Cholera is a bacterial infection caused by consuming food or water contaminated with the bacterium Vibrio cholerae. The incubation period for cholera typically ranges from 1 to 5 days, but it can vary from just a few hours to a maximum of 5 days. The Vibrio cholerae bacteria thrive in contaminated water sources, such as rivers, lakes, and wells, often used for drinking, cooking, and other domestic purposes.

History of Cholera

Cholera has existed for many centuries. The first global epidemic occurred in the 19th century, and since then, six pandemics have claimed millions of lives worldwide. The current, seventh pandemic began in South Asia in 1961 and continues to impact populations around the globe.

Cholera vs. Diarrhea

Cholera and diarrhea share some similar symptoms, but they are not the same. Cholera is a specific type of diarrheal disease caused by an infection of the intestine with the bacterium Vibrio cholerae, which is typically present in contaminated food or water. In contrast, diarrhea is a general term that refers to loose, watery stools or a frequent need for bowel movements. Various factors, such as viral or bacterial infections, food poisoning, or intestinal disorders, can cause diarrhea.

Cholera is characterized by a rapid onset of diarrhea and vomiting, whereas diarrhea can develop more gradually. Furthermore, cholera can lead to severe and life-threatening dehydration, while diarrhea is often milder in comparison.

How Do You Know?

Cholera is usually diagnosed through physical examination, medical history, laboratory tests, and occasionally imaging studies. The common methods for diagnosing cholera include these approaches:

1. Physical Examination and Medical History

 a. Symptom Assessment: The doctor will inquire about symptoms, including diarrhea, vomiting, and signs of dehydration.

b. Physical Examination: The doctor will look for signs of dehydration, such as dry mouth, sunken eyes, and reduced urine output.

2. Laboratory Tests

a. Stool Test: A stool sample is collected and sent to a laboratory to check for the presence of the Vibrio cholera bacterium. The types of stool tests include:

i. Microscopic Examination: A laboratory technician examines the stool sample using a microscope to identify Vibrio cholerae.

ii. Rapid Diagnostic Test (RDT): This is a quick test that detects the presence of cholera antibodies in the stool sample.

 iii. Culture Test: This test involves growing the bacteria from the stool sample in a laboratory to confirm the presence of Vibrio cholerae.

3. Imaging Studies

a. Abdominal X-ray: An abdominal X-ray may reveal signs of dehydration, such as decreased bowel gas and intestinal distension.

Who Is At Risk

Cholera can affect anyone, but certain individuals are at a higher risk of infection and severe illness. Children under five years old whose immune systems are still developing may often engage in hand-to-mouth contact and can easily get affected by the cholera bacteria. People with weakened immune systems, such as those living with HIV/AIDS, cancer, or those taking immunosuppressive medications, are also more vulnerable.

Additionally, individuals living in areas with poor sanitation and hygiene are at increased risk since the cholera bacteria are common in environments with inadequate waste management, including open defecation, lack of clean water, and poor hygiene practices. Pregnant women are at risk for cholera as well and this can lead to complications such as miscarriage, premature birth, and low birth weight.

Furthermore, malnourished individuals are more susceptible to cholera because malnutrition can compromise immune function, making it more difficult for the body to fight off infections. Older adults also have a higher risk of cholera due to age-related declines in immune response and the potential presence of underlying health conditions.

Symptoms of Cholera

Most people infected with cholera do not show any symptoms, although the bacterium can be found in their feces for 1 to 10 days after infection. Symptoms typically appear 5 to 12 days after infection. Some common symptoms of cholera include;

• Diarrhea: Cholera is characterized by profuse, watery diarrhea, often referred to as "rice-water stool."
• Vomiting: Many individuals with cholera experience vomiting, which can contribute to dehydration.
• Dehydration: Cholera can cause severe dehydration, potentially leading to shock, organ failure, and even death.
• Low Blood Pressure: A significant drop in blood pressure can occur due to cholera.
• Rapid Heart Rate: Dehydration may result in a rapid heartbeat.
• Dry Mouth and Thirst: Patients often experience a dry mouth and intense thirst.
• Sunken Eyes: Dehydration can cause the eyes to appear sunken.

Severe Symptoms

• Severe Dehydration: If left untreated, cholera can lead to severe dehydration, which may result in seizures, coma, and even death.
• Kidney Failure: Severe dehydration can also cause kidney failure.
• Shock: Cholera can induce shock, potentially leading to organ failure.

As of November 25, 2024, there have been 490,700 reported cholera cases and 3,693 deaths worldwide. The five countries with the highest number of cholera cases are Afghanistan: 160,794 cases; Sudan: 35,675 cases; the Democratic Republic of the Congo: 28,618 cases; the United Republic of Tanzania: 7,248 cases and Burundi: 2,200 cases. This data shows how fatal cholera can be if left untreated. If you suspect that you or someone else has cholera, it is crucial to seek medical attention immediately.

REFERENCE

Information from https://www.who.int/news-room/fact-sheets/detail/cholera#:~:text=Researchers%20estimate%20that%20there%20are,oral%20rehydration%20solution%20and%20antibiotics, https://www.afro.who.int/news/who-provides-technical-support-fight-cholera-outbreak-ghana, https://www.unicef.org/ghana/stories/cholera-prevention-your-guide-stayingsafe#, and www.ecdc.europa.eu/en was used in this story