Cholera Disease: Epidemiology, Signs and Symptoms, Control measures

Cholera disease is an acute notifiable infection of the gastrointestinal tract (GIT) disease of sudden and rapid onset, characterized by vomiting, profuse dehydration, severe diarrhea with rice-water stool and marked toxemia.

Meanwhile, muscular crumps, suppression of urine and shock occur later. Internationally its quarantine period is 5 days. The incubation period is from 1 to 7 days and varies from a few hours to 5 days but commonly lasts for 2days.

Epidemiology of Cholera

The Vibro cholera was discovered by Robert Koch in 1883 and is a delicate brain negative organism. The El-tor biotype is named after the Eltor quarantine station in Egypt where it was first isolated in 1920 and has been responsible for most epidemics in recent years.

Meanwhile, the classical type is limited to the Indo-Pakistan subcontinental. For the El-tor biotype, the first outbreak was originally found in Indonesia but has now assumed a pandemic spread. It has spread across Asia, Africa, into the meditation Europe, to the Gulf Coast of the USA.

Mode of Transmission

The infection spreads through contaminated water, food such as shellfish and drink. Eating and drinking utensils washed with contaminated water are vehicles for transmission of cholera.

Host Factors that Influence Cholera Disease

• Gastric Acidity; this is more common in persons with hypochlorhydria (a lower than normal amount of hydrochloric acid in the gastric juice)
• Dense Population or overcrowding is another factor that promotes cholera
• Poor personal and environmental sanitation are also contributory factors to its spread.

Signs and Symptoms

• There is an abrupt onset of vomiting and purging of large amounts of rice-water stools (up to 1 liter per hour)
• Increased thirst due to excessive fluid loss
• Eyes and cheeks are sunken
• Urine output is reduced or stopped.
• Patients have muscular cramps
• Pulse is rapid and feeble
• The extremities are cold and blue.

Control measures of Cholera Disease

During epidemics, the clinical recognition of cases is relatively easy. Sporadic cases, however, can easily be missed and hence in endemic areas any case of severe gastroenteritis must be considered as cholera until the contrary is proved.

• Early detection, isolation, and notification of infected cases are very important.
• Surveillance or a search for the source of infection should be made and remedy given if discovered
• Concurrent disinfection of stools, fomites, houses, linens, and clothing should be done.
• Oral rehydration of patients is an early-emergency measure to save a life.
• Food sanitation should be enforced and public swimming pools closed during the epidemic.
• Control of immigration during an epidemic
• There should be designated places in camps and hospitals for treatment of cases
• People should boil water, eat only cooked foods and raise the standard of personal hygiene
• Dead bodies of cholera cases are wrapped in a sheet soaked in 2% Lysol before disposal by burying.
• Health education should focus on proper personal and domestic hygiene, including measures to take during an outbreak of cholera and how to prepare and use salt sugar solution (SSS)

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