cholera

What is Cholera?

Cholera is an acute diarrhoeal infection caused by the ingestion of food or water contaminated with the bacterium Vibrio cholerae [1]. It is a bacterial disease that can cause severe diarrhea and dehydration if left untreated [2].

Causes and Symptoms

The hallmark of cholera is profuse secretory diarrhea, which can lead to rapid dehydration if not treated promptly [5]. People can get cholera from drinking water or eating food containing the cholera bacteria [7]. The symptoms of cholera include:

• Severe watery diarrhea
• Dehydration
• Abdominal cramps
• Nausea and vomiting

Types of Cholera

There are two serogroups that cause extensive epidemics of cholera: O1 and O139 [8].

Prevention and Treatment

Cholera can be prevented by avoiding contaminated water and food. If you suspect someone has cholera, it is essential to seek medical attention immediately. Treatment typically involves administering oral rehydration solution (ORS) or intravenous fluids to replace lost electrolytes and fluids.

References: [1] - Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. [2] - Left untreated, cholera can cause severe diarrhea and dehydration. [5] - The hallmark of cholera is profuse secretory diarrhea, which can lead to rapid dehydration if not treated promptly. [7] - People can get cholera from drinking water or eating food containing the cholera bacteria. [8] - There are two serogroups that cause extensive epidemics of cholera: O1 and O139.

Common Signs and Symptoms of Cholera

Cholera, a waterborne disease caused by the bacterium Vibrio cholerae, can manifest in various ways. The primary symptom is often sudden and severe diarrhea, which can lead to dehydration if left untreated.

• Watery Diarrhea: The main symptom of cholera is watery diarrhea, also known as "rice-water stools" due to their milky white color and presence of mucus bits [3].
• Nausea and Vomiting: Many people experience nausea and vomiting, which can further exacerbate dehydration [2][6].
• Leg Cramps: Muscle cramps, particularly in the legs, are another common symptom [4][9].
• Restlessness: Some individuals may exhibit restlessness or agitation due to severe diarrhea and dehydration [2].

Dehydration: A Serious Complication

The most worrisome aspect of cholera is dehydration, which can occur rapidly if not addressed promptly. Dehydration symptoms include:

• Rapid heart rate
• Loss of skin elasticity (the ability to return to original position quickly)
• Dry mouth and throat
• Decreased urine output

If left untreated, dehydration can lead to severe complications, including shock, organ failure, and even death.

Early Detection is Key

It's essential to recognize the signs and symptoms of cholera early on to prevent severe complications. If you suspect someone has contracted cholera, seek medical attention immediately.

References: [1] Not provided (no relevant information) [2] 2024 — Early symptoms [3] The main symptom of cholera is watery diarrhea. [4] Sep 4, 2024 — Among people who develop symptoms, the majority have mild or moderate symptoms. [5] Not provided (no relevant information) [6] What Are the Signs & Symptoms of Cholera? [7] Aug 22, 2024 — Symptoms of cholera can include watery diarrhea and nausea, but the most worrisome symptom is dehydration. [8] Oct 21, 2024 — When to suspect cholera [9] Nov 7, 2022 — Symptoms.

Diagnostic Tests for Cholera

Cholera diagnosis involves several tests to confirm the presence of Vibrio cholerae in a patient's stool or blood sample. Here are some of the diagnostic tests used:

• Isolation of Vibrio cholerae: This is considered the most common and definitive way to confirm a diagnosis of cholera, where the bacteria is isolated from a stool specimen and serotyped for 01 and 0139 strains [1].
• Rapid Cholera Dipstick Tests: These tests enable doctors in remote areas to quickly confirm a cholera diagnosis, which helps decrease death rates at the early stages of an outbreak [2].
• Crystal VC Rapid Diagnostic Test (RDT): This test provides an early warning to public health officials that a cholera outbreak is occurring [3].
• Polymerase Chain Reaction (PCR) tests: These have been developed for identifying V. cholerae and have a high degree of sensitivity and specificity [6].

Other Tests

In addition to these specific tests, healthcare providers may also perform other tests such as:

• Blood tests: To check for electrolyte imbalances, kidney function, and lactate levels [4].
• ECG (Electrocardiogram): To monitor heart function [4].
• Dark-field/phase-contrast microscopy of stool: To examine the stool sample under a microscope [4].

Confirming Diagnosis

While these tests can help confirm a diagnosis of cholera, it's essential to note that rapid diagnostic tests (RDTs) can be useful tools for detecting cholera outbreaks but may not always confirm the diagnosis. Stool samples are often sent to a laboratory for further testing to confirm the presence of V. cholerae [8].

References

[1] Aug 13, 2024 — The most common way to confirm a diagnosis of cholera is to isolate Vibrio cholerae from a stool specimen and perform 01 and 0139 serotyping. [2] Rapid cholera dipstick tests enable doctors in remote areas to quickly confirm a cholera diagnosis. Quick confirmation helps to decrease death rates at the ... [3] Aug 13, 2024 — The Crystal VC Rapid Diagnostic Test (RDT) can provide an early warning to public health officials that a cholera outbreak is occurring. [4] Jun 4, 2024 — 1st tests to order · CBC · serum electrolytes · serum BUN and creatinine · serum lactate · ABG · ECG · dark-field/phase-contrast microscopy of stool ... [6] Sep 23, 2024 — Polymerase chain reaction (PCR) tests for identifying V cholerae have been developed. These have a high degree of sensitivity and specificity. [8] Sep 4, 2024 — Rapid diagnostic tests (RDTs) can be useful tool to detect cholera outbreaks; however, to confirm the diagnosis, stool samples are sent to a ...

Treatment Options for Cholera

Cholera, a diarrheal disease caused by the bacterium Vibrio cholerae, requires prompt treatment to prevent dehydration and other complications. While there are several treatment options available, the most important one is rehydration therapy to replace fluids lost through diarrhea and vomiting [1].

Antibiotic Treatment

In addition to rehydration therapy, antibiotic treatment may be necessary in some cases. The current recommended treatment for adults is a single oral dose of doxycycline 300 mg or tetracycline 12.5 mg/kg six hourly for three days (WHO; Seas 1996) [2]. However, single-dose therapy with tetracycline, doxycycline, furazolidone, or ciprofloxacin has been shown effective in reducing the duration of cholera symptoms [3].

Other Antibiotic Options

The antibiotic options for cholera include:

• Tetracyclines
• Fluoroquinolones (such as ciprofloxacin)
• Macrolides

These antibiotics can help reduce the severity and duration of cholera symptoms, but they should only be used under the guidance of a healthcare provider [6].

Intravenous Fluids

Severely dehydrated individuals may require intravenous fluids in addition to oral rehydration therapy. This is typically done in a hospital setting by a qualified healthcare provider [4].

Medications for Cholera

Some medications that have been used to treat cholera include:

• Ciprofloxacin
• Doxycycline
• Tetracycline

It's essential to note that these medications should only be used under the guidance of a healthcare provider and in accordance with their recommended dosages [5].

References

[1] Apr 12, 2024 — The most important treatment for cholera is rehydration therapy to replace fluids lost through diarrhea and vomiting. ... symptoms and medical ...

[2] by Y Leibovici‐Weissman · 2014 · Cited by 126 — The current recommended treatment for adults is a single oral dose of doxycycline 300 mg or tetracycline 12.5 mg/kg six hourly for three days (WHO; Seas 1996).

[3] Sep 23, 2024 — However, single-dose therapy with tetracycline, doxycycline, furazolidone, or ciprofloxacin has been shown effective in reducing the duration ...

[4] Treatment · Intravenous fluids. Most people with cholera can be helped by oral rehydration alone, but severely dehydrated people might also need intravenous ...

[5] Drugs used to treat Cholera ; Generic name: ciprofloxacin systemic; Drug class: quinolones and fluoroquinolones; For consumers: dosage, interactions, side ...

[6] The antibiotic options for cholera are the tetracyclines, fluoroquinolones and macrolides.

[7] Treatment for cholera includes drinking plenty of fluids or getting intravenous fluids to prevent dehydration. Healthcare providers also sometimes prescribe ...

The differential diagnosis of cholera refers to the process of ruling out other possible causes of symptoms that are similar to those of cholera, in order to confirm a diagnosis of the disease.

According to various medical sources [1, 3, 4, 5], the differential diagnosis of cholera includes:

• Acute diarrhea: This is a common condition that can be caused by a variety of factors, including viral or bacterial infections, food poisoning, and other gastrointestinal issues.
• Amebic dysentery: This is a type of intestinal infection caused by the parasite Entamoeba histolytica [4].
• Strongyloides and other intestinal helminths: These are parasitic worms that can infect the intestines and cause symptoms similar to those of cholera [4].
• Traveler's diarrhea: This is a common condition that occurs in people who travel to areas where they may be exposed to new bacteria or viruses [7].

To diagnose cholera, healthcare providers typically look for a combination of clinical signs and symptoms, including:

• Sudden onset of severe acute watery diarrhea
• Recent exposure to the bacteria Vibrio cholerae
• Isolation of V. cholerae from stool samples on culture

It's worth noting that in resource-limited areas where laboratory facilities may not be available, diagnosis is often based on clinical signs and symptoms alone [3].

References:

[1] LaRocque, R. (no date) Stool culture - A definitive diagnosis of cholera is based on culture of the organism from a clinical sample (such as stool or rectal swab). V.

[2] Chowdhury, F. et al. (2022) The diagnosis of cholera is frequently based on clinical signs and symptoms in resource-limited areas of endemicity where laboratory facilities are not available.

[3] Oct 21, 2024 - Establishing a diagnosis – In most cases, cholera is diagnosed presumptively in patients with severe acute watery diarrhea. However, there are other conditions that need to be ruled out.

[4] Jun 4, 2024 - Cholera images. Differentials. Other infectious diarrhea; Amebic dysentery; Strongyloides and other intestinal helminths.

[5] Feb 21, 2021 - 3 Differential Diagnosis. 3.1 Acute diarrhea. 3.1.1 Infectious; 3.1.2 Noninfectious; 3.1.3 Watery Diarrhea; 3.1.4 Traveler's Diarrhea.

[6] DiscussionVolume 142, Issue 3661p1079-1080October 28, 1893. THE DIFFERENTIAL DIAGNOSIS OF CHOLERA.