health and wellness · life of a medic

Cholera 

There’s a cholera crisis ongoing..an endemic of sorts and I thought it wise to debunk just what this enigma is and to write in the simplest way I know how to what to do should you suspect you have it.
First 

What is it?

Cholera is a bacterial infection. It is caused by V. Cholerae  (V. for vibriae so called because it was thought that the bugs vibrate when moving -anyway)

It’s spread via a fecal oral route and is found in humans and contaminated water. 

How does it spread?

Either through drinking contaminated water (bacterial load of 10^3- 10^6 needed ) or through eating contaminated food either by fecal matter getting into contact with food (dirty hands) or washing fruits and vegetables with contaminated water. A smaller bacterial load is needed if ingesting it via food. 

how does it work?

Typically the bugs go to your intestines the duodenum and produce enterotoxins which make the body secrete alot of fluid into the small intestines. 

The large intestine typically tries to absorb but because of the large amounts of fluid released its unable to and therefore one passes it as  secretory diarrhea. 

What kills you?

Dehydration. 

I can’t overstate that Cholera if not treated can kill you within 24hours due to the severe dehydration that results in shock. 
What symptoms will you see? 

Diarrhea. (Food at first and then progresses to look like rice water «the water that cleans rice » )

The diarrhea can become explosive and one may be unable to run to the loo. 
Vomiting.

 May or may not be there.  Typically due to acidemia. 

Abdominal cramps 

May or may not be there. Painful bouts due to the ileum secreting a lot of fluid..

Dehydration 

The diarrhea and vomiting lead rapidly to dehydration..

Can be noticed as thirst. A lot of thirst.  Then your heart beating too first (tachycardia),unable to breathe well,  Progress to drowsiness and even coma. 

Hypoglycemia

You are losing water and food. So the body is losing glucose. And the back up mechanisms are failing as well. It’s the second thing that can kill you. It can give you convulsions and coma.
What do you do? 

So you’ve eaten at a restaurant, and you have a stomach upset. Or you’ve drunk water and you are not too sure about it and now your stomach is killing you. 

Your friend who was also with you has the same complaints. 

You’ve seen the symptoms …pain, diarrhea, vomiting etc

What to do?

The Mainstay of Treatment is REHYDRATION

1. So  First get water. You can make a home made ORS or get someone to buy the formulation in a chemist. (You can buy ORS and keep in the house and just have it with you.) 
Nonetheless home made ORS get 1 litre of clean water ( boiled/ with water guard or just plain water) add 6 teaspoons of sugar and half a teaspoon of salt and drink that.  

2. Rush to hospital. 

We will need to test you. Report a possible incident and most importantly we will give you IV fluids (direct to your blood ) and then continue maintaining with the ORS.
3. If confirmed to be having Cholera; stay in isolation and complete your medication.

You are in safe hands. Help the doctors and medical personnel take care of you.

How to prevent it?

-Clean your hands 

-Wash your fruits and vegetables with running water 

-Avoid discredited hotels.

-Avoid eating in the streets 

-BOIL your water, use water guard, (chlorinate your water ) drink safe water.

Will Cholera always kill you?

No. Some people have no symptoms, others get a mild disease others it’s severe. 

The good news is that your body can build an immunity if in an endemic region.

Also if you have ORS with you. And keep drinking till you get to hospital you may Just save your life.



In Summary! 


Finally stay healthy, stay safe and May the Lord protect you all from the endemic/epidemic/pandemic that is Cholera. 




Dr. Jemimah K. 

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