What Is Cholera ?
Cholera is water borne disease which is spread due to infection with bacteria called Vibrio Cholerae. It causes extreme dehydration in the body due to severe diarrhoea condition accompanied with vomiting. Since the cholera virus is carried in the water which may be used for consumption by many people, and is an extremely infectious disease, cholera generally affects large chunks of population of a given region at the same time.
It tends to occur more in areas where water supplied is not treated, does not have proper drainage system or the basic rules of sanitation are not found. The last cholera outbreak in US occurred in 1911 and since then due to development of advanced water treatment and drainage system, another outbreak has been avoided. But cholera still continues to plague the African continent, Southeast Asia and Mexico.
The main cause of cholera is the bacteria called Vibrio Cholerae. This bacterium finds its way into untreated or contaminated water such as that stored in unsanitary conditions. Sometimes it may also be present in fruits and vegetables grown in dirty water. When this bacterium enters the body, it prompts the small intestine to produce a toxin called CTX which makes the body secrete a large amount of water and salts in a very short span of time. Due to the loss of such essential fluids in the body, the body becomes weak and with continued secretion without proper supplements, it may even prove to be fatal.
The main symptoms of cholera are associated with loss of fluids from the body, such as :
- Severe Diarrhoea – The diarrhoea brought on due to cholera is extremely severe and can result in loss of up to 1 litre of liquid in an hour. In appearance it is milky white and may contain rice-sized stools which are also termed as “rice water stool”
- Vomiting and Nausea – This is generally a precursor to diarrhoea but the vomiting is violent and the feeling of nausea can last for several hours.
- Rapid heart rate – Due to the body secreting so many fluids, the heart rate tends to increase.
- Low blood Pressure – Abnormal loss of fluids over a continued period of time also results in low blood pressure.
- Muscle Cramps – Loss of essential salts or electrolytes from the body also causes muscle cramps.
The first sign of cholera is when the body starts secreting fluids. Both vomiting and diarrhoea produce the same result i.e. water from the body. Such abnormal loss of body water in turn causes feeling of extreme thirstiness. If the vomiting or diarrhoea persists for more than 3-4 hours, then chances are that it may be a cholera infection. The body also becomes extremely weak within a matter of hours, even to the extent that even getting up from the bed is impossible. Muscle cramps, dry mucous, low blood pressure and rapid heart rate are other signs which indicate that the body is undergoing severe dehydration at a very rapid pace.
Cholera is usually identified and diagnosed only on visual examination of the rice-water stool which is a unique trait of cholera. In case a large chunk of population is affected, a rapid dip test is also used for quick diagnosis. This consists of a dip test strip which is dipped into the stool sample to check whether it changes colour due to the presence of cholera virus or not. For those whose sample comes positive for cholera, a further test is conducted to determine antibiotic resistance so that appropriate medicines can be prescribed.
Diagnosis is done by a doctor on examination of the fluid excretions. If the characteristic traits of rice-water stool are recognized in the secretions, diagnosis of cholera is almost a certainty. In some cases, the doctor sends a stool sample for lab test to positively identify the presence of the Vibrio Cholerae before diagnosing cholera.
In case the symptoms appear similar to those of other diseases like dysentery, some additional tests for specific diseases may be done to eliminate the possibility of another disease. Most such tests are done on the stool sample only. The doctor may also enquire about your living conditions, your source of water for consumption etc. to determine the possibility of water being contaminated.
The prognosis largely depends on the severity of infection of the cholera virus as well as on the stage at which treatment was started. If the infection was not too severe and the disease was diagnosed at an early stage, the prognosis is likely to be excellent. On the other hand, if the infection is very severe, cholera may turn to be fatal even in a matter of a day or two before any treatment can even start taking effect. Even when cholera is treated completely, the body still remains weak for a couple of months and living in hygienic surroundings becomes an essential.
The main cause for cholera is untreated or contaminated water. Therefore, cholera can easily be prevented by establishing water treatment plants and following sanitary protocols in preparation of foods in different facilities. Maintaining personal hygiene like washing hands before and after every meal, keeping the surroundings of your house clean and eating only cooked fruits and vegetables also goes a long way in preventing cholera. A person can also get himself vaccinated against cholera but the vaccines are not easily available and last for only two years.
Cholera can be of Two Types :
- Classic Cholera – this is the most common type of cholera where large quantities of fluids are secreted from the body in a short span of time.
- Cholera Sicca – this is a very rare form of cholera in which the fluids are withdrawn from the body system but are stored in the digestive system instead of being secreted.
Cholera basically induces loss of fluids from the body which are essential for its normal functioning. Because of this, other body organs may also start malfunctioning. The pace of heartbeat increases significantly. Many patients also experience a sudden drop in blood pressure. Since the body is not retaining either food or water, it also leads to a drop in sugar levels in the body which causes unconsciousness or seizures. Sometimes, kidneys may also stop functioning in which excess of waste builds up in the body which can prove to be fatal.
Home Remedies :
Apart from clean drinking water, some other home remedies which can be tried out are as follows :
- Decoction of guava tree root and boiled water can be tried to minimize the feeling of nausea.
- To keep body hydrated, drink lemon juice with either sugar or salt.
- Coconut water and cucumber juice also help in keeping the body hydrated.
- To ease the feeling of restlessness, onions and black pepper ground together can also be consumed.
Treating cholera doesn’t really require medicines as much as it requires replenishment of the fluids that the body is losing. Rehydrating the body is the best technique. Oral Rehydration Therapy (ORT) is a WHO approved treatment technique which has been proven to be quite effective and is also very simple to administer. Along with this, the body may also need to be replenished with essential electrolytes like Potassium which can be supplemented through potassium rich food or drink like coconut water. In case of very severe diarrhoea, antibiotics like doxycycline are prescribed. One must also maintain the body strength by eating glucose-rich or carbohydrate-rich foods.
Natural Calamities and Cholera :
Cholera is contracted because of contaminated water. The contamination can be due to negligence of human beings themselves or because of natural calamities like earthquakes, volcano eruptions and famine. The 2010 cholera outbreak in Haiti occurred because the underground water of the region was contaminated due to an earthquake. If you live in a region where a natural calamity has occurred in the recent past, to ensure that your drinking water is safe, it is better to distil or boil tap water before drinking.