Cholera

Description
The acute enteric infection that has caused several outbreaks worldwide in the
recent years is known ascholera, otherwise called as violent dysentery. It has widely
affected those locations with less potable supply of water, or those with inaccessible
basic needs, and most especially those crowded places with lack of sanitation and
hygiene practices.
Cholera is transmitted through fecal- oral route, more likely the ingestion of directly
or indirectly fecal contaminated water or food by soiled hands, utensils or
mechanical carrier like flies. A person who is infected by this illness can transmit the
organism through his feces or vomitus. So, obviously, the diagnosis for this enteric
infection is through fecal analysis. But, presently, the availability of the new rapid
diagnostic test (RDT)is a promising way of early diagnosis. However, it is still being
verified by the WHO to be utilized.
The extremely short incubation period of cholera pertaining to a few hours to five
days with average of 3 days has marked its deadly threat to those infected to it;
considering that its mild form causes no symptomsat all. That is why it could result
to severe dehydration, coma and death if left untreated.
The initial clinical manifestations of an individual infected with cholera are:

Acute colicky pain of the abdomen

Mild diarrhea with yellowish colored stools

Headache and vomiting

Fever, which may or may not be present

Marked mental depression

Later on, if not treated right away it could get worse to more profuse watery
diarrhea (grayish white or rice water colored stools), vomiting and severe or violent
leg cramps leading to mild up to severe dehydration.

Symptoms of dehydration may be manifested by:

Mild Dehydration

Moderate Dehydration

Somewhat dry mucous membranes

Pale, cool skin on arms & legs
Slight tachycardia
Increased capillary refill
Anxiety

Dry mucous membranes

Severe Dehydration

Poor skin turgor

Cool truncal skin
Sunken fontanel/eyes
Rapid, thread pulse
Supine hypotension
Increased thirst
Restlessness, confusion, or irritability Dry, cracked mucous membranes
Very poor skin turgor
Cold, mottled, or cyanotic skin
Sunken fontanel/ eyes
Marked tachycardia & hypotension
Narrowed pulse pressure
Delayed capillary refill
Unconsciousnes
According to World Health Organization, there are 48 countries that had been
affected by cholera in the past 3 years. The continents of Africa, Americas (Haiti),
Asia, and Oceania were the ones which are mostly affected by this infection.
Nevertheless, it has occurred an overwhelming 52% increase of reported cases last
2009 to 2010 in the countries globally and which did not spared 45% of lives from
32 countries with reported cases of deaths.
In May 2011, the re-emergence of its cases pushed through a more integrated and
comprehensive management utilizing strong surveillance, early detection and
control, and prevention strategies.
Prevention

Provision or assisting the community to access to potable and clean water

resource i.e. boiling water if not sure to be clean

Teaching the community on proper sanitation practices, handling and

preserving food

Educating them of the importance of hand washing before handling or eating

food, and after defecating

Proper detection of cases as part of rigid surveillance.

(WHO Standard case definition) Cholera case is suspected if:

in an area where the disease is not known to be present, a patient aged 5

years or more develops severe dehydration or dies from acute watery diarrhoea;


in an area where there is a cholera epidemic, a patient aged 5 years or more
develops acute watery diarrhoea, with or without vomiting.