What is Cholera?


Cholera is a bacterial disease that normally spreads through contaminated water. Cholera causes dehydration and severe diarrhea. If cholera is not treated, it can be fatal within a short span of a few hours, even in people who were are considered healthy.

Modern sewage and water treatment have virtually eliminated cholera in many industrialized countries. The last major outbreak in the United States happened in 1911. However cholera is still present in South Asia, Haiti, Africa, Haiti, and central Mexico. The risk of cholera epidemics is highest when there are natural disasters, war, or poverty, which forces people to live in crowded condition without access to adequate and clean sanitation
Cholera is easily treated. However death, typically results from severe dehydration that can prevent with a simple and inexpensive rehydration solutions.

Symptoms of Cholera

Most people that are exposed to cholera bacterium (Vibrio cholera) will not become ill and may never know they have been infected. How we, because they shed cholera bacteria in the stool for seven to 14 days, the contaminated water can still infect others. The most prevalent cases symptoms of cholera cause mild to moderate diarrhea and is often difficult to distinguish from diarrhea caused by other problems.
1 in 10 people who are infected with cholera develops signs and symptoms of cholera, usually within a few days of infection

Symptom of Cholera include

  • Diarrhea. Cholera-related diarrhea comes on very quickly may cause dangerous and rapid fluid loss, which can be as much as a quart or liter an hour. Diarrhea due to cholera often cause pale, and a milky appearance that resembles water in which rice has to be rinsed (rice-water stool)
  • Nausea and vomiting – This typically happens in the early stages on cholera, vomiting may persist for hours at a time.
  • Dehydration – Dehydration can develop within only a couple of hours after the onset of cholera symptoms. It depends on how much body fluid has been lost, dehydration can range from mild to severe. A loss of more than 10 percent of total body weight indicates severe dehydration.

Signs and symptoms of cholera dehydration include irritability, irregular heartbeat (arrhythmia)little to no urine output, low blood pressure, sunken eyes, dry mouth, extreme thirst, lethargy dry and shriveled skin that is slow to bounce back wen you are pinched into a fold,

Dehydration can lead to rapid decline of minerals in your blood (electrolytes) that control the balance of fluids in your body. This is called an electrolyte imbalance.

Electrolyte imbalance

An electrolyte imbalance can develop serious signs and symptoms such as:

  • Shock– this is the most serious complication of dehydration. It transpires when low blood volume causes a decrease in blood pressure and a drop in the amount of oxygen in your body. If this is not treated, the severe hypovolemic shock causes death within several minutes.
  • Muscle cramps – These result from the rapid loss of salts such as chloride , sodium and potassium.

Signs and symptoms of cholera in children

Generally, children will have the same signs and symptoms as adults, but they may be particularly sensitive to hypoglycemia or low blood sugar, due to fluid loss, causing:

  • Comas
  • Seizures
  • Alter state of Consciousness


When to see a Physician

The risk of cholera is very low in industrialized countries, even in endemic areas where you are not likely to become infected if you follow food after a recommendation. However there are sporadic cases of cholera occurring throughout the world, if you develop severe diarrhea after visiting an area wit active cholera, see your doctor.

If you have diarrhea or severe diarrhea, and you think ou have been an episode to cholera, this is a medical emergency and will require treatment right away. Severe dehydration is a medical emergency and requires treatment right away regardless of the original cause.

Causes of Cholera
A bacterium called Vibrio cholera cause the cholera infection. The fatal effects of cholera are caused by a potent toxin called CTS and the bacteria created in the small intestine. CTX attaches to the intestinal walls, where it impedes the normal flow of sodium and chloride. this causes the body to secrete large amounts of water. Leading to diarrhea in rapid loss of fluids and salts (electrolytes)

Contaminated water supplies are the main source of cholera infection, although uncooked fruits and vegetables and raw shellfish and other foods can have V. cholera.
Cholera bacteria has to life cycles on in the environment and another one in humans.

Cholera bacteria in the environment.

Cholera bacteria occurs in coastal waters, in which they attach to any copepods, tiny crustaceans. The cholera bacteria travels with their host spreading the word as the crustaceans follow their food source- certain types of algae and plankton that grow tremendously when the water departures increase. Algae growth is fueled additionally by the urea found in sewage and in agricultural runoff

Cholera bacteria in humans
When humans ingest cholera bacteria the many not become ill themselves, however they still pass the bacteria in their stool. When human feces begins to contaminate food and water supplies, both can serve as model breeding grounds or the cholera bacteria.

Because more than a million cholera bacteria – which is approximately the on you find in contaminated water, are needed to cause illness, cholera usually is not transmitted through casual person-to-person contact/

The most common methods of cholera infect are standing water and certain food types, which include raw fruits, raw vegetables, grains, and seafood.

  • Surface to well water – Cholera bacteria can lie dormant in water for long periods of time, and contaminated public wells are frequent sources of large-scale cholera outbreaks. People living in crowded conditions without adequate sanitation are especially at risk for cholera.
  • Seafood – eating raw or undercooked seafood, especially shellfish, that originates from locations exposed to cholera bacteria.
  • Raw fruits and vegetables – Raw unpeeled fruits and vegetables are a Frequent source of cholera infection in areas where cholera is endemic. These can be developing nations, uncomposted manure fertilizer, irrigation water containing raw sewage, contaminating the field.
  • Grains – In regions where there is cholera widespread, grains such as millet and rice can become contaminated after cooking and allow to remain at room temperature for several hours, becoming a breeding area for cholera bacteria growth.

Risk Factors to Cholera

Everyone is susceptible to cholera, with the exception of infants who gain immunity from a mother who has previously had cholera. Yet, certain factors can make you more vulnerable to the bacteria or more likely to experience severe signs and symptoms. Risk factors for cholera include:

  • Poor sanitary condition. Cholera is more likely to flourish in a condition where water supply is difficult to maintain. These conditions could be areas of natural disasters, impoverished countries, refugee camps, areas devastated by famine.
  • Reduce or no stomach acid (hypochlorhydria or achlorhydria) . Cholera bacteria can not survive in an acidic environment, the ordinary stomach acid often serve as the first -line of defense against infections, people with low levels of stomach acid, such as children , older adults and individuals who take antacids, proton pump inhibitors, or H-2 blockers , are at greater risk for cholera.
  • Household exposures, Your chances of getting cholera increases significantly if someone you live with has the illness.
  • Type O blood, For reasons that are not entirely clear, people with type O blood are twice as likely to develop cholera.
  • Raw or undercooked shellfish– eating shellfish from water known to have the cholera bacteria significantly increases your risk.

Complications from Cholera
Cholera can quickly become fatal, due to the rapid loss of large amounts of fluids and electrolytes, leading to death in two to three hours. In less extreme circumstances, people who do not receive treatment may die of dehydration and shock hours or days later after the symptoms first appear.
Although shock and severe dehydration are the most devastating complications, other can occur, including

  • Low blood sugar (hypoglycemia ) -low levels of blood sugar (glucose) which is the body’s primary energy source. this can happen when someone is too ill to eat. Children are at the greatest risk for this, causing unconsciousness, seizures and death.
  • Low potassium levels (hypokalemia ) Individuals with cholera lose many minerals, including potassium in their stools. Very low potassium levels interfere with nerve and heart functions and can be life-threatening.
  • Kidney ( renal) failure – When the kidneys lose their ability to filter excess amounts fo fluids, some electrolytes and waste build up in the body in people with cholera, often accompanied by shock.

Test and Diagnosis.

Although severe cholera may be evident through the symptoms in endemic areas, the only way to establish a diagnosis is to identify the bacteria in a stool sample.
Rapid cholera dipstick test is available, enabling health care providers in a remote area to confirm the diagnosis of cholera earlier. Quicker confirmation helps reduce death rates at the start of cholera outbreaks and leads to faster public health interventions for outbreak control.

Treatments for Cholera
Cholera demands immediate treatment because the disease can cause death within hours

  • Rehydration – The goal is to replace lost fluids and electrolytes using a simple rehydration solution, oral rehydration salts (ORS). Th ORS solution is available as a powder can be reconstituted in bold or bottled water. Without rehydration support half the individuals with cholera die. With medication a number of fatalities fall to less than 1 percent
  • Intravenous fluids– During a cholera epidemic, the majority of people can be helped by oral rehydration alone, severely dehydrated people may also need intravenous fluids
  • Antibiotics – while antibiotics are not the necessary art of cholera treatment, some antibiotics may reduce the amount and duration of cholera caused diarrhea. A single dose of doxycycline ( Vibramycin, Monodox, Oracea) or Azithromycin (Zmax, Zithromax) can be helpful.
  • Zinc supplements – Research as shown that signs it may decrease and shorten the duration of diarrhea in children with cholera.

Cholera Prevention

Cholera is rare in developed countries with a few cases related to travel outside to developing countries or regions that are contaminated and improperly cooked seafood.

If you are traveling to a cholera-endemic area your risk of contracting the disease is extremely low if follow these precautions.

  • Wash your hands with soap and water frequently, at least 14 seconds before rising, if soap and water aren’t available to use alcohol-based hand sanitizer
  • Drink only safe water, including bottled, or boiled water. Hot beverages are generally safe and canned or bottled drinks are as well. Wipe the outside before you open them.
  • Eat foods that are completely cooked and hot, avoid street vendors if possible, make sure it is cooked in your presence and serve hot.
  • Avoid sushi and well as raw improperly cooked fish and seafood of any kind.
  • Stick to first and vegetables you can peel yourself, bananas, avocados and oranges. Do not eat grapes, salads and fruits that are not peeled, including berries.
  • Avoid dairy foods, which can be contaminated with pastured milk.


Cholera vaccine – for adults traveling to cholera- affected areas, the vaccine is now available in the US. The U.S food and Durg administration approved Vaxchora, a vaccine for prevention of cholera. It is a liquid does take by mouth 10 days before travel.