CHOLERA bacteria occur naturally in coastal waters, where they attach to tiny crustaceans called copepods. The cholera bacteria travel with their hosts, spreading worldwide as the crustaceans follow their food source.
Cholera bacteria in people
When humans ingest cholera bacteria, they may not become sick themselves, but they still pass the bacteria in their stool. When human feces contaminate food or water supplies, both can serve as ideal breeding grounds for the cholera bacteria.
Because more than a million cholera bacteria approximately the amount you’d find in a glass of contaminated water are needed to cause illness, cholera usually isn’t transmitted through casual person-to-person contact.
The most common sources of cholera infection are standing water and certain types of food, including seafood, raw fruits and vegetables, and grains.
- Surface or well water. Cholera bacteria can lie dormant in water for long periods, and contaminated public wells are frequent sources of large-scale cholera outbreaks.
- Seafood. Eating raw or undercooked seafood, especially shellfish, that originates from certain locations can expose you to cholera bacteria. Most recent cases of cholera occurring in the United States have been traced to seafood from the Gulf of Mexico.
- Raw fruits and vegetables. Raw, unpeeled fruits and vegetables are a frequent source of cholera infection in areas where cholera is endemic. In developing nations, uncompostedmanure fertilizers or irrigation water containing raw sewage can contaminate produce in the field.
- Grains. In regions where cholera is widespread, grains such as rice and millet that are contaminated after cooking and allowed to remain at room temperature for several hours become a medium for the growth of cholera bacteria.
Symptoms
Symptoms of cholera infection may include:
- Diarrhea. Cholera-related diarrhea comes on suddenly and may quickly cause dangerous fluid loss as much as a quart (about 1 liter) an hour. Diarrhea due to cholera often has a pale, milky appearance that resembles water in which rice has been rinsed (rice-water stool).
- Nausea and vomiting. Occurring especially in the early stages of cholera, vomiting may persist for hours at a time.
- Dehydration. Dehydration can develop within hours after the onset of cholera symptoms. Depending on how many body fluids have been lost, dehydration can range from mild to severe. A loss of 10 percent or more of total body weight indicates severe dehydration.
Signs and symptoms of cholera dehydration include irritability, lethargy, sunken eyes, a dry mouth, extreme thirst, dry and shriveled skin that’s slow to bounce back when pinched into a fold, little or no urine output, low blood pressure, and an irregular heartbeat (arrhythmia).
- Muscle cramps. These result from the rapid loss of salts such as sodium, chloride and potassium.
- Shock. This is one of the most serious complications of dehydration. It occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body. If untreated, severe hypovolemic shock can cause death in a matter of minutes.
Signs and symptoms of cholera in children
In general, children with cholera have the same signs and symptoms adults do, but they are particularly susceptible to low blood sugar (hypoglycemia) due to fluid loss, which may cause:
- An altered state of consciousness
- Seizures
- Coma
When to see a doctor
If you have diarrhea, especially severe diarrhea, and think you may have been exposed to cholera, seek treatment right away. Severe dehydration is a medical emergency that requires immediate care regardless of the cause.
Complications
Cholera can quickly become fatal. In the most severe cases, the rapid loss of large amounts of fluids and electrolytes can lead to death within two to three hours. In less extreme situations, people who don’t receive treatment may die of dehydration and shock hours to days after cholera symptoms first appear.
- Low blood sugar (hypoglycemia). Dangerously low levels of blood sugar (glucose) the body’s main energy source may occur when people become too ill to eat. Children are at greatest risk of this complication, which can cause seizures, unconsciousness and even death.
- Low potassium levels (hypokalemia). People with cholera lose large quantities of minerals, including potassium, in their stools. Very low potassium levels interfere with heart and nerve function and are life-threatening.
- Kidney (renal) failure. When the kidneys lose their filtering ability, excess amounts of fluids, some electrolytes and wastes build up in your body a potentially life-threatening condition. In people with cholera, kidney failure often accompanies shock.
Prevention
If you’re traveling to cholera-endemic areas, your risk of contracting the disease is extremely low if you follow these precautions:
- Wash hands with soap and water frequently, especially after using the toilet and before handling food. Rub soapy, wet hands together for at least 15 seconds before rinsing. If soap and water aren’t available, use an alcohol-based hand sanitizer.
- Drink only safe water, including bottled water or water you’ve boiled or disinfected yourself. Use bottled water even to brush your teeth. Hot beverages are generally safe, as are canned or bottled drinks, but wipe the outside before you open them.
- Eat food that’s completely cooked and hot and avoid street vendor food, if possible. If you do buy a meal from a street vendor, make sure it’s cooked in your presence and served hot.
- Stick to fruits and vegetables that you can peel yourself, such as bananas, oranges and avocados. Stay away from salads and fruits that can’t be peeled, such as grapes and berries.
Be wary of dairy foods, including ice cream, which is often contaminated, and unpasteurized milk
Courtesy: www.Mayo Clinic Staff
