Cholera Information

Cholera is a bacterial disease that is usually spread through contaminated water. It often causes severe diarrhea, and this infection can cause death to the human body extremely quickly—sometimes within hours. Thanks to the water and sewage treatment facilities available in industrialized countries, cholera is very rare in such places. It is, however, still a concern in some parts of the world. It is seen most at times and in places where it can least be tolerated, such as during times of war or famine, when people are forced to live in refugee camps or food distribution camps. Such close quarters, combined with lack of hygiene, causes cholera to spread quickly. Fortunately, cholera can be easily treated. Since death is usually due to the dehydration caused by diarrhea, rehydration can restore health. The bacterial infection itself can be treated with antibiotics.

Cholera is caused by a bacterium, Vibrio cholerae, which spends part of its life cycle in nature and part of it inside humans. The main source of a cholera infection or outbreak is contaminated water supplies, though the bacteria can also live in raw shellfish, uncooked fruits and vegetables, and other foods. Vibrio cholerae occur in coastal waters, where they attach to tiny crustaceans called copepods. Copepods eat certain algae and grow extremely fast in warm waters. Algae grows fastest when it feeds on sewage and agricultural runoff—which contains animal waste. When the algae prosper, so do the copepods, and therefore, so do the cholera bacteria. Because of this lifecycle, most serious cholera outbreaks happen in the spring and fall. When humans walk in this water or eat food from it, the bacteria are ingested as well. When the bacteria are excreted through human feces, food or water supplies can become contaminated. A large number of the bacteria are needed to cause serious sickness, so cholera is not transmitted through person-to-person contact, but through sources that many people have common access to.

Some of the most common of these include:

• Surface or well water. Vibrio colerae can live in water for long periods, so when a source of water is not sanitary, or when there is too close a contact between sewage and non-purified water, everyone who uses that water source can be exposed to cholera. This is why people living in crowded camps are at such high risk.

• Seafood. Shellfish are particularly high-risk, and seafood that comes from the Gulf of Mexico is also a concern. In some cases, seafood that is smuggled from other countries where cholera is more common is the culprit. If the seafood is cleaned and thoroughly cooked, there is little risk of cholera.

• Raw fruits and vegetables. If you eat food that grows in the ground, with its outer skin or peel still on, you have exposed yourself to the soil in which it grew. This soil may have been exposed to manure-based fertilizer or to sewage which carries the cholera bacteria.

• Grains. If cholera is already present in a region, when grains are cooked and left to return to room temperature, they become an ideal medium for the vibrio cholerae to inhabit and reproduce. When these cooked grains are eaten, they become a course of infection.

Even if you have been exposed to the bacteria that cause cholera, chances are that you never knew you had it. Unfortunately, the bacteria still live in your stool, and if your conditions aren’t sanitary, they can spread to others for up to fourteen days. Diarrhea is the chief symptom of cholera, but most people experience such a mild case of if that they do not distinguish it from normal diarrhea that occurs for other reasons. There are symptoms characteristic of cholera, but these only occur in one out of every ten people who contract cholera.

These symptoms are:

• Severe diarrhea. This diarrhea comes on suddenly, and it is watery and milky in appearance. There is a great deal of mucous and dead cells in the diarrhea, and a great deal of it comes at once. The danger of cholera is in dehydration, and most of the body’s fluids are lost through the diarrhea.

• Nausea and vomiting. These occur in addition to diarrhea and can last for hours. Nausea and vomiting happen at the onset of cholera, and in its later stages.

• Muscle cramps. As the body’s fluids drain out in the diarrhea, and to a lesser extent, in the vomit, so do valuable minerals such as sodium and potassium. The leeching of minerals from the muscles causes the muscles to cramp.

• Dehydration. This can develop within hours of the onset of diarrhea. Signs of dehydration can include lethargy, dry mouth, extreme thirst, irritability, little urine output, irregular heartbeat, and low blood pressure.

• Shock. As the fluids leave the body, blood volume and pressure drops dramatically, and the result is that oxygen cannot reach your organs and tissues. Deprived of oxygen, these begin to die. This is the actual cause of death in cholera: shock due to severe dehydration.

• Extreme drowsiness. This can lead to coma, and is one of the signs to look for in children.

• Fever. Any infection will lead to a fever, but a high fever combined with other symptoms may point to cholera.

• Convulsions. Severe dehydration can lead to convulsions, especially in children.

Outbreaks should be contained as fast as possible, because cholera can quickly become fatal. Some of the most serious complications of cholera include:

• Hypoglycemia. Also called low blood sugar, this complication occurs when the blood sugar falls abnormally low and people are too sick to eat to replenish it. This can lead to seizures, coma, or death.

• Hypokalemia. Also called low potassium levels. Too little potassium can interfere with heart and nerve functions, and is especially serious in those who already have low levels because of malnutrition.

• Kidney failure. When kidneys can no longer filter, waste builds up in the body and poisons you. This condition often accompanies shock.