Cholera – Causes, Symptoms & Therapy

Cholera

The number of cholera victims has decreased over time due to better education and higher standards of hygiene. But even today, cholera poses a serious threat to travelers visiting developing countries.

What is cholera?

It has been known to mankind for centuries as a deadly disease: cholera. According to the first records, it appeared in India for the first time in the sixth century, from where it spread to Europe at the beginning of the 19th century, helped by increasing overseas shipping.

Until the pathogens could be identified and methods developed to combat them successfully, it repeatedly caused epidemics that cost the lives of thousands of people. Today it mainly occurs in places with a lack of basic hygienic standards.

In this respect, cholera only occurs extremely rarely in Germany. In order to prevent a sudden spread, cases of cholera in Germany must be reported to the competent authority by the attending physician.

causes

Bacteria are to blame for outbreaks of cholera , more precisely the bacterium Vibrio cholerae. It is assumed that the bacterium can only use humans as a reservoir; the majority of researchers considers an infection from and through animals to be impossible.The above-average sensitivity of the bacterium to a dry environment is also known. The bacterium needs a moist environment to maintain its pathogenicity, that is, its ability to cause diseases. For example, the bacteria can survive for several weeks in the faeces of a person suffering from cholera.

When to the doctor?

As a preventive measure, a doctor should be consulted for vaccination against cholera. This applies in particular before a stay abroad in a country where the drinking water and waste water supply is considered contaminated by western standards. In addition, the supply of drinking water must be completely avoided.

If cholera is suspected, a doctor must be consulted immediately, since full cholera is life-threatening for the person concerned. If there is an increase in diarrhea that has a very thin or watery consistency, there is cause for concern. If the condition persists for several trips to the toilet, a doctor must be consulted. If you vomit repeatedly without nausea or cardiac arrhythmias , you should see a doctor. A feeling of internal dehydration despite adequate hydration needs to be investigated.

If hoarseness or cramps occur, especially in the calves, a doctor should be consulted. If your blood pressure drops and your pulse is racing at the same time, you should consult a doctor. A significantly reduced amount of urine, a drop in body temperature and sunken eyes are indications of cholera. A doctor’s visit is necessary to clarify the symptoms medically and to initiate countermeasures. A conspicuous and suddenly wrinkled skin structure should be presented to a doctor. A doctor should be consulted in the event of disturbances in consciousness , general malaise or abdominal pain.

symptoms and course

An infection does not necessarily result in an outbreak of cholera. The incubation period, i.e. the time until the first symptoms appear, is between a few hours and five days after infection with cholera. The incubation period is usually two to three days.

If there are no symptoms after this period has expired, it can be assumed that the bacterium was not able to multiply in sufficient quantities and that an outbreak of cholera is no longer to be feared. The symptoms that come into question include primarily watery diarrhea , also known as rice water diarrhea.

The diarrhea is watery, slightly cloudy, and contains mucus residue; it is reminiscent of rice water. The diarrhea is accompanied by nausea , abdominal pain and occasionally additional vomiting . And this is exactly where the danger of cholera lies: people lose up to 20 liters of water every day through diarrhea. Cholera can have other consequences: the loss of water thickens the blood, which significantly increases the risk of thrombosis .

Diagnose

The first indication for the doctor treating you that cholera could be present is rice water diarrhea. To ensure a diagnosis, the bacterium Vibrio cholerae must be detected. This can be done on the patient’s feces. If this is not possible, a swab from the patient’s rectum can be used as the basis for detecting the pathogen.

Special precautions must be taken for transporting the swab or stool sample. As already mentioned, the bacterium is sensitive to dry environments. For this reason, the samples must be transported in a specific solution before they can be tested for the cholera pathogen.

complications

If cholera is not treated or treated too late, the patient usually dies. The disease usually breaks out after an infection in only 15 percent of all cases and is quickly mistaken for diarrhea, especially if the course of the disease is mild. However, the risk of infection is still high and even with mild courses the mortality rate is quite high. Even if treatment is started in good time, about one percent of patients die as a result of the disease.

Due to the typical vomiting and diarrhea, cholera causes dehydration , sometimes the loss of fluid is seven to ten liters per day. Other complications include shock, urinary retention, muscle pain, hypotension , circulatory insufficiency due to lack of electrolytes, renal insufficiency or secondary infections of the lungs, skin and middle ear. Comatose states are also not uncommon in cholera diseases. An infection discovered early can usually be successfully treated. Even if the body can defend itself against the infection, it has to be supplied with a lot of nutrients due to the massive loss of fluids.

treatment and therapy

Death from cholera infection occurs due to dehydration of the organism. This is where the therapy comes in. Even before the result of the detection of the pathogen is available, the patient has to compensate for the loss of water. The World Health Organization has developed a solution for this, the ingredients of which are inexpensive and therefore also available in developing countries.

It consists of simple sugar (glucose), sodium citrate, table salt and potassium chloride. This solution enables the small intestine to pump sodium ions and water molecules together with them into the cell interior using special cell pumps. In particularly severe cases, the solution can be injected directly into the patient’s bloodstream via infusions, bypassing the intestinal system.

Antibiotics , especially those from the tetracycline family, cannot prevent water loss, the actual cause of cholera death, but they can kill the bacteria that have entered the body and thus promote the process of recovery.

prevention

Cholera occurs almost exclusively in countries with poor sanitation standards. For this reason, an effective variant would be to avoid visiting such countries. If this is not possible, a vaccination is recommended. The cholera vaccination must be boosted every two years; their protection is therefore not long-term.It should also be noted that the protection is not 100 percent. This means that although it reduces the risk of an infection ending in the outbreak of cholera, it cannot always guarantee this. A residual risk therefore also exists with vaccination. For this reason, increased hygiene requirements remain indispensable.

This includes, for example, not drinking untreated water, but mineral water or boiled tap water. This also applies to ice cubes; Ice cubes should be avoided with drinks. Likewise, because of the risk of contact with contaminated faeces, fruit and vegetables should at best only be eaten cooked or at least well washed and peeled. Coupled with frequent hand washing, these measures offer good, if not 100 percent, protection against cholera.

Dorothy Farrar

Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.

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