Cholera has made the news lately with the devastation to the Caribbean nation of Haiti. This nation is still recovering from a 7.0 magnitude earthquake and severe weather. Flooding from Hurricane Tomas only made conditions worse for this population. These disasters set up prime conditions for Cholera. Cholera is now endemic in many countries. Since the 19th century, cholera has had six subsequent pandemics killing millions across all continents.
With the exposure to contaminated or untreated drinking water, an acute intestinal infection occurs from the bacteria Vibrio Cholerae. An infection of the small intestine causes watery diarrhea. The incubation period could be less than one day to 5 days. Watery diarrhea quickly leads to severe dehydration and even death. Symptoms can be mild to severe. Cholera occurs in places with poor sanitation, crowding, war, and famine or any location that has had a disaster that disrupts water and sanitation. At risk are camps for refugees or displaced people, slums or any area where minimum requirements of clean water and sanitation are not met. Other routes of infections occurs from contaminated fish and shellfish, contaminated produce or from leftover cooked grains that have not been properly reheated.
Symptoms include abdominal cramps, dry mucus membranes or dry mouth, dry skin, excessive thirst, glassy or sunken eyes, lack of tears, lethargy, low urine output, nausea, rapid pulse, dehydration, sunken “soft spots” in infants, tiredness , vomiting, and watery diarrhea (diarrhea starts with a “fishy” odor and stools look like water with flecks of rice in it).
Diagnosis and Tests: Blood and stool cultures:
Treatment is to replace fluids and electrolytes lost through diarrhea. Depending on the conditions replacement of fluids is through intravenous application or drinking fluids. Severe dehydration can cause death. Cholera is confirmed through a stool culture or rectal swab. The U.S. Centers for Disease Control and Prevention (CDC) does not recommend cholera vaccines for most travelers and is not available in the US. Always take precautions with food and drinking water even if vaccinated. Efforts in areas that have Cholera outbreaks should be directed toward establishing clean water, food and sanitation. Focus is on prevention through hygiene and soap distribution. If traveling, observe food safety recommendations in countries reporting cholera.
World Health Organization: http://www.who.int/topics/cholera/en/
Mayo Clinic: http://www.mayoclinic.com/health/cholera/DS00579