Cholera

Susceptible Host:
A person can get cholera by drinking water or eating food contaminated with the cholera bacterium. Large
epidemics are often related to fecal contamination of water supplies or street vended foods. The disease is
occasionally transmitted through eating raw or undercooked shellfish that are naturally contaminated.
Causative Agent: Vibrio cholerae O-group 1 or O-group 139.
Environment:
Brackish and marine waters are a natural environment for the etiologic agents of cholera, Vibrio cholerae
O1 or O139. There are no known animal hosts for Vibrio cholerae, however, the bacteria attach themselves
easily to the chitin-containing shells of crabs, shrimps, and other shellfish, which can be a source for human
infections when eaten raw or undercooked.
Susceptibility:
Cholera is most likely to be found and spread in places with inadequate water treatment, poor sanitation,
and inadequate hygiene.
Subclinical:
Infection is often mild or without symptoms, but sometimes it can be severe.
Clinical:
Approximately 5-10% of persons will have severe cholera which in the early stages includes:
profuse watery diarrhea, sometimes described as rice-water stools,
vomiting
rapid heart rate
loss of skin elasticity
dry mucous membranes
low blood pressure
thirst
muscle cramps
restlessness or irritability
Resolution:
Infected persons, when treated rapidly, can recover quickly, and there are typically no long term
consequences. Persons with cholera do not become carriers of the disease after they recover, but can be reinfected if exposed again.
Levels of Prevention:
Primary
Vaccinations1. Dukoral (manufactured by SBL Vaccines)
2. ShanChol (manufactured by Shantha Biotec in India.
Education
1. Drink and use safe water
2. Good hand hygiene
3. Use latrines or bury your feces; do not defecate in any body of water
4. Cook food well (especially seafood), keep it covered, eat it hot, and peel fruits and
vegetables
5. Clean up safelyin the kitchen and in places where the family bathes and washes clothes

Secondary:
Stool Culture

Interventions:

Cholera

Cholera can be simply and successfully treated by immediate replacement of the fluid and salts lost through
diarrhea. Patients can be treated with oral rehydration solution, a prepackaged mixture of sugar and salts to
be mixed with water and drunk in large amounts. This solution is used throughout the world to treat
diarrhea. Severe cases also require intravenous fluid replacement. With prompt rehydration, fewer than 1%
of cholera patients die.
Antibiotics shorten the course and diminish the severity of the illness, but they are not as important as
receiving rehydration. Persons who develop severe diarrhea and vomiting in countries where cholera occurs
should seek medical attention promptly.

Symptomatology: