Cholera, first discovered in the USA, is an infectious disease that spreads through contaminated food and water. As per the records of WHO (World Health Organization), 21,000 to 143,000 people among every 1.3 million to 4 million people affected by cholera die every year. 

Detailed knowledge of this bacteria-borne disease can help you stay protected from its deadly effects. Moreover, a deep understanding of this topic is necessary to clear the examination if you are an NEET-PG aspirant.

Keep reading to learn about cholera’s types, symptoms, causes, and treatment procedures.

What is Cholera?

Cholera refers to an infectious water-borne disease caused by Vibrio cholerae bacteria. In most cases, individuals diagnosed with cholera do not show any symptoms, or there are few symptoms. However, some of the affected people may experience dehydration and diarrhoea. 

With the introduction of modern water treatment and sewage, cholera is no longer a risk factor in most countries worldwide. However, some countries prone to natural calamities, war, poverty, etc., have high risks of cholera. These include Latin America, the Middle East, Africa, and parts of Asia.

What are the Different Types of Cholera?

Cholera is mainly divided into the following two types:

1. Endemic Cholera

This is a minor cholera outbreak that happens to an individual every season. It helps create anticholera immunity in you, protecting you from severe risks. However, if it happens to children below the 5-year age group who have low immunity, they can develop symptomatic illness risks.

2. Epidemic Cholera

It is the most severe form of cholera disease that occurs simultaneously in all age groups. A group of individuals who lack pre-existing immunity are at higher risk of epidemic cholera.

Here are some additional pointers:

• Cholera is also classified based on the O-antigen of LPS (lipopolysaccharide) structure. 
• There are 200 plus serogroups of Vibrio cholerae. Among them, serogroups O1 and O139 of Vibrio cholerae can cause cholera due to their ability to produce cholera toxin (CTX). 
• Non-O1 and non-O139 strains typically lack CTX, causing sporadic infections like bacteremia and gastroenteritis but not cholera. 
• O1 strains include Inaba, Ogawa, and Hikojima serotypes.

What are the Causes of Cholera Transmission?

When water gets contaminated by the faeces of an affected person, it can cause cholera. Individuals who don’t exhibit any symptoms but are infected with the bacteria can spread cholera.

Cholera is caused by the following factors:

• Foods or Drinks from Local Vendors

Having food from street vendors may cause cholera as it can be undercooked. Even if the food is cooked well, if the vendor does not follow proper hygiene while preparing the food, it can be contaminated by bacteria.

• Grains

If grains like rice get contaminated after cooking and are stored at room temperature, it will allow the cholera bacteria to grow on them.

• Undercooked or Raw Seafood

Seafood and fish caught in polluted waters can spread cholera. Moreover, if they are undercooked or consumed raw, the chances of being infected with cholera are high.

• Public Water Supplier

If you drink water from ponds or wells that lack proper sanitation, it can cause cholera. The water sources may have come in contact with contaminated faeces, which are actively spreading cholera disease.

• Raw Vegetables

If you use manure fertilisers or contaminated water to grow vegetables, it can result in the spreading of cholera. Such instances are generally seen in developing countries.   

What are the Symptoms of Cholera?

Here are some of the symptoms of cholera:

• Nausea and Vomiting

Vomiting is common in the early stages of cholera. It can last for hours, contributing to fluid loss.

• Diarrhoea

Cholera causes sudden onset of watery diarrhoea, often resembling “rice-water stools” due to its pale, milky appearance. This can lead to rapid fluid loss, sometimes up to 1 litre per hour.

• Dehydration

Dehydration can develop quickly and range from mild to severe. A weight loss of over 10% can indicate severe dehydration.

• Electrolyte Imbalance

Dehydration leads to a rapid loss of essential minerals like sodium, chloride, and potassium, causing an electrolyte imbalance.

• Dehydration Symptoms

Including irritability, extreme thirst, sunken eyes, fatigue, dry mouth, dry skin, little or no urination, low blood pressure, and irregular heartbeat.

• Complications of Electrolyte Imbalance

Muscle cramps due to salt loss and potentially life-threatening shock if severe dehydration is untreated. Shock can lead to death within minutes if not addressed promptly.

How to Diagnose Cholera? 

The procedure to diagnose cholera consists of the following steps:

• If you have cholera symptoms like severe watery diarrhoea, dehydration, or vomiting, doctors will suspect it as cholera. 
• Chances are higher in the case of patients with recent travel to cholera-prone areas or exposure to poor sanitation. 
• Based on the symptoms, doctors will advise a stool test.

All you need to do is send your stool to the laboratory and wait for the result. However, doctors mostly start the treatment procedure before getting the lab results.

What are the Treatment Procedures for Cholera?

Here are the treatment methods for cholera:

• Fluid Rehydration: Drinking plenty of fluids or receiving intravenous fluids to prevent dehydration is the primary treatment for cholera.
• Antibiotics: Healthcare providers may prescribe antibiotics like doxycycline, erythromycin, or azithromycin to help reduce the duration of illness.
• Zinc Supplements: Children aged 6 months to 5 years are treated with zinc supplements to aid recovery.

Note: Antidiarrheal medicines are not recommended as they can worsen symptoms.

How to Prevent Cholera?

Here are the tips to follow for the prevention of cholera:

• Maintaining Hand Hygiene

You should wash your hands frequently with soap and water for at least 15 seconds to avoid the bacteria that can cause cholera. If soap and water are not available, an alcohol-based hand sanitiser can be helpful to maintain hygiene.

• Safe Water

Consider drinking only bottled, boiled, or disinfected water, and always use safe water for brushing teeth. Avoid adding ice to drinks unless it is made from safe water. Hot beverages and canned or bottled drinks are generally safe, but wipe the container before opening them.

• Food Safety

Eat hot and freshly cooked food. Try to avoid street vendor food unless it is cooked in your presence and served hot. Moreover, you should consider avoiding raw or improperly cooked fish and seafood. 

Opt for fruits and vegetables that you can peel yourself, such as bananas and avocados. Avoid salads and fruits that cannot be peeled, like grapes and berries.

• Cholera Vaccine

Consider getting vaccinated if you travel to areas where cholera disease is prevalent. The vaccine is recommended for individuals aged 2 to 64 and should be taken at least 10 days before travel.

FAQs About Cholera

1. Is cholera a communicable disease?

Though cholera is contagious, you will not get affected by the disease through sneezing, coughing, or any other casual contact. If you drink contaminated water or consume food made from such water, you can get cholera.

2. Do bacteria cause cholera?

Cholera is a bacterial disease caused by Vibrio cholerae, a gram-negative bacterium. It typically spreads through contaminated food or water, often due to faecal contamination from infected individuals. The bacteria can be found in polluted water supplies, undercooked or raw seafood, and improperly handled foods. 

3. Does cholera have any other name?

Yes, cholera has been called blue death since the 1800s as the affected person’s blood gets thick due to dehydration, and their skin turns grey or blue due to lack of oxygen.

4. What are the complications of cholera?

Cholera causes shock and severe dehydration, leading to a person’s death. Other complications of this disease include kidney failure, low blood sugar, and low potassium levels. 

5. Are oral cholera vaccines contraindicated for pregnant women?

Oral cholera vaccines are not contraindicated for pregnant women, but they are generally not recommended due to limited data on their safety during pregnancy. Despite this, studies have shown no evidence of harmful effects from these vaccines in pregnant women, who are at high risk of severe complications from cholera itself.

6. Is cholera and typhoid the same?

Cholera and typhoid fever are life-threatening diseases transmitted through contaminated food and water. However, cholera is caused by Vibrio cholerae, and typhoid is caused by Salmonella Typhi.

Conclusion

Cholera outbreaks can be fatal, but some preventive measures and proper hygiene can protect you from the infection. One must avoid street foods and drinks as they can be highly contaminated. Since it is a water-borne disease, you should be cautious about your drinking water. Following a hygienic routine and simple precautions can help you stay protected from this fatal infection. 

If you are a medical student preparing for NEET PG exams, a detailed study of cholera disease and related topics is necessary for your syllabus. DocTutorials can help you in this regard. Our live sessions, detailed study material, engaging videos, etc., cover these topics in-depth to provide complete knowledge. Join our NEET PG course and take your exam preparation to the next level!