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Complete Overview About Cholera - Symptoms, Treatment And Causes

Last Updated: Sep 04, 2019

What is Cholera and How is it Transmitted?

Cholera is defined as an water-borne disease occurring due to causative bacterium, Vibrio cholera. This disease is characterised as watery diarrhea because toxins secreted by bacteria are targeting receptors of human intestine which leads to dehydration if left untreated. Being a water-borne disease, cholera is transmitted through infected drinking water or eating food contaminated by bacteria. World Health Organization is receiving report of approx. 150,000 cases every year about cholera which is very common in locations such as Africa, South Asia and Latin America.

Cholera does not spread from one person to another person but it does gets transmitted through feces and more often in countries where poor sanitation and lack of proper water supplies are present. This disease also affects people when conditions like natural disaster or war occurs and they have to stay in crowded location without any adequate sanitation.

What are the Early Signs of Cholera?

Early signs and symptoms of cholera can be listed as watery diarrhea with flecks of mucus and gastrointestinal lining known as rice-water stool that develops within 6 hours to 5 days of time period after exposed to bacteria. This sign is followed by dehydration and vomiting persisting for hours at a time. Dehydration is removal of water from body and this further carried out symptoms like irritability, lethargy, sunken eyes, dry mouth, extreme thirst causing electrolyte imbalance.

This imbalance shows signs of muscle cramps due to rapid loss of sodium, chloride and potassium salts, severe hypovolemic shock. There are rare cases where children experiencing cholera having symptoms of hypoglycemia, an altered state of consciousness, seizures and coma conditions. Many cases of cholera disease show mild to medium diarrhea resulting hard to distinguish between cholera and diarrhea. After detecting proper treatment is necessary for such disease as it may lead to rapid deterioration and death in a matter of minutes.

What are the Causes of Cholera?

Vibrio cholera named bacteria is found as basic cause behind cholera disease that naturally occurs in coastal water where they attached to tiny crustaceans called cope-pods. Algae are the food sources of such copepods fueled by the urea found in sewage and agricultural runoff. Standing water and certain type of foods are most common causes of cholera that includes seafood, raw fruits and vegetables, and grains. Seafood such as shellfish originated from location of standing waters can expose human with cholera bacteria.

Consumption of raw fruits and vegetable grown with the use of un-composted manure fertilisers or irrigation of water from raw sewage can leads to disease. Poor sanitation conditions, reduced or nonexistent stomach acid as hypochlorhydria or achlorhydria conditions, household exposure, consumption of food contaminated with feces containing such bacteria can be considered as origin of cholera disease. The areas with inadequate drinking water and sewage treatment are at higher risk of developing cholera and spread in nearby areas.

What are the Preventive Measures for Cholera?

Good hygiene and safe food preparation are two important points need to be take care for people living in cholera- endemic areas. Certain recommendations are mentioned below as preventive measure against cholera disease:

  • Drink only safe water - Consuming water that is boiled or disinfected with chlorine, iodine or other products is suggested. If area is highly infected with bacteria then only drink bottled water without any broken seals. Other drinks such as packaged juices, soft drinks, carbonated water, etc. can be consumed to satisfy water requirement of body.
  • Maintain physical hygiene - According to this statement, hand should be washed with soap and water or other alcohol-based hand cleaners frequently. It is mandatory to wash hands after using bathrooms and before preparing any food.
  • Food - It is suggested to consume food which is prepared fresh and served hot. Try to avoid packaged food, raw fruits and vegetables, under cooked meat and seafood.

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How do You Test For Cholera?

If a person is having watery stool that looks like rice water is identified as a susceptible patient of cholera. It is very common that medical professional test the stool sample or rectal swab for detection of Cholera in person. The collected sample is sent to the laboratory for determination of Vibrio Cholera bacteria in it. In laboratory, technician looks for motile, comma-shaped bacteria easily seen in microscope. Further diagnosis is made after isolation of bacteria from such diarrheal fluid.

For distinguishing cholera from other diseases such as dysentery (diarrhea with inflammation in GI tract) caused by pathogens, bacteria and protozoa, definite diagnosis is performed.

What is the Best Treatment for Cholera?

Primary treatment for cholera is getting rehydrated means restoration of electrolytes and body fluids back in body of a patient with the help of administering Oral Rehydration Salts (ORS) formulations. ORS is available in form of powder that needs to be dissolved into at least one liter of water as well as ready to drink formulations.

This ORS is administered as per severity of diarrhea and if severe diarrhea is observed than intravenous fluid replacement is done. Antibiotics are also prescribed that shorten and diminish the severity of illness along with rehydration therapies. Antibiotics help by reducing the duration of diarrhea by half and also remove the bacteria or bacterial toxins from the body that prevents the spread of disease.

What are the Precautions for Cholera?

  • Washing vegetables and fruits.
  • Washing utensils and dishes which are used to prepare or eat food.
  • Brushing or flossing your teeth.
  • Making ice
  • Preparing drinks or food
  • Drinking

It is vital to prevent consuming products such as:

  • Fish which is caught in the tropical reefs that can be contaminated.
  • Under cooked or raw shellfish or meat.
  • Unpasteurised milk products or meat.
  • Unpeeled vegetables and fruits.

Generally, the doctor prescribes treatments which focus on keeping you hydrated. The treatment also depends on the severity of the diarrhea. Antibiotic and intravenous fluids which kill the bacteria is usually prescribed. These medicines also prevent the spread of cholera.

What are the Home Remedies for Cholera?

Home remedies of cholera which have been proven effective are as below:

  • Use of onion- Consuming onion paste with pinch of black pepper helps in signs of thirst and restlessness. As onion have anti-inflammatory, antibiotic and anti-diarrheal like properties, it is used as home remedy for cholera.
  • Coconut water and cucumber leaves- Administration of equal portion of cucumber leaves juice and coconut water two times in a day can provide relief from symptoms of cholera.
  • Lemon juice- Vitamin C is available in good amount in lemon which makes it’s freshly made juice an important remedy for patients suffering from cholera.
  • Cloves- This natural ingredient helps in prevention of recurrence of dehydration, feeling of excess thirst like conditions if 4 gm of clove is boiled in 3 liter of water and consumed after cooling in every two hours.

Why is Cholera Called the Blue Death?

Cholera is also known as Blue death. Cholera is a disease that is caused by Vibrio cholera bacterium found in water of coastal region. This bacterium is affecting GI tract of body resulting into loss of body fluids and electrolytes because of diarrhea and vomiting.

This loss of fluid take body into dehydrated state if kept untreated and it can kill any person within just 12 hours of time. Extreme of loss of fluids from body changes color of skin from pale yellow to bluish grey color. This is the basic reason behind why cholera is called as the Blue death.

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Written ByDr. Akhilesh Singh Post Graduate Course In Diabetology,CCEBDM(DIABETOLOGY) & CCMH ( CARDIOLOGY)General Physician
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