that move about following the algae on which they feed.
Eating raw or undercooked seafood, especially shellfish from certain areas, is one of the causes of cholera. Since the 1970s, most cases of cholera in the United States were found to be the result of eating oysters and crabs harvested in the Gulf of Mexico or imported from countries where cholera is a widespread and ongoing problem. Shellfish are more likely to be infected with cholera bacteria than other types of seafood because they must filter large amounts of water in order to extract food; this action concentrates the bacteria in their bodies. The problem is worse during seasons when ocean water is warm and bacteria proliferate.
Drinking unpurified water is another of the primary causes of cholera, and probably the best known. Public wells and other water supplies are likely to become contaminated following wars or natural disasters. In 2010, an outbreak of cholera occurred in Haiti following an earthquake in January and flooding in later months. The inadequate sanitation and crowded living conditions that inevitably follow such catastrophic events put people at risk for the disease. Any water supply, however, may become contaminated if it is not protected from sewage.
One of the least discussed causes of cholera is normally healthful fruits and vegetables that become contaminated in the fields where they grow. In regions of the world where cholera is endemic, raw, unpeeled fruits and vegetables are a common source of infection. Developing nations may use manure fertilizers that have not gone through the composting process and may irrigate crops with water tainted by raw sewage. Such produce can be the source of a cholera outbreak.
Scientists and medical personnel understand the mechanism by which cholera kills; however, other people may not. V. cholerae, the bacteria that causes the disease, produces a powerful toxin that binds to the walls of the small intestine and disrupts the normal flow of sodium and chloride. The body begins to secrete huge amounts of water causing diarrhea so severe that it upsets the body's electrolyte balance, which is essential for normal functioning of cells and organs. Untreated, cholera can cause death within hours.
Cholera, an infection caused by the Vibrio cholerae bacterium, often causes only mild illness in patients, although infected patients with few symptoms can still pass the bacterium on to others. Between five and 10% of people infected develop more severe symptoms of cholera which can lead to death if the patient is not treated. Fortunately, this disease can be prevented with some basic hygiene, and vaccines are also available in some regions of the world where cholera is endemic.
People usually ingest the bacteria which cause this disease by consuming poorly sanitized water or food which has been handled by someone with cholera. It takes 24 to 48 hours for the bacteria to multiply in the gut, and then the symptoms of cholera emerge. During active cholera infection, the bacteria will be shed in the patient's stool, and the patient can spread infection to other people.
The hallmark of cholera is persistent watery diarrhea. In severe cases, the diarrhea turns gray and cloudy, and is often described as having a "rice water" appearance. In addition, patients can develop leg cramps and vomiting. If the cholera is allowed to persist, the symptoms of cholera become more extreme as the patient starts to experience dehydration. The patient will develop excessive thirst, produce less urine, have a rapid heart rate, and eventually fall into a coma and die. Fever is not associated with cholera.
When people in areas where cholera is common recognize the signs and symptoms of cholera, they should seek medical attention as quickly as possible. The doctor will rehydrate the patient with oral fluids and a fluid drip, and the doctor can administer antibiotics to kill the bacteria. The longer the patient's case of cholera is allowed to persist, the more severe the potential complications for the patient, including issues like kidney failure.
The chance of contracting cholera can be reduced by using water which has been properly treated or boiled immediately before use, washing hands regularly, and using good hygiene when preparing food. Oral vaccines which confer some resistance to cholera are also available in some areas. People should remember that it is possible to be infected with cholera but to have only mild or nonexistent symptoms, and in areas where cholera is endemic, anyone could be carrying the bacteria, whether or not he or she is displaying the symptoms of cholera. Travelers should be especially careful about traveling in regions with endemic cholera.
Cholera is a highly treatable bacterial infection, though it kills quickly when not treated. That makes speed — especially the speed with which fluids are administered to prevent dehydration and shock — one of the most important factors in cholera treatment. Oral rehydration solution (ORS) is made up of a mixture of salts and glucose, which are dissolved in water. ORS is ideal for replacing the fluids and minerals that are lost when a person becomes dehydrated. ORS sachets are available from many pharmacists, camping shops and travel clinics. If you are traveling to regions of the world affected by cholera, take ORS sachets as a precaution.
Along with rehydration, cholera treatment options include antibiotics to treat the underlying infection, and zinc to treat diarrhea. Children who have taken zinc have had less severe diarrhea than children who did not take the supplement. People who have symptoms and believe they have been exposed to cholera should seek medical care as soon as possible. Other symptoms include nausea and vomiting, muscle cramps from loss of nutrients, dehydration and shock. Children with cholera may have a fever or convulsions, experience extreme drowsiness, or fall into a coma.
About 10 percent of people who are infected suffer more dangerous symptoms, including severe, watery diarrhea that comes on suddenly. People with severe cases can lose up to a quart (946 mL) of fluids in an hour, which is why it is critical to quickly start cholera treatment.
A rehydration solution (ORS) that includes water, salt and sugar is needed to replace the lost fluids. Just drinking water is not sufficient to treat cholera, because water will not replace the electrolytes and other nutrients being lost. Powdered rehydration solutions are available in developing countries and require only the addition of water before being ready to use.
Without proper rehydration, about half of people who contract cholera die. Less than 1 percent of those who are treated with rehydration do. People with access to more advanced medical treatment can get fluids through an intravenous (IV) line. One dose of an antibiotic known as azithromycin also can help both adults and children who have severe cholera, because it decreases the amount of time a patient will have diarrhea and should decrease the amount of vomiting a patient does.
The risk of cholera is low in industrialized nations, and good food safety and hand-washing practices will generally prevent people from getting the disease, regardless of their location. Cholera is most commonly passed through feces. Most people who are infected do not get sick, but the bacteria remain in their stool for up to 14 days after infection. It generally causes diarrhea, and cholera treatment focuses on rest and staying hydrated, similar to treatment for stomach flu.