CHOLERA

 CHOLERA

 

Cholera is a disease that most of us have come across at some point, if not in real life, then probably in movies or literature. Cholera has shaped our collective consciousness as a population, because of the huge impact it has had on human history. Cholera pandemics in the early 19th century are estimated to have claimed up to tens of millions of lives.

Cholera is an infectious disease caused by a comma-shaped bacterium – Vibrio Cholerae. This bacterium causes acute diarrhea and an intestinal infection through the ingestion of contaminated food or water. Cholera is derived from the Greek word Khole meaning ‘flow of bile.’ In Latin, the word Cholera means ‘bilious diarrhea.’
Cholera is most common in children below five years but is not limited to this age group only. In endemic areas, cholera can affect all age groups and can even lead to death. The Vibrio cholerae bacterium enters the digestive and intestinal system through food and water. Within five days of eating or drinking this contaminated food or water, the person will develop painless but copious watery diarrhea. In some cases, the diarrhea is so severe that it cause acute dehydration and requires immediate hospitalization and medical attention.

Symptoms of Cholera

Within one to five days of ingesting the cholera bacterium, a person will develop symptoms that range from mild to severe. Cholera is a potentially life threatening disease and requires awareness and early recognition of the symptoms so as to avoid complications and fatalities.
Symptoms for Cholera include:

• Watery diarrhea with a ‘fishy’ smell
• Stomach cramps
• Dry mouth and skin
• Dry mucous membranes
• Loss of skin elasticity
• Excessive thirst
• Dehydration<
• Low urine output
• Leg cramps and muscle cramps
• Heart palpitations
• Nausea and vomiting
• Low blood pressure
• Exhaustion and weakness
• Sunken eyes
• Irritability and restlessness

The watery diarrhea symptom of cholera may contain flecks of mucous and cells that lend it the term ‘rice-water stools.’ The volume of diarrhea from a person suffering from cholera is very high. An adult can produce nearly 10 to 18 liters of diarrheal fluid in a day. This can cause severe dehydration rapidly and therefore requires immediate medical treatment as soon as the symptoms become evident. Dehydration can lead to renal failure, electrolyte failure, shock, coma, and even death. In countries that are underdeveloped, cholera epidemics can result in nearly 60% fatalities.
Cholera is diagnosed through a stool sample or a rectal swab. The bacterium that causes cholera is identified in the sample and treatment begins immediately.

Causes of Cholera

The bacterium Vibreo Cholerae causes cholera. This bacterium is transmitted via food or drink. Reports show that raw seafood such as oysters are particularly susceptible to contamination. Poor hygiene and undercooked food also results in contamination. Some people may be more prone to cholera if they have a deficiency or absence of hydrochloric acid in their bodies. Natural disasters such as floods and earthquakes can also lead to cholera epidemics. This happens because clean drinking water and food becomes scarce in the aftermath of such disasters. Waste disposal is also affected and poor hygiene increases the chances of cholera bacteria spreading more easily.

Remedies for Cholera

A cure for cholera generally entails antibiotics though many doctors do feel that antibiotics should be reserved for only more serious cases. Medication such as tetracycline, doxycycline, furazolidone, erythromycin, or ciprofloxacin (Cipro, Cipro XR, Proquin XR) are all used to treat cholera. Experts believe that the first step in treating cholera should include re-hydration. Oral rehydration therapy (ORT) consists of water mixed with a blend of sugar and salts to replace lost electrolytes. This mix can be blended at home or bought commercially. In severe cases, cholera may require intravenous fluid replacement. Anti-diarrheal medication should not be used in cases of cholera as they prevent the removal of bacteria and toxins from the body.
Home remedies for cholera typically help provide relief from the symptoms, but are unlikely to help cure the condition. Because of the serious nature of a cholera infection, medical attention is absolutely necessary, and home treatments should only be reserved as a backup or a complimentary treatment. Here are some home treatments that are quite popular:

• The use of lemon for example is very popular in reducing the levels of cholera bacilli in the intestines and digestive system. Lemon juice drunk either sweet or salted can help.
• A decoction of the root bark of the guava tree and boiled water should be drunk twice daily to reduce cholera symptoms such as nausea and vomiting.
• Onions and fresh black pepper ground together is another easy home remedy for cholera to treat restlessness and thirst.
• Mix equal quantities of coconut water and cucumber juice to relieve excessive thirst and prevent dehydration.
• Steep half a nutmeg in half a liter of water and make an infusion. Add to this infusion half a liter of coconut water. Administer this 15ml at a time to lessen cholera symptoms.
• Rough chaff also known as Achyranthes aspera should be mixed with half cup of water and given to the cholera patient daily.

Cholera is known to cause an intense visceral congestion. This can be treated by keeping the skin warm by applying a heated blanker or having a hot bath. Rubbing the skin till warm and red also helps. To prevent vomiting, ice bags can be applied directly to the stomach and the throat. Cold compresses on the stomach offer relief for stomach cramps and abdominal pains.
Cholera can be controlled through proper hygiene and disposal of waste matter. Clean drinking water is also imperative to prevent a cholera epidemic from occurring. If in any doubt about the cleanliness of the water, always boil before drinking. Wash food stuffs such as vegetables and fruits in a solution of potassium permanganate before eating or cooking as well.
If left untreated, cholera can become very severe very quickly and can lead to death in a matter of days. In countries where clean water and food are at a premium, cholera epidemics still have the power to incite fear due to its highly contagious nature.

Diet for Cholera

Re-hydration is the first step towards recovery from cholera. A diet for cholera patients should involve replacing lost fluids and reducing excessive thirst. Patients should drink lots of water, soda, and coconut water throughout the day. Keep in mind that too much liquid can cause vomiting, so only small amounts should be drunk at a time. Patients can even be given cubes of ice to suck on.
AS the patient’s recovery progresses, with a move from watery diarrhea to a semi solid stool stage, buttermilk can be added to the diet. As he/she recovers, semi-soft boiled rice can be introduced as well. Make sure that solid foods and uncooked vegetables are avoided completely until there is a complete recovery. The diet after recovery from cholera should include a glass of warm water with lime and honey as soon as the patient gets up. Breakfast can consist of fresh fruits and milk. Play around with variations of steamed vegetables or salads for lunch and dinner. Proteins and carbs can come in the form of cottage cheese and whole wheat tortillas. Fresh fruit juices can be had as mid morning and evening snacks.

Suggestion for Cholera

Cholera can be prevented. Developing countries have managed to control and end cholera epidemics by offering clean drinking water and food and improving levels of hygiene by providing easy access to clean toilets and hand washing facilities.
People can prevent developing cholera by maintaining a high level of hygiene, washing hands frequently, drinking clean treated water, and eating clean fresh food. There are now also vaccines available against cholera. However the effectiveness of vaccines is hotly debated, and with increased public awareness and concerns over the unethical practices of some pharmaceutical manufacturers, vaccines for cholera may not always be the best option. Unbiased reports are also not in agreement on the effectiveness of cholera vaccines, with some studies reporting a 90% success rate while others place the rate around 50%. Cholera vaccines are administered orally and offer protection for a maximum of two years. In case people are traveling to countries with a high risk of cholera, taking such vaccines are highly recommended. If traveling to a place where cholera is rife, just remember the CDC motto – “Boil it, cook it, peel it, or forget it”. Water should be drunk only from sealed bottles or purified with iodine or chlorine. Food should be had cooked and heated. Avoid ice, unclean fruits, raw foods, salads, and ice cream when traveling in high cholera areas.