Cholera: A dangerous disease comes from daily habits

Cholera, also known as cholera, is very common in our country. This is an infectious disease that spreads very quickly. Since its appearance until now, cholera has caused 7 major pandemics in the world. In our country, every year there are still thousands of cases with diverse symptoms. Why did cholera spread so quickly? What are the symptoms of the disease and how to prevent it? Where does cholera come from? These questions will be answered in the following article.

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1. What is cholera? Causes of cholera

Cholera is classified as a group A infectious disease. This is a particularly dangerous subgroup of infectious diseases. They have the ability to spread very quickly and spread widely. In addition, this group of diseases has a high mortality rate or the causative agent is unknown.

Cholera in humans is characterized by an acute infection of the gastrointestinal tract. Specifically in the small intestine. The causative agent of the disease is the cholera bacterium, because its appearance under the microscope is similar to a comma. Its scientific name is Vibrio cholera. When infected inside the body, cholera bacteria will adhere to the lining of the small intestine. Here, they proliferate and secrete toxins. It causes many gastrointestinal symptoms in humans.

Cholera: A dangerous disease comes from daily habits

2. Where is the cholera bacteria present?

Cholera is present in the feces of an infected person. Without good hygiene, pathogens can spread to water and food sources. Thereby creating a source of human-to-human transmission. Cholera is most likely to occur in places where water treatment is not up to standard and the environment is unsanitary.

Cholera bacteria can also live in the environment in coastal areas, brackish water. Aquatic species such as shrimp and crabs, shellfish, etc. are sources of cholera pathogens in nature. If not processed properly, people can get sick after eating these animals.

Cholera: A dangerous disease comes from daily habits

Raw seafood contains cholera pathogens

3. How cholera is transmitted?

The most important route of transmission is from person to person through contaminated drinking water and food . Direct person-to-person transmission through contact is very rare. Therefore, there is no need to worry about normal contact with patients or medical staff, etc.

The patient excretes the bacteria in feces and vomit. Stools containing cholera bacteria for a period of 17 days if not treated with antibiotics. With specific antibiotic treatment, cholera bacteria will disappear gradually. The fastest is 2 days, the longest is 6 days. Some patients after recovering still continue to excrete bacteria outside, maybe 3-6 months. This amount of waste, if discharged directly into sewers, ditches, rivers, .. will become a source of pathogens. It should be noted that there are people infected with cholera without symptoms, or have been cured. Cholera bacteria are still present in their feces. If these subjects neglect hygiene, they can become an important source of infection.

4. What areas often occur cholera?

Cholera often occurs in slow and developing countries. Especially in densely populated areas with poor sanitation and lack of fresh water. Africa, Southeast Asia and Haiti still have many cases every year. Contaminated water is a factor that helps cholera spread widely and quickly become an epidemic.

Cholera epidemic situation in Vietnam:

From 1993-2004

Outbreaks occur in all three regions of the North, Central and South with several thousand cases reported annually. However, the disease did not break out into a major epidemic, with very few deaths

 2005-2006

The whole country has not recorded any cases

Since the end of 2007

The epidemic broke out again in 19 northern provinces/cities. There have been thousands of cases but no deaths.

                        

In addition, cholera has a marked seasonal variability. In endemic areas, the disease usually increases in summer and autumn. In our country, it is usually in the dry season, around February, April, and April. Seasonal climate change affects aquatic animals that harbor pathogens. On the other hand, it is also associated with increased risk behaviors (pilgrimage, tourism). And create situations that are easy to come into contact with pathogens such as unhygienic food, lack of clean water.

5. Risk factors

People with the following behaviors are at high risk of cholera infection:

  • People who eat and drink with cholera patients
  • Live in an area that uses substandard latrines. Untreated waste is dumped directly into rivers, canals, etc.
  • Use fresh manure in farming.
  • People in flooded areas, estuaries, and coastal areas.
  • Having unhygienic eating habits. People often eat raw vegetables, undercooked seafood, shrimp paste, blood pudding, dog meat, etc.

Cholera: A dangerous disease comes from daily habits

Eating blood pudding is at risk of cholera

  • People with reduced stomach acid status or taking medication to reduce stomach acid.
  • Those who are not immune to cholera are more susceptible to the disease.
  • People with blood type O when infected can have more severe disease.

6. Common Symptoms

In people already immune to cholera, the presentation is usually very mild, transient diarrhea. Immunity can be created actively by vaccination with vaccines, or passively in people who have been infected and recovered from the disease. For those who are not immune to cholera, the disease typically occurs in the following periods:

6.1 Incubation period

It is the time from when cholera bacteria enter the body until the first symptoms appear. This is when bacteria multiply and develop, accumulating toxins in the body. The incubation period of cholera is asymptomatic. Usually lasts from 6-48 hours, up to 5 days. Even if there are no symptoms, the pathogen can still spread and spread during this period.

6.2 Onset period

It is the time when the first symptoms begin to appear. In cholera, this period is often sudden with a transient feeling of fullness in the abdomen. It then quickly turns into watery diarrhea. Usually no fever, no abdominal pain, no vomiting.

6.3 Full-blown period

This is when the full symptoms of the disease appear. Complications, if any, will manifest during this time. The full-blown phase of cholera includes the following symptoms:

  • Diarrhea, watery stools, clear or cloudy like rice water.
  • Stool has a characteristic fishy odor.
  • Vomiting
  • Thirsty
  • Mucosal dryness
  • Cold skin, loss of elasticity
  • Sunken eyes
  • Restless or irritable
  • Cramps (also called cramps)
  • Exhausted

Cholera: A dangerous disease comes from daily habits

6.4 Consequences of cholera if not treated properly

If not treated promptly, the patient will lose a lot of water due to vomiting and diarrhea. Severe dehydration will lead to low blood pressure, shock, kidney failure, etc. The worst outcome is death.

7. How is cholera diagnosed?

Management and care of patients with acute diarrhea are similar for most etiologies. However, accurate identification of the cholera infection is very important. People with cholera need to be isolated and fully reported to avoid spreading the disease.

7.1 The information the patient needs to pay attention to and provide clearly with the doctor

  • Accommodation characteristics
  • Do you frequent or travel in cholera epidemic areas?
  • Have you ever been in contact with a sick person?
  • Occurrence and characterization of symptoms
  • Medicines used.

7.2 Some tests to do

  • Stool examination and culture for cholera bacteria. Stool culture has definite diagnostic value. Since then cholera cases are reported fully and accurately, preventing the epidemic from spreading. 
  • Rapid test, use early warning of cases at risk of cholera. Rapid tests are useful in reporting outbreaks in the community. However, a stool culture is still needed for an accurate diagnosis of cholera.
  • Blood tests, kidney function, .. to find and promptly treat complications.

8. Key points in cholera treatment

8.1 Principles of treatment

  • Rehydration and electrolytes. Electrolytes are very important substances for the functioning of cells in the body. In cholera, electrolytes are often lost with water due to diarrhea and vomiting.
  • Kill germs to avoid spreading with specific antibiotics.
  • In addition, zinc supplementation has also been shown to improve symptoms of cholera in children.

8.2 Types of solutions commonly used in the treatment of cholera

  • Oresol: is a solution of salt and sugar prepared in a certain ratio. Oresol solution for children and adults can be different.
  • Salted porridge. Sugar salt solution (8 teaspoons sugar + 1 teaspoon salt).
  • Types of fluids used in medical facilities.

Depending on the degree of dehydration, the type of fluid and the amount used will change. For mild dehydration, take oresol as needed (taken when thirsty) and after a bowel movement. If you vomit a lot, you can take small sips.

More severe cases require hospitalization for rehydration and proper monitoring.

9. Methods of prevention

9.1 General preventive measures

  • Ensure food hygiene and safety.
  • Use clean water.
  • For children, improved nutrition will help prevent disease. Breastfeeding children, scheduled visits to prevent and treat malnutrition in time.
  • Vaccination - cin creates active immunity to cholera for the body.

9.2 Prevention when there is cholera

Everyone who lives in or travels to an outbreak or outbreak area should follow:

  • Drink only cooled boiled water. Or bottled water, canned drinks. It is necessary to carefully check that the bottles and cans of water are new and intact.
  • Avoid tap water and ice cubes of unknown origin.
  • Wash hands frequently with soap and water. Especially before cooking, before eating and after going to the toilet.
  • If soap and water are not available, alcohol-based hand sanitizer can be used. Alcohol concentration must be 60 degrees or more to be effective. 

Cholera: A dangerous disease comes from daily habits

Wash your hands often to prevent cholera

  • Avoid eating foods that have been left cold for too long. Avoid eating raw vegetables or wash them thoroughly before eating.
  • Use standard latrines and toilets.

Cholera in humans is an acute infectious disease that spreads rapidly. Dirty water and raw seafood are major sources of pathogens. Habits of eating raw food and poor sanitation will increase the risk of cholera infection. The main symptom of cholera is diarrhea that causes dehydration. Adding water, electrolytes and antibiotics will improve the condition. Washing hands often, eating cooked food, drinking boiling water and using clean water are effective weapons to prevent cholera.

Author: Le Duong Linh, Medical consultation: Doctor Nguyen Trung Nghia


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