Cholera is an acute intestinal infection that is caused by consuming food or water contaminated with the bacterium Vibrio cholerae. Globally, there are 1.443 million cases of cholera, and approximately 28,000 to 142,000 cholera deaths, each year.
Symptoms and causative factors
Cholera is a very serious disease. It affects adults as well as children and can kill within hours if untreated. In the majority of cholera infections (80%), however, the person will have no symptoms. Of those who developed symptoms of cholera, most would experience only mild symptoms. Twenty percent of those with symptoms, however, will have more severe symptoms, including profuse watery diarrhea, vomiting, and leg cramps.
Symptoms can occur within two hours to five days after the first exposure to Vibrio cholerae.
spread of cholera
Cholera is spread by eating food or drinking water contaminated with Vibrio cholerae. Contamination occurs when fecal matter from a sick person comes into contact with food or water supplies. Even when a person infected with cholera has no symptoms, the bacteria are present in the person's stool for 1-10 days after infection. These bacteria can be shed back into the physical environment, potentially infecting other people.
Poor environmental management and overcrowded areas increase the risk of cholera dramatically. Ensuring that food and water supplies are clean and well managed is the easiest way to prevent the spread of cholera. The development and use of tap-water systems, chlorination facilities, water filtration, safe water storage containers, and proper sewage disposal have helped reduce the spread of cholera.
Cholera is not usually spread directly from person to person.
treatment and care
About 80% of cholera cases can be successfully treated if proper treatment and care is received. This includes oral rehydration salts and electrolytes. Provision of clean and safe drinking water and proper sanitation is very important to control this deadly disease and other water borne diseases.
People who are becoming ill with cholera can be treated with oral rehydration fluids. Intravenous fluids may be administered if the patient is severely dehydrated.
Antibiotics may be used to reduce the severity of symptoms. However, the widespread use of antibiotics in areas with many cases of cholera is generally not recommended. Antibiotics do not prevent the spread of disease, and they can lead to increased antimicrobial resistance to Vibrio cholerae.
Complications
In extreme cases of cholera, diarrhea is so profuse that severe dehydration can set in, which can lead to sunken eyes, cold skin, decreased skin elasticity, wrinkling of the hands and feet, and a bluish tint to the skin .
Death can occur within a few hours of symptom onset if the patient does not receive treatment.
Available Vaccines-
Globally, two World Health Organization (WHO) prequalified oral cholera vaccines (OCVs) are available: Dukoral and Shanchol/mORC Vax. Dukoral is prescribed for adults and children older than 6 years of age in 2 doses and also for children over 2 years of age and at least 6 years of age in 3 doses. Shanchol Vaccination Schedule 2 doses are given at 2-week intervals for children who are less than 1 year of age.
Vaccines provide protection against clinically significant cholera for a period of more than 4 months after vaccination, up to about 65%-85% up to 5 years after vaccination, depending on the vaccine.
Vaccination tips
The WHO's position on cholera vaccination is that vaccination may provide a short-term, immediate protective effect, while long-term interventions to improve water and sanitation are put in place. Accordingly, that suggests that the cholera vaccine be used in areas where the disease is endemic and should also be considered in areas at risk for outbreaks.
In cholera-endemic countries, that suggests vaccination should target areas and groups of people at high risk. High-risk individuals often include young children.
Vaccines and aid workers are advised to carry vaccines for holidays in cholera-prone areas.
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