Cholera

communicable disease

What is cholera?
Cholera is an acute infectious disease caused by a bacterium, Vibrio cholerae (V. cholerae) Most people who get the disease ingest the organisms through food or water sources contaminated with V. cholerae.

What is cholera?
which results in a painless, watery diarrhea in humans. Some affected individuals have copious amounts of diarrhea and develop dehydration so severe it can lead to death. Although symptoms may be mild, approximately 5%-10% of previously healthy people will develop a copious diarrhea within about one to five days after ingesting the bacteria. Severe disease requires prompt medical care.

Signs and Symptoms

watery diarrhea that often contains flecks of whitish material (mucus and some epithelial cells) that are about the size of pieces of rice. smells "fishy." The volume of diarrhea can be enormous; vomiting

rapid heart rate loss of skin elasticity dry mucous membranes low blood pressure Thirst muscle cramps restlessness or irritability (especially in children)

Mode of Transmission
By drinking water or eating food contaminated with the cholera bacterium, Vibrio cholerae. the source of the contamination is usually the feces of an infected person. The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water.
Cholera has been found in only two other animal populations: shellfish and plankton.

Mode of Transmission
The cholera bacterium may also live in the environment in brackish rivers and coastal waters. Shellfish eaten raw have been a source of cholera, and a few persons in the United States have contracted cholera after eating raw or undercooked shellfish from the Gulf of Mexico.

Communicability
The disease is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk for becoming ill.

History of Cholera
Reports of cholera-like disease have been found in India as early as 1000 AD. Cholera is a term derived from Greek khole (illness from bile) Later in the 14th century to colere (French) and choler (English). In the 17th century, cholera was a term used to describe a severe gastrointestinal disorder involving diarrhea and vomiting.

Cholera outbreaks
England had several in the 18th century, most notable being in 1854, when Dr. John Snow did a classic study in London that showed a main source of the disease (resulting in about 500 deaths in 10 days) came from at least one of the major water sources for London residents termed the "Broad Street pump." The pump handle was removed, and the cholera deaths slowed and stopped. The pump is still present as a landmark in London. Although Dr. Snow did not discover the cause of cholera, he did show how the disease could be spread and how to stop a local outbreak. This was the beginning of modern epidemiologic studies.

Cholera outbreaks
V. cholerae was first isolated as the cause of cholera by Filippo Pacini in 1854, but his discovery was not widely known until Robert Koch (who also discovered the cause of tuberculosis), working independently 30 years later, publicized the knowledge and the means of fighting the disease.

Patoglomonic Sign
rice-watery stool

Treatment
The main treatment for cholera is fluid and electrolyte replacement, both oral and IV. Antibiotics usually are used in severe infections where dehydration has occurred. Hydration (usually by IV for the very ill) of the patient is the key to surviving the disease

Patient condition

Treatment

No dehydration

Oral rehydration salts (ORS)

Some dehydration

Oral rehydration salts (amount in first four hours)

Severe dehydration

IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above

Management
Cholera can be prevented with appropriate measures such as
safe drinking water and non contaminated foods; some protection can be obtained from oral vaccines while avoiding areas where cholera commonly occurs or has had a recent outbreak. Proper handwashing Proper sanitation Foods should be well cooked.