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Cholera

Overview

Cholera is a serious infectious disease of the intestine caused by bacteria. It is more common in underdeveloped countries than in industrialized ones. If it isn't treated very quickly, cholera will cause severe diarrhea, possibly leading to death. Cholera is particularly dangerous in young children. In 2005, according to the World Health Organization, 131,743 people were sickened with cholera and 2,272 died worldwide, but the disease is greatly under-reported. Most cases are found in Africa and in Asia, with the Indian subcontinent reporting the highest number of cases. The disease has been endemic in southern Asia for at least 1,000 years. In 1817, an outbreak of cholera that began in India spread west into Turkey and east into the Philippines, reaching pandemic proportions across Europe and Russia. Subsequent 19th century epidemics spread the disease to Europe, Africa, and the Americas. In the 20th century, cholera reached its greatest expansion, re-visiting Latin America for the first time in a century, and tightening its grip across Africa.

Cause

Cholera is caused by a comma-shaped bacterium called Vibrio cholerae. V. cholerae can be found in contaminated food and water. When the bacteria are not causing outbreaks, they live in brackish waters and seacoasts and estuaries. They can exist in these areas in both harmless and diseasecausing forms.

Transmission

You can get infected with cholera by eating food or drinking water that has been contaminated with cholera bacteria. In epidemics, the bacteria can be found in the stool of people who are infected. Cholera can spread rapidly in areas where there is poor sanitation--inadequate treatment of drinking water and sewage. Raw shellfish also has been a source of cholera. A few people in the United States have gotten the disease after eating raw or undercooked shellfish caught in the Gulf of Mexico and from nations of the American and Asian Pacific Rim.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Allergy and Infectious Diseases

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National Institute of Allergy and Infectious Diseases | health information

You probably will not catch cholera from casual contact with an infected person because the bacterium must be swallowed.

A simple rule of thumb is "Boil it, cook it, peel it, or forget it."

If you travel to areas when cholera is present, such as parts of Asia, Africa, and South America, you can pick up the disease by eating contaminated food or drinking untreated water.

Symptoms

People infected with cholera often have no symptoms or have only mild symptoms. A small number of infected people may have very serious symptoms such as: · Severe watery diarrhea · Vomiting · Cramps Within just a couple of hours, uncontrolled diarrhea and vomiting can lead to a quick loss of the body's fluids, immobility, and shock. (Shock is a series of body reactions including a weak pulse and cold sweats.)

Diagnosis

A laboratory test can identify cholera bacteria in the stool of an infected person.

Treatment

If you have been diagnosed with cholera and have diarrhea, your healthcare provider will give you an oral rehydration solution, which is a mixture of specific amounts of sugars, salts, and water. This will replace the fluids your body is losing. If your diarrhea is severe, you may need fluid replacement intravenously (through the veins). The key to a successful recovery is to start getting your fluids replaced immediately. Although antibiotics can shorten the length and decrease the severity of cholera, rehydration is the most important treatment.

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Prevention

If you are traveling in an area where cholera has been a problem, you should take precautions to prevent getting sick. CDC suggests the following: · Drink only water that you have boiled or treated with chlorine or iodine. Other safe beverages include tea and coffee made with boiled water and carbonated, bottled beverages with no ice. · Eat only foods that have been thoroughly cooked and are still hot, or fruit that you have peeled yourself. · Do not eat undercooked or raw fish or shellfish, including ceviche. · Make sure all vegetables are cooked. · Avoid salads. · Do not eat foods and drink beverages from street vendors. · Do not bring perishable seafood back to the United States--it is dangerous and illegal. A simple rule of thumb is "Boil it, cook it, peel it, or forget it." There is a vaccine for cholera, but it's not available in the United States.

Research

The National Institute of Allergy and Infectious Diseases (NIAID) supports research to learn more about Vibrio cholerae. In one study in Dhaka, Bangladesh, NIAID-supported researchers are trying to understand how the human immune system reacts to infection with cholera. This information may help develop more effective vaccines against the bacteria. NIAID-supported researchers determined the DNA blueprint--genomic sequence--of the cholera bacterium. This knowledge will help shed light on the role the bacterium plays in causing human infection and disease.

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More Information

National Library of Medicine MedlinePlus 8600 Rockville Pike Bethesda, MD 20894 888-FIND-NLM (888-346-3656) or 301-594-5983 www.medlineplus.gov Centers for Disease Control and Prevention 1600 Clifton Road Atlanta, GA 30333 800-CDC-INFO (800-232-4636) www.cdc.gov World Health Organization Avenue Appia 20 1211 Geneva 27 Switzerland 41-22-791-21-11 www.who.int

4 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Allergy and Infectious Diseases www.niaid.nih.gov December 2010

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Cholera Fact Sheet

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