Cholera: Causes, Symptoms, Treatment and Prevention

Cholera is an acute, diarrhoeal illness resulting from an infection of the intestine. While easily treatable, it can lead to death if left untreated. Learn about the signs and symptoms of cholera and its treatment.

A cholera infection is often mild or without symptoms, but can sometimes be severe, with symptoms like diarrhoea, vomiting, and leg cramps leading to severe dehydration and shock.

Unlike other infectious diseases, cholera can be easily treated. However, if left untreated, cholera can cause death often as a result of severe dehydration, which can be prevented with a simple rehydration treatment.

The risk of a cholera epidemic is high among people living in crowded areas without adequate sanitation.

Sources of Infection

The most common sources of cholera infection include:
Contaminated surface water or public wells, where cholera bacteria can lie dormant for long periods of time.
Undercooked seafood, especially shellfish.
Raw fruits and vegetables that have been contaminated with manure fertilisers or irrigation water with raw sewage.
Grains such as rice and millet that may be contaminated after cooking, especially if left to remain at room temperature for several hours.

How Does the Bacteria Cause Disease?

V. cholerae produces a potent toxin, called CTX, in the small intestine which binds to the intestinal walls interfering with the normal flow of sodium and chloride.

This causes the body to secrete enormous amounts of water, leading to diarrhoea and a rapid loss of fluids and salts (electrolytes).

Symptoms of Cholera

The infection is often mild or without symptoms, but can be severe. Symptoms may include:
Watery diarrhoea flecked with mucus and dead cells, resembling rice water (rice-water stool).
Nausea with persistent vomiting and muscle cramps.
Dehydration — signs and symptoms here include irritability, lethargy, sunken eyes, a dry mouth, extreme thirst, dry skin, little or no urine output, low blood pressure, and an irregular heartbeat (arrhythmia).
Shock — this occurs when low blood volume causes a drop in blood pressure and if left untreated, can cause severe hypovolemic shock and death.

In children it may present as:
Extreme drowsiness or even coma

Cholera Complications

Shock and severe dehydration are the most common complications of cholera. Other complications include:
Low blood sugar (hypoglycemia). Unusually low blood sugar levels can result in seizures, unconsciousness and even death.
Low potassium levels (hypokalemia) due to the loss of large quantities of minerals can interfere with heart and nerve functions.
Kidney (renal) failure occurs when the kidneys lose their filtering ability leading to the build-up of excess amounts of fluids and wastes in the body.

Cholera Treatment

The main goal in cholera treatment is to replace fluids and electrolytes using a simple rehydration solution called Oral Rehydration Salts (ORS). The solution is available as a powder that can be reconstituted in boiled or bottled water.

Antibiotics such as a single dose of azithromycin can be used for both adults and children with severe cholera.

Prevention of Cholera

Your risk of  contracting the disease can be low if you follow these precautions in cholera-endemic locations:
Drink only boiled water or water treated with chlorine or iodine.
Eat only foods that have been thoroughly cooked and are still hot.
Eat fruit that is thoroughly washed and that you have peeled yourself.
Avoid salads and eat only cooked vegetables.
Avoid buying food and beverages from street vendors.
Wash your hands with soap and water frequently.
Avoid sushi and do not eat raw or improperly cooked fish and seafood.
Avoid dairy foods such as unpasteurised milk and ice cream.
Cholera vaccine — contact your doctor or a public health institution if you need information on the vaccine.

Cholera: Causes, Symptoms, Treatment and Prevention

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