Cholera
Cholera is an acute epidemic infectious disease that causes severe watery diarrhoea, which can lead to dehydration and even death if untreated. It is caused by eating food on drinking water contaminated with a bacterium called Vibrio cholerae.
Modern sewage and water treatment have effectively eliminated cholera in most countries. The disease is most common in places with poor sanitation, crowding war and famine. Common locations include parts of Africa, South Asia and Latin America. If you are travelling to one of those areas, knowing the following cholera facts can help protect you and your family.
Cholera can be easily treated. Death from severe dehydration can be prevented with a simple and inexpensive rehydration solution.
Symptoms –
Most people exposed to the cholera bacterium don’t become ill and don’t known they have been infected. But because they shed cholera bacteria in their stool for seven to 14 days, they can still infect others through contaminated water.
Symptoms of cholera infection can include –
• Diarrhoea
Cholera-related diarrhoea comes on suddenly and can quickly cause dangerous fluid loss – as much as about 1 litre an hour. Diarrhoea due to cholera often has a pale, milky appearance that resembles water in which rice has been rinsed.
• Nausea and vomitting
Vomiting occurs especially in the early stages of cholera and can last for hours.
• Dehydration
Dehydration can develop within hours after cholera symptoms start and range from wild to severe. A loss of 10% or more of body weight indicates severe dehydration.
Sign and symptoms of cholera dehydration includes –
• Irritability
• Sunken eyes
• Extreme thirst
• Dry mouth
• Little or no urinating
• Low blood pressure
• An irregular heartbeat
• Fatigue
• Shriveled skin that’s slow to bounce back when pinched into a fold
Dehydration can lead to a rapid loss of minerals in your blood that maintain the balance of fluids in your body. This is called an electrolyte imbalance.
An electrolyte imbalance can lead to serious signs and symptoms such as –
• Muscle cramps
These result from the rapid loss of salts such as sodium, chloride and potassium.
• Shock
It occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body. It untreated, severe hypovolaemic shock can cause death in minutes.
Children usually have the same cholera symptoms as adults. Children may also experience the following –
• Severe drowsiness
• Fever
• Convulsions
• coma
Causes –
Cholera is caused by bacteria called Vibrio cholera. The disease’s deadly effects are the results of a strong toxin known as CTX that is produced by there bacteria in small intestine.
CTX interferes with the normal flow of sodium and chloride when it binds to your intestinal walls. When the bacteria attaches to the small intestine’s walls, your body begins to secrete large amounts of water that lead to diarrhoea and the rapid loss of fluids and salts.
Contaminated water supplies are the primary source of cholera infection. Uncooked fruits, vegetables and other foods can also contain the bacteria that can cause cholera.
Cholera is not usually passed from person to person through casual contact.
Risk Factors –
Everyone is susceptible to cholera, with the exception of infants who get immunity from nursing mothers who have previously had cholera. Still, certain factors can make you more vulnerable to the disease or more likely to have severe signs and symptoms.
Risk factors for cholera includes –
• Poor sanitary conditions
• Reduced or nonexistent stomach acid
• Household exposure
• Type O blood
• Raw or undercooked shellfish
Complications –
Although shock and severe dehydration are the worst complications of this condition, other problems can occur, such as-
• Low blood sugar (hypoglycemia)
Low level of blood sugar can occur when people become too ill to eat. Children are at greatest risk of this complication, which can cause seizures, unconsciousness and even death.
• Low potassium levels
People with cholera lose large quantities of minerals, including potassium, in their stools. Very low potassium levels interfere with heart and nerve function and are life threatening.
• Kidney failure
When the kidneys lose their filtering ability, excess amounts of fluids, some electrolytes and wastes build up in the body – a potentially life-threatening condition. In people with cholera, kidney failure often accompanies shock.
Diagnosis –
Although signs and symptoms of severe cholera can be unmistakable in areas where it’s common, the only way to confirm a diagnosis is to identify the bacteria in a stool sample.
Rapid cholera dipstick tests enable doctors in remote areas to quickly confirm a cholera diagnosis.
Treatment –
Common methods for treatment includes –
• Oral rehydration salts
Prepackaged mixtures are commercially available, but widespread distributism in developing countries is limited by cost, so homemade ORS recepies are used, with common household ingredients.
• Intravenous fluid rehydration
Severe cases of cholera require intravenous fluid replacement. An adult weighing 70kg will need at least 7 litres of intravenous fluids.
• Antibiotics
Antibiotics can shorten the duration of the illness, but the WHO does not recommend the mass use of antibiotics for cholera, because of the growing risk of bacterial resistance.
Anti-diarrhoeal medicines are not used because they prevent the bacteria from being flushed out of the body.
• Zinc supplements
Prevention –
To prevent such infection one should take care of following points –
• Wash your hands
• Drink only bottled or boiled water
• Avoid raw food and shellfish
• Ensure that food is thoroughly cooked.
• Avoid street food
Ayurvedic Perspective –
In Ayurveda, Cholera can be correlated with Vishuchika. In common words it is known as Haiza. It is caused by a vitiation of external forces i.e.krimi into the body that causes a damage to all three doshas but involves vitiated pitta and vata as predominant factors.
Beneficial Herbs –
• Kushtha
• GauriphaI
• Daraharidra
• Bilva
• Bhunimba
• Ajwain
• Isabgol
Effective Medications –
• Kutajghan Vati
• Vatsakadi Churna
• Bilwadi Churna
• Agnikumara rasa
• Bolbadha Vati
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