Vibrio Cholera

Caroline Boucher Env. Science 1/6/12

Suppose you went on a vacation to India, and while there you decide to enjoy some local cuisine made by a street vendor. After you finished eating, your hands are messy and you opt to just wash your hands in a small trickle of water coming from a pipe from the sidewalk. But not only do you wash your hands, you throw water on your face to cool yourself down; however, little did you realize some dripped into your mouth. By the next day you have severe diarrhea and is immensely dehydrated. But what caused such horrible symptoms? The answer is cholera. Unless you do take that vacation to India, there is not too much to worry about; because thanks to modern hygienic advances, such as clean sanitation systems and drinking water, the disease is rare in the US and other developed countries. However, it remains a huge public health problem in countries where hygienic practices and sanitation systems are not established. For example, the cholera epidemic in parts of Africa has been ongoing for more than 30 years, due to inadequate sanitation and water treatment systems. People who are most suitable to acquire the disease include: young children, type O blood, low immune system (AIDS or malnourished) and even people with genetic diseases. If you believe you have cholera, contact a doctor immediately. The doctor will first perform a physical exam. They will also ask you a few questions such as, recent travel history, food consumption, medicine intake, and medical history. If they suspect cholera, he will ask for a stool sample; this is only way to actually confirm a diagnosis. Other ways of finding a diagnosis is dipstick tests and swab samples. These methods are mostly used remote areas because they are quicker. Transmission usually results from consuming water or food that is contaminated with feces from an infected person. This kind of transmission is common in areas with poor sewage systems and unclean drinking water. The bacteria may also live in brackish rivers and coastal

waters. Shellfish eaten raw have been a source of cholera, and a few persons in the United States have contracted cholera after eating raw or undercooked shellfish from the Gulf of Mexico. The disease is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk for becoming ill. Within 6 hours to 5 days after exposure, the symptoms range from being mild to severe. Characteristics include: huge volumes of explosive watery diarrhea (sometimes called "rice water" because of the similarity of appearance to water that has been used to wash rice and having a fishy odor), vomiting, and leg cramps. Due to rapid loss of fluids (up to 20 liters daily), severe dehydration and shock can occur in these individuals. Signs of dehydration include loss of skin plasticity, sunken eyes, fast heartbeat, low blood pressure, and rapid weight loss. Shock occurs as a result of collapse of the circulatory system. The disease is treated using oral rehydration therapy (ORT), which consists of large volumes of water mixed with a blend of sugar and salts. The goal is to replace lost fluids and electrolytes using a simple rehydration solution. Prepackaged powdery mixtures are available that can be mixed in a bottled water, but distribution in developing countries is limited by cost. Therefore, homemade ORT recipes using common household ingredients and materials have been developed. Several cases of cholera require intravenous fluid replacement if the person is extremely weak. Antibiotics can also shorten the illness, but may reduce both the amount and duration of cholera-related. Do not use anti-diarrheal medicines, since they prevent flushing of the bacteria out of the body. So remember next time you take that vacation to India. Cholera is a horrible and nasty disease to get. Remember to be careful as to what you eat and drink and you should be fine. Finally, be thankful that we live in a developed country and do not have to worry about it.

References
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