According to the World Health Organization, 3-5 million cases of cholera are seen every year in developing countries and almost 100 thousand of these cases result in death. Usually mild and asymptomatic, the disease can sometimes become severe and, if left untreated, it can result in death. Cholera, a contagious disease, first appeared in India and spread all over the world between 1827-1975. This disease, which is only seen in humans, is a very important public health problem in developing countries. Refugees and migration increase the risk of getting cholera. It is more common in arid and desert-covered areas and in summer.
What is cholera?
Cholera disease, which spreads easily and causes fatal effects in societies affected and fighting by natural disasters and poor crowded groups, is an infection caused by the bacteria of vibrio cholerae in the small intestine. Vibrio cholerae produces a poison called enterioxin that has a protein structure in the small intestine. Enterioxin causes the secretion of an enzyme called adenyl cyclose from the epithelium cells located in the wall of the small intestine. This enzyme causes the body fluid to pass into the cavity by increasing the production of a substance called 3,5 monophosphate of cyclose endorozin. Fluid and electrolytes taken into the body are excreted from the small intestines without being reabsorbed, and serious disease symptoms begin to manifest within the first 6-48 hours after the pathogenic bacteria are taken into the body.
What are the symptoms of cholera?
The first sign of cholera disease is severe diarrhea. Cholera is suspected when very watery and painless diarrhea accompanies vomiting. In addition to these symptoms;
• Shock due to fluid loss,
• Abdominal pain and abdominal swelling,
• Due to vomiting and diarrhea, electrolytes from the body are lost and muscle cramps develop accordingly,
• Respiratory failure and bruising,
• Dryness in the mouth and hoarse voice specific to cholera,
• Eyes collapse, abdomen collapses, skin wrinkles,
• Low blood pressure, fatigue, weakness and moaning,
• Increased heart rate
• Excessive thirst.
What are the causes of cholera?
Cholera disease is caused by a pathogenic bacteria called vibrio cholerae. The contamination of sewage with drinking water is one of the most important spreading causes of the disease. Drinking or using the water mixed with the microbe is sufficient for it to enter the body. Washing vegetables and fruits with dirty water and consuming vegetables and fruits without washing are among the causes of cholera transmission. Eating with the plates, glasses, forks used by a cholera patient, using their towel, and wearing their clothes cause the disease to become infected. Paper money and house flies also play an important role in the spread of cholera. Consuming undercooked and raw seafood also increases the risk of developing cholera disease.
How is cholera diagnosed?
The incubation period of cholera varies between 6 hours and 48 hours. There is a painless diarrhea and the stool is in the form of discharge from the intestines. Odorless and reminiscent of rice water, the stool contains white substances similar to rice grains. The vomiting of the cholera patient is also in the form of gushing. Body temperature can drop to 32-35 degrees and kidney failure is seen in 10% of the patients. Less urination (oliguria) or no urination (anuria) is observed. If the anuria condition persists for more than 24 hours, the patient may be lost. The stool of the patient suspected of cholera is sent to the laboratory and under the microscope, very fast moving bacilli are observed at first glance. Stool culture is done for definitive diagnosis. If bacteria that grow in culture produce toxins, they may be the harbinger of large-scale outbreaks.
What are the treatment methods for cholera?
The first thing to do for the treatment of cholera disease is to replace the lost fluid and electrolytes. The patient is immediately admitted to the hospital and the vascular access is opened and the treatment is started with fluid and liquid. Timely and correct intervention is of great importance for the excretion of bacteria in the small intestine that cause cholera. The patient is given plenty of packaged oral rehydration solution containing sugar and salt. Intravenous fluid therapy has a curative effect on 99% of the patients. Cholera vaccine is especially important in epidemic periods. The vaccine protects 50% of the disease. Even if the condition of cholera patients returns to normal, the pathogenic bacteria will take 7 more days to be eliminated from the body. In order to understand that the bacteria are completely excreted from the body, 2 stool cultures should be taken every 24 hours. If both cultures are negative, it is an indication that the bacteria have been completely excreted.