Cholera

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             Cholera

Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. There are many serogroups of V. cholerae, but only two – O1 and O139 – cause outbreaks.

Mode of Transmission

• Through faecally contaminated water, food or drinks 
• Direct person to-person contact, especially in overcrowded, low sanitation settings, also add to transmission of infection.

Signs and Symptoms

• Incubation period is from few hours to five days; commonly one-two days 
• Typical cases are characterized by sudden onset of profuse, efortless, watery diarrhea followed by vomiting, increased thirst, rapid dehydration, muscular cramps and suppression of urine 
• In non-outbreak situations, Cholera may present as simple gastroenteritis or as watery diarrhea 
• In an endemic situation, there could be many mild or asymptomatic cases or carriers

Complications

• Dehydration 
• Circulatory failure 
• Shock and electrolyte imbalance leading to acidosis, myocarditis, heart failure, tubular necrosis and eventual death

Diagnosis

• Acute watery diarrhea: It is an illness characterized by three or more loose or watery (non-bloody) stools within a 24-hour period. 
• Suspected Cholera case: Any person aged two years or older presenting with acute watery diarrhea and severe dehydration or dying from acute watery diarrhea 
• Confirmed Cholera case: A case of acute diarrhea with isolation and identification of vibrio cholerae serogroup O1 or O139 by culture of a stool specimen or on a Polymerase Chain Reaction (PCR) test.

Treatment

• Cholera is an easily treatable disease. Majority of people can be treated successfully through prompt administration of oral rehydration solution (ORS). WHO/UNICEF ORS standard sachet is dissolved in one litre (L) of clean water 
• Mass administration of antibiotics is not recommended, as it has no proven efect on the spread and may contribute to antimicrobial resistance. 
• Zinc is an important adjunctive therapy for children under five. It reduces the duration of diarrhea and may prevent future episodes of other causes of acute watery diarrhea. 
• Breastfeeding should also be promoted.

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