Contents
What is cholera?
Cholera is an infection caused by Vibrio cholerae, or cholera vibrio, whose structure resembles a comma – it is a slightly curved stick. When it enters the human body, the small intestine is primarily affected. Vibron cholera releases a toxin that causes watery or secretory diarrhea. This exotoxin is a trigger for a number of chemical reactions. As a result, water and electrolytes begin to actively enter the intestinal lumen, then diarrhea develops. If treatment is not started on time, then such conditions lead to: dehydration, dehydration, collapse (lowering blood pressure and, as a result, hypoxia of tissues and organs, metabolic disorders) and oliguria (reducing the daily dose of urine).
Turning to the “Small Academic Dictionary”, you can find the definition of cholera as an acute infectious disease of the intestine, accompanied by vomiting, diarrhea, a decrease in body temperature and convulsions. Cholera is a contagious disease, the microorganism enters the person, most often through untreated water, as well as marine products. For its diagnosis, a cultural study is required, or more simply, sowing, and serological methods, that is, taking blood for laboratory analysis.
Treatment for cholera consists of active rehydration, doxycycline therapy or other antibacterial drugs, and electrolyte replacement. If therapy is not carried out properly, then life-threatening conditions can occur, and even death. That is why one should not only know the definition of cholera, but also understand its symptoms, and also be able to distinguish it from other similar diseases.
Symptoms of cholera
Having overcome the gastric barrier, cholera vibrio enters the small intestine and begins to multiply actively. For microorganisms, this is a very nutrient medium, consisting of bile and food proteins. Due to their violent life, toxins are released, which cause the initial stage of the disease.
Symptoms begin to appear about 3 days after infection. If a person took antibiotics shortly before infection, then the incubation period can be delayed up to a week or even more.
In normal situations, the body reacts as follows:
If the disease is mild, then there is a single vomiting, as well as diarrhea with fluid loss up to 3% of body weight. If the cholera vibrio leaves the body completely, then after two days the disease stops;
With the course of cholera, to an average degree, symptoms such as: repeated diarrhea, up to 20 times a day, feces have a cloudy color. At the same time, frequent sharp pains occur in the abdomen, as well as false urges to empty the intestines. A person loses up to 6% of fluid from body weight;
If cholera is severe, then shortness of breath is added to the symptoms described above, convulsions and cyanosis of the extremities are possible. At the same time, pains in the abdomen are not acute, but dull, the place of their localization is the umbilical and epigastric region. Fluid loss can be up to 9% of body weight.
It is almost impossible to calculate the moment when the microorganism enters the large intestine, since at this stage there are no specific signs. Nevertheless, during the incubation period, symptoms such as sweating, increased heart rate, cold extremities, a slight increase in body temperature, weakness and malaise, headache, dry mouth and rumbling in the abdomen can be noted.
But these signs do not always appear, and most often the disease has an acute onset. The first symptom to pay attention to is a sharp urge to defecate, which is not possible to contain. At this time, the stool has a mushy, or immediately liquid form. As the stool becomes more frequent, the stools become like rice water: they are cloudy in color, sometimes there are gray-colored flakes. The smell is either absent or there is a smell of fresh water. Fever is not among the symptoms that characterize the onset of cholera. The prodromal period is either blurred or absent altogether.
The most dangerous include some atypical forms of cholera with the following symptoms:
“Dry” form, when diarrhea and vomiting are not observed, at the same time the intestines are filled with water. This is due to paralysis of his muscles, diarrhea does not have time to develop and the disease ends in death;
The erased form has a minimal set of symptoms, they proceed sluggishly, but transiently. The general condition is not disturbed and the patient poses a real threat to the health of others, since he does not seek medical help;
Lightning form. The disease begins abruptly and reaches its peak in a few hours, all body functions are inhibited, the pressure drops rapidly. Such a course often leads to the death of a person or ends in a coma.
It is worth knowing that in addition to an abrupt onset with the manifestation of any symptoms, cholera vibrio can simply live in the human body, and the disease will proceed in a subclinical form, that is, hidden.
Diagnosis of cholera
Diagnosis of the disease, as a rule, is not difficult in the presence of specific symptoms (vomiting and diarrhea without fever), but in isolated cases, cholera occurs in a mild form with erased signs. It is in such situations, which are observed everywhere, that laboratory diagnostics are required.
Bacteriological examination requires both feces and vomit. In laboratory conditions, vibriocarrier is determined, this requires fecal masses. If a person died from cholera, then a segment of the small intestine and part of the gallbladder are taken for research.
Compliance with certain conditions when determining the presence of vibrio cholera are required:
The culture must be delivered to the laboratory as soon as possible;
Dishes for collecting feces and vomit should not contain even the slightest trace of chemicals, since the vibrio is extremely sensitive to them;
The possibility of infection must be completely excluded.
If it is not possible to deliver the material for diagnostics within 3 hours, then preservatives should be used in which the vibrio is able to survive. Transportation is carried out in a metal container on a specialized transport. All samples are signed with the obligatory indication of the time of sampling of the material and its name. The result can be obtained already after 3 hours when using the express method, after 8 hours a preliminary answer will be ready, and the final answer after 9 or more hours.
Consequences and complications of cholera
As a rule, with competent and adequate treatment, timely restoration of the water-salt balance, cholera does not cause complications. If dehydration has reached a critical point, then the disease can end very badly for a person – a fatal outcome. Death occurs as a result of either sepsis, or hypovolemic shock, or DIC. The pathogen does not directly affect the organ systems, therefore, after treatment, they retain their functionality.
As possible complications after the disease, as well as during its course, the following can be distinguished:
Kidney failure, as a result of disruption of the organs. As a result, a metabolic disorder occurs;
Spasms of individual muscle groups;
Development of myocardial infarction, especially in old age;
Inflammation of the veins – phlebitis;
Possible development of pneumonia;
Violation of cerebral circulation and respiratory failure;
drop in blood pressure;
The risk of permanent carriage of this microorganism without symptoms;
After the disease passes, antibodies to this type of pathogen continue to circulate in the body. But this does not guarantee that it is impossible to become infected with another subspecies of vibron cholera.
cholera treatment
The main medical measures include the following actions:
Taking antibacterial drugs to which this microorganism is sensitive;
If dehydration of moderate and severe severity is observed, then the patient is prescribed water-salt solutions and a glucose solution administered intravenously;
In order to maintain the normal functioning of the gastrointestinal tract and restore its work, a course of probiotics is prescribed;
After the illness, follow-up at the polyclinic at the place of residence is necessary for at least 3 months.
It is advisable to start these measures in advance, when the first symptoms appear. Efficiency of taking drugs guarantees a speedy recovery with minimal losses to the body. As for the diet, it is not prescribed for this disease.
In the absence of vomiting and the first degree of dehydration, patients are prescribed one of the following types of antibacterial drugs: doxycycline, ofloxacin, tetracycline, levomecithin and others. The course of treatment is 5 days, the dosage is determined by the doctor, the drugs are taken in the form of tablets.
In the presence of vomiting and severe dehydration, the following antibacterial drugs are used: amikacin, gentamicin, doxycycline, sisomycin and others. Medicines are administered intravenously, the course of treatment is also 5 days.
Even if cholera is suspected, the patient is subjected to a medical examination, and the persons in contact with him are isolated. Discharge occurs after complete recovery, in the absence of symptoms, and after 3 negative cultures.
The recommendation for persons who have had cholera is to be exempted from sports and heavy physical labor for 3 months. This applies to those patients whose disease proceeded in severe form.
Cholera Prevention
Since the disease is contagious, you should know the main preventive measures aimed at eliminating the ways of its transmission:
Compliance with all known hygiene procedures and compliance with sanitary standards, such as: washing hands, eating food after heat treatment, drinking clean high-quality water, etc .;
It is necessary to beware of visiting those places and regions where outbreaks of the disease have been recorded;
Foods to be eaten must be protected from insects. Quite often, it is flies that are carriers of cholera and other infectious diseases, especially insects that have been in landfills and garbage cans;
All rooms where the patient stayed must be thoroughly disinfected;
Persons who have had contact with people infected with cholera are hospitalized until the presence or absence of cholera vibrio in the body is determined;
Wastewater must be disinfected;
Water in places of mass bathing, in the water areas of ports should be subjected to specific studies.
If a person is sent to a region where outbreaks of the disease are observed, then a single vaccination is carried out in advance. With prolonged stay in a dangerous area, revaccination is carried out 3 months after receiving the initial dose.
International epidemiological rules require all persons arriving from disadvantaged countries to be observed for 5 days for cholera infection.
So, cholera is an insidious disease, it can pass without a trace, leaving no memory of itself, or it can end in death, infect a huge number of people, as well as very serious complications. It is possible to determine the presence of a microorganism only in the laboratory, but knowing the main symptoms of the disease and its danger, a person is able to seek medical help in a timely manner. The success of treatment directly depends on at what stage it will be started. Modern medicine has accumulated considerable experience in the fight against cholera vibrio and has a clear algorithm of action in case of its detection. That is why cholera outbreaks are extremely rare in developed countries.