Dating back centuries past, cholera is a disease that has been around for a long time. A very common case was the outbreak of cholera in London in 1854 which led John Snow to investigate the relationship between the source of water of water supply and cholera. He traced cholera occurring in that period to the company who provided them with water. He did so using spot maps and identifying people who had died of the condition. His findings led to the improvement of water supply and sanitation.
The advancement in healthcare and technology, also with the development of cholera vaccines, the occurrence of cholera may not be as high as before in developed countries where there are improved sanitary conditions in contrast to the developing countries. However, cases are still being recorded and sometimes epidemics ensue in developing countries which may be attributed to poor sanitation, unsafe drinking water, poverty, poor nutritional status. Cholera, due to its contribution in understanding how the health of the public can be affected by something they share in common, is regarded as the “Father of Public health”.
Cholera can affect anyone, an adult or a child, male or female irrespective of place or time. It is a highly contagious and could be fatal if treatment is not started early and effectively. It may begin as a single infection but could become an epidemic and affect many other people if not checked. Cholera is a bacterial infection reportedly caused by Vibrio cholerae, however, the severity of the disease may depend on the host’s factors like malnutrition, overcrowding, bad housing, genetic factors, exposure to contaminated food or water may increase susceptibility to the infection. During an epidemic, cholera is passed from one person to another and initially the increase in the number of people infected with the disease occurs at a slower pace. Also, the number of people at risk of the infection and the sources of the infection are very vital determinants of the spread of the disease.
Cholera is an acute disease that causes diarrhoea and has been reported to cause high numbers of death annually. People are exposed to the bacteria by eating contaminated food and water. As with infections, it has an incubation period of the first few hours to 5(five) days, this implies that a person can be infected without knowing and could spread the infection to others during the incubation period before showing any symptoms or signs of the infection. Outbreaks of cholera could be seasonal or spontaneous. The common symptoms of cholera include frequent passing of loose stools, vomiting, nausea, as well as symptoms and signs of dehydration depending on how severe the dehydration is at the time of presentation. There may be the presence of dry lips, increased thirst, sunken eyes, crying without tears, dry skin, lethargy, kidney damage and death if not corrected promptly.
Management of cholera includes measures that are aimed at treating the infection, correcting dehydration, treating any complications that have occurred, preventing more complications and preventing the further spread of the infection. There is also need to trace individuals who have been in contact with the infected person recently to help in curtailing the occurrence of an epidemic.
Management starts with a medical history which will include finding out the recent meal or contact with someone who had similar symptoms, and thorough physical examination. Management technique will depend on the stage at which the person is presenting.
It is important to mention that a form of treatment could be started at home or before presentation to the healthcare facility. This is the rehydration therapy commonly known as oral rehydration salt solution, where the fluids lost through diarrhoea and vomiting are replaced through liberal fluid intake. However, it is very necessary to report to your primary health care provider. Treatment modality will be determined by your primary care physician based on the findings obtained from the medical history and examination. Zinc is also important in the management of cholera in children as it reduces the duration of the diarrhoea and may prevent further episodes.
Preventive measures for cholera requires a multisectoral and multidisciplinary approach to reduce the overall burden of the disease on the people. Some useful measures include
• Proper personal hygiene like regular handwashing
• Adequate food hygiene practices to prevent contamination
• Provision and intake of safe potable water
• Proper waste disposal and management
• Adequate nutrition to strengthen the host immune system to fight infections
• Adequate environmental sanitation
• Administration of Cholera vaccines
• Health education to individuals and families in the community to identify and treat uncomplicated cases at home. Also, health education on hygienic food preparation.
• Putting adequate surveillance systems on ground to check and report recurrences.
Health quote of the week
“Healthcare is vital to all of us some of the
time, but Public health is vital to all of us all of the time.” –Charles Everett Koop