Cholera is an acute, diarrheal illness. It is caused the bacteria name as Vibrio cholerae. It is the infection of the intestine. The infection is often mild or without symptoms, but sometimes it can be severe. Vomiting also occurs in most patients.

Less than 10% of ill persons develop typical cholera with signs of moderate or severe dehydration.

The watery diarrhea is speckled with flakes of mucus and epithelial cells ("rice-water stool") and contains enormous numbers of vibrios. The loss of potassium ions may result in cardiac complications and circulatory failure.

Causes

Cholera is an acute illness characterized by watery diarrhea. The toxin released by the bacteria causes increased secretion of water and chloride ions in the intestine, which can produce massive diarrhea.

Cholera occurs in epidemics when conditions of poor sanitation, crowding, war, and famine are present. The infection is acquired by ingesting contaminated food or water.

In the United States, cholera was prevalent in the 1800s but has been virtually eliminated by modern sewage and water treatment systems. However, as a result of improved transportation, more persons from the United States travel to parts of Africa, Asia, or Latin America where epidemic cholera is occurring.

Symptoms

Symptoms include those of general GI tract upset, including profuse diarrhea. Symptoms are caused by the enterotoxins that V. cholerae produce.

Few symptoms are given below-

1) The first sign of cholera may be mild diarrhoea. This is followed by sudden violent purging.

2) The stools are loose, watery, and greyish-brown in colour. Diarrhoea is usually accompanied by nausea and vomiting.

3) The patient gets severe cramps in the stomach, and feels very thirsty and restless. The temperature rises, but the skin is generally cold and clammy and the pulse is weak. In the next stage, the body becomes colder; the skin dry, wrinkled, and purple; the voice weak and husky; and the urine, scanty and dark.

4) The blood pressure falls, the cramps are agonizing, and signs of collapse appear rapidly.

Dehydration can occur rapidly

*Rapid pulse (heart rate)

*Dry skin

*Dry mucous membranes or dry mouth

*Excessive thirst

*Glassy eyes or sunken eyes

*Unusual sleepiness or tiredness

*Low urine output

*Sunken "soft spots" (fontanelles) in infants

Treatment

Cholera can be simply and successfully treated by immediate replacement of the fluid and salts lost through diarrhea. Patients can be treated with oral rehydration solution which is a prepackaged mixture of sugar and salts to be mixed with water and drunk in large amounts. . During an epidemic, 80-90% of diarrhoea patients can be treated by oral rehydration alone, but patients who become severely dehydrated must be given intravenous fluids.

In severe cases, an effective antibiotic can reduce the volume and duration of diarrhoea. Tetracycline is the usual antibiotic of choice. Other antibiotics that are effective when V. cholerae are sensitive to them include cotrimoxazole, erythromycin, doxycycline, chloramphenicol and furazolidone.