Cholera is a very old disease and have been affecting humans for quite sometime. It was discovered in 1883. It is caused by the bacterium Vibrio Cholerae. This bacteria affects the small intestine and its main effects on the body are dehydration and electrolyte imbalance. Treatment therefore should be based on replenishing fluids and possible treatment with antibiotics, however antibiotics are not always indicated.
Poor countries like Haiti are especially prone to the cholera disease. Cholera thrives in unsanitary conditions like contaminated drinking water and food. Because of the unfortunate occurrences that occurred with the earthquake, and the fact that many of the displaced earthquake victims are still living in temporary tents under squalled conditions, these conditions are ideal for the spread of the cholera bacteria and now have resulted in the spreading of this epidemic.
Under ideal conditions the cholera bacteria is normally controlled by the acidity of the stomach. However when the bacterial growth has reached levels above 1 million cholera bacteria, then some of these bacterium will escape the acidity of the stomach and will make it to the small intestine. In the small intestine the bacteria will focus on getting to the wall of the intestine. It does so by producing a whip like flagella that propels the bacteria from the lumen of the intestine, through the mucus layer and then into the intestinal wall. After the bacteria reaches the intestinal wall, it will conserve its energy and stop producing flagellin. They then start producing toxins. These toxins cause are the cause for the diarrhea. The bacteria operate by turning off certain beneficial protein production while at the same time begins the production of toxins which drive chlorine outside of the wall of the intestine into the lumen.
The patients in Haiti with cholera will experience weakness, extreme dehydration, diarrhea, cramps in the abdomen and vomiting. Hypotension will be one of the earlier signs as the diarrhea starts. If patients do not receive medical attention shortly after the symptoms appear will most likely experience hypovolemic shock or distributive or septic shock due to the levels of bacteria building up in the blood stream. Some patients will also experience changes in their voice which will become weak and high-pitched. The skin of most patients will be cold, the eyes will appear sunken and the patient will experience extreme thirst. As the disease progresses the patient will experience acidosis, hypokalemia , which is the term for below normal levels of potassium in the blood, and also hyponatremia which is the term for below normal levels of sodium in the blood. As fluid balance and hemodynamic instability persists, there will eventually occur kidney failure.
The treatment of cholera soon after the symptoms appear is essential for early recovery. It is highly recommended to administer clear, clean fluids and electrolytes to the victim in order to replenish the fluid volume and electrolytes that have been lost. The administration of antibiotics, is highly suggested for rapid recovery. However the principal treatment remain replenishing of fluids and electrolytes. When medical attention is given the mortality of cholera is only 1%, however unattended the mortality rate is upwards of 60%.