Anger

Cholera is an acute one caused by Vibrio Cholerae, which usually occurs in the form of epidemics. The disease affects both children and adults.

How is it produced?

The Vibrio Cholerae lives in salty coastal waters or in salubrious estuaries. Man becomes infected by intake of contaminated food, but above all by ingestion of water contaminated by infected human feces. There is no animal reservoir.

Common sources of contaminated food are usually the raw fish or shellfish o undercooked and raw fruits and vegetables.

Cholera is common in areas where there is no infrastructure for sewage sanitation (no sewerage), or in war zones where infrastructure has been destroyed and in refugee camps. exist cholera endemic areas in Africa, India and Southeast Asia. Epidemics appear periodically, the last notable epidemic being that of Zimbabwe from August 2008 to May 2009. It affected more than 90,000 people and killed more than 4,000.

Symptoms

Once the person is infected, and after a period of incubation from a few hours to 5 days, the cholera starts suddenly as a watery, very liquid, grayish diarrhea, with mucus but without blood. It does not usually cause abdominal pain but it does cause vomiting.

Diarrhea is caused by the action of a toxin made by the microorganism in the small intestine.

Most are usually mild diarrhea, but in 5-10% of cases, fluid losses can become very voluminous and complicate with death in a few hours. Symptoms of severe dehydration are weakness, hypotension, drowsiness, coma, and even death if left untreated.

Diagnosis

Given the clinical suspicion of cholera, the diagnosis must be confirmed by identifying the V. cholerae in stool by the microscope.

Treatment

The main thing is to replace fluids and salts lost through diarrhea as quickly as possible. The early oral rehydration saves many lives in cholera epidemics.

Oral rehydration solutions are usually sufficient in most mild cases without vomiting. Are preparations containing glucose, sodium, potassium, chlorine and bicarbonate to which water is added and which have been shown to be highly effective in replacing losses caused by diarrhea. There are several commercialized preparations or they can be prepared at home following the indications of the WHO (World Health Organization).

When the sick are seriously ill or have a lot of vomiting, it is necessary to intravenous treatment using serums until the patient improves.

antibiotics are not essential for cure but they reduce the duration of the disease and the loss of fluid. There are several effective antibiotics, tetracyclines or ciprofloxacin can be administered in a single dose or in short cycles, as indicated by the healthcare professional.

WHO recommends seeking medical or health care for all people who are in areas with cholera and have diarrhea, especially if it is severe diarrhea, while they begin to drink controlled water or unsweetened solutions such as soups.

Precautionary measures

The most important thing to prevent cholera is to have good infrastructure for the supply of clean water for human consumption and channeling of wastewater as sewerage.

You also need to take hygienic measures how to wash your hands well when preparing and storing food.

The injectable vaccine that was used in the past is no longer recommended. There are oral vaccines, but their protection is not 100%, so it is also recommended to follow hygienic measures in areas with cholera.

The cholera vaccination It has been eliminated as mandatory for the international transit of travelers. For international travelers the risk is usually low even if they go to endemic areas, if the appropriate measures are taken.

The hygienic measures suitable are the following:

• drink only bottled water
• avoid ice unless you are sure it is made from bottled water
• eat only foods that are well cooked and still hot
• avoid raw seafood or fish
• peel the fruits and vegetables.

WHO recommends bringing oral rehydration solutions to travelers.

The vaccination is usually recommended to travelers who will have close contact with the population in endemic areas as humanitarian aid personnel, in refugee camps or war zones.