A bacterial condition that usually spreads to humans through contaminated water is called cholera. It causes severe diarrhea and dehydration, and left untreated can be fatal within a few hours.
While in industrialized countries cholera is eliminated, it continues to exist in Africa, Southeast Asia, and other regions. Moreover, the risk of getting cholera significantly increases when poverty, natural disasters, or war make people live in crowded conditions.
However, this condition is easily treated. For example, death from dehydration can be prevented with cheap rehydration solutions.
Symptoms
In most cases, people who get the bacterium (Vibrio cholerae) do not experience any symptoms and do not know they are infected. However, the most common symptom of cholera is mild to moderate diarrhea. It is hard to say you are infected with this bacterial disease because there are multiple conditions that cause diarrhea. Other people may develop more severe symptoms of this disease that usually appear within several days after they get infected. For example:
- Severe diarrhea – It often happens suddenly and may lead to dangerous fluid loss (approximately 1 liter per hour). In most cases, diarrhea that is caused by cholera has a milky and pale appearance.
- Nausea and vomiting – These symptoms may also cause dehydration. Moreover, when vomiting occurs due to cholera, it may last up to several hours.
- Dehydration – This symptom usually occurs within a few hours after previous ones begin. When you lose 10% of your body weight, it usually means you are severely dehydrated. The most common signs it happens are fatigue (extreme tiredness), irritability, extreme thirst, hypotension (low blood pressure), and irregular heartbeats.
When dehydration occurs, it may remove minerals from the blood. These minerals help maintain the balance of body fluids. This health problem is usually called an electrolyte imbalance.
Electrolyte Imbalance
Check below some symptoms that occur when an electrolyte imbalance occurs:
- Muscle cramps – It often happens due to a sudden loss of salts, including potassium, chloride, and sodium.
- Shock – This is a dangerous complication of dehydration. When it happens, decreased blood volume causes hypotension. Without treatment, it may lead to severe hypovolemic shock and death within a few minutes.
If you live or travel in regions where cholera is common, you should get tested regularly each time you return from travel. If any of the previous symptoms occur, immediately contact your healthcare provider.
Causes
A bacterium called Vibrio cholerae causes this infection. The deadly effects that are caused by the disease are a result of toxins produced by these bacteria in the small bowel. When it occurs, the body begins to secrete high amounts of water that causes diarrhea and a quick loss of fluids and salts (also known as electrolytes).
While not everyone who gets this bacteria becomes ill, it still passes in the stool, which may lead to contamination of the food and water supplies. However, the primary sources of cholera infection are contaminated food and water. This bacterium is usually found in the following places. For example:
- Surface or well water – Regular sources of cholera infection are contaminated public wells, especially for people who live in crowded conditions without proper sanitation.
- Seafood – Those who eat raw or undercooked seafood (including shellfish) that come from contaminated water are at higher risk of getting the infection. Commonly, people become infected with cholera in the U.S. from seafood from the Gulf of Mexico.
- Raw fruits and vegetables – If you eat raw and unpeeled fruits and vegetables from areas where cholera is common, you are more likely to develop it.
- Grains – In underdeveloped countries, you can get cholera even from grains such as millet and rice.
Risk Factors
Anyone may develop this disease. The only exception is a baby that gets immunity from the mother that have had cholera. However, physicians identified some factors that may increase your risk of developing cholera. Examples include:
- Poor sanitation – You are more likely to develop cholera where a sanitary environment is difficult to keep. These include impoverished countries, refugee camps, and during war or natural disasters.
- Decreased stomach acid – This bacterium cannot survive in an acidic environment, and stomach acid usually is a defense against cholera. However, young children, older adults, and people who administer antacids, H-2 blockers, or proton pump inhibitors may have low stomach acid levels. As a result, the bacteria can grow and multiply.
- Household exposure – If you live with an infected person, your risk of developing cholera increases.
- Type O blood – The risk of developing cholera significantly increases in people with type O blood. However, experts do not fully understand why it happens.
- Raw and undercooked shellfish – Sometimes, even industrialized nations have large-scale cholera outbreaks due to shellfish from contaminated waters.
Complications
This bacterial infection usually develops quickly and can be fatal. Death usually occurs due to loss of large amounts of fluids. Without immediate treatment, dehydration and shock occur within several hours or sometimes days. While shock and dehydration are the most severe complications of cholera, this disease may cause other complications. For example:
- Hypoglycemia (low blood sugar) – Sugar (glucose) is the primary source of energy in the body. If blood sugar drops too low, it may cause seizures, unconsciousness, and even death.
- Reduced potassium levels – You may lose a lot of minerals (such as potassium) if you have severe diarrhea. As a result, it may interact with nerve function and the heart.
- Kidney failure – This is a life-threatening condition because it affects the ability of the kidneys to filter toxins and other waste from the body. As a result, it begins to build up in the body.
How to Prevent Cholera?
Generally, cholera happens quite rarely in the U.S. It mostly occurs in people who travel in regions where this disease is common or eat contaminated shellfish. Check below some tips that may help prevent cholera when traveling:
- Regularly wash your hands with soap and water, especially after using the toilet or handling potentially contaminated foods or surfaces.
- Drink bottled water only. Usually, hot beverages are as safe as canned or bottled drinks.
- You should eat food that is completely cooked and hot.
- Avoid sushi because it commonly contains raw fish and seafood products.
- It is recommended to eat fruits and vegetables that can be peeled (such as bananas, oranges, and avocados) and avoid grapes, berries, and others that cannot be peeled.
Vaccination
Another way to prevent this disease when traveling to regions where it is common is a cholera vaccine (Vaxchora). It can be used by people between 2 and 64 years old. If you take the vaccine in liquid form, you should administer it by mouth at least 10 days before traveling.
Diagnosis
While the disease cannot be unmistakable in regions where it’s common, to confirm the condition, doctors usually perform a stool test to check for the bacteria. Early diagnosis and proper treatment are the key to preventing life-threatening complications such as severe dehydration and death.
Treatment
Without immediate treatment, this disease may cause death within a few hours after the symptoms begin. Check below some treatments usually recommended for people with cholera:
- Rehydration – It is very important to use a simple rehydration solution (such as oral rehydration salts or ORS) to prevent severe symptoms. The rehydration solution is usually available in powder form, which is made with boiled or bottled water. In addition, approximately 50% of people with cholera die, but with treatment, the rate of death decreases to less than 1%.
- Intravenous fluids – For people with severe dehydration, intravenous fluids may be needed.
- Antibiotics – These medications are used to destroy the bacteria that cause the disease. However, antibiotics are not necessary every time.
- Zinc supplements – Some studies showed that zinc lessens the symptoms, such as diarrhea and the duration of the disease.
Frequently Asked Questions
What is the primary cause of cholera?
People usually get infected with this bacterium from contaminated water. This bacterium is found in surface or well water. For more details, discuss it with your healthcare professional.
What are the main cholera symptoms?
While some people do not become ill, others may experience severe symptoms that may lead to death without treatment. These include:
- Leg cramps
- Restlessness
- Irritability
- Vomiting
- Severe diarrhea
If any of the previous symptoms occur, immediately contact your doctor.
How to prevent cholera?
If you planning to travel in regions where cholera is common, you can get the vaccine (known as Vaxchora) to prevent the disease. You should take it at least 10 days before traveling. If you have additional questions, ask your healthcare provider.
