Cholera - Medtick

Cholera

What is it?

A bacterial infection that lives in water:

  • Found in regions with poor sanitation
  • Lack of clean water and water hygiene
  • Brackish water (water that is saltier than fresh water, but not as salty as seawater) i.e. Estuaries
  • Areas of natural disasters and places of overcrowded areas living in poor conditions
This bacteria releases toxins that release water from ones intestines leading to severe diarrohea, this condition is a MEDICAL EMERGENCY

Countries include:

Caribbean

  • Cuba
  • Dominican Republic
  • Haiti
  • Mexico

Africa

  • Angola
  • Benin
  • Burkina Faso
  • Burundi
  • Cameroon
  • Central African Republic
  • Chad
  • Comoros
  • Congo
  • Côte d’Ivoire
  • Democratic Republic of Congo
  • Djibouti
  • Equatorial Guinea
  • Eritrea
  • Eswatini (Swaziland)
  • Ethiopia
  • Gabon
  • Gambia
  • Ghana
  • Guinea
  • Guinea-Bissau
  • Kenya
  • Lesotho
  • Liberia
  • Libya
  • Madagascar
  • Malawi
  • Mali
  • Mauritania
  • Mozambique
  • Namibia
  • Niger
  • Nigeria
  • Rwanda
  • São Tomé and Príncipe
  • Senegal
  • Sierra Leone
  • Somalia
  • South Sudan
  • Sudan
  • Togo
  • United Republic of Tanzania (Zanzibar)
  • Uganda
  • Zambia
  • Zimbabwe

Middle East

  • Syria
  • Yemen

Asia

  • Afghanistan
  • Pakistan
  • Tajikistan
  • Bangladesh
  • Bhutan
  • Cambodia
  • China
  • Laos
  • Myanmar
  • Nepal
  • India
  • Philippines
  • Taiwan
  • Timor-Leste

Australasia and Pacific

  • Papua New Guinea
  • Tonga

One gets symptoms very quickly involving severe vomiting and dehydration (one can lose fluids -as much as 20 litres per day).

Some person will not have no symptoms but can be a carrier , hence it can spread very rapidly, good hygiene practice is essential

Cause

  • Bacteria: Vibrio chloerae
    • Spreads by contaminated water (which has contaminated faeces from another infected mammal)-typically spread via the “fecal-oral” route
    • Transmitted via foods that have been washed or prepared with contaminated water

Symptoms

  • Severe watery diarrhoea (appears like washed water in rice)?
  • Balance and dizziness problems?
  • Dry cough longer than three weeks or breathing difficulties?
  • Abdominal pain and/or are constant violently vomiting or vomiting longer than two days?
  • Aching, painful muscles, muscle cramps/spasms/stiffness?
  • General discomfort (muscle weakness), uneasiness or ill feeling (malaise) and/or fatigue (tiredness)?
  • Headache which is on and off or a constant headache longer than 24 hours?
  • Heart palpitations, irregular heartbeats?
  • Irritated, depressed, anxiety and/or panic attacks?
  • Skin turgor (meaning a section of skin that’s pinched and is slow to return to normal position)?
  • Sunken eyes?
  • Low blood pressure?
  • Weight loss?

Complications /Information to beware of/General tips:

Medical Emergency Condition

And/or do not wait, phone for an ambulance if have or develop:


  • If one has this condition phone the medical doctor practice rather than visiting the practice as one may spread it to others.
  • An infected person should stay away from work or school at least 48 hours after last attack of vomiting or diarrhoea.
  • Do not touch your face with unwashed hands
  • Avoid close contact with infected people
  • Avoid close contact with people who are already ill
  • Do not share towels and utensils, dishes , drinking glasses
  • Clean and disinfect frequently touched objects and surfaces
  • After an illness, clean surfaces that may have the virus on them with detergent and chlorine bleach.
  • Don’t prepare any food for other people until at least 2 or 3 days after diarrhea/vomiting stops.
  • Don’t eat food that is prepared by someone who is ill with diarrhea/vomiting.
  • Stay home and away from other people when ill.
  • One should reconsider to keeps pets if one has a weak immune system this includes when there are young children, pregnant women and elderly persons over 65 years old.
  • How to wash Hands
  • Diarrhoea advice
  • How to prevent food poisoning

General tips

Take the following steps to avoid passing the illness on to others:

  • Wash your hands thoroughly with soap and water after going to the toilet.
  • Stay away from work or school until you’ve been completely free from any symptoms for at least 48 hours.
  • Help young children to wash their hands properly.
  • Don’t prepare food for others until you’ve been symptom free for at least 48 hours.
  • Don’t go swimming until you’ve been symptom free for at least 48 hours.
  • Where possible, stay away from other people until your symptoms have stopped.
  • Wash all dirty clothes, bedding and towels on the hottest possible cycle of the washing machine.
  • Clean toilet seats and toilet bowls, and flush handles, taps and sinks with detergent and hot water after use, followed by a household disinfectant.
  • Avoid sexual contact until you’ve been symptom free for at least 48 hours.

NHS choices 


If you’re travelling to a country where there’s a high risk of getting the condition, the Information below can help prevent infection:

  • Don’t drink the local water unless you’re sure it’s clean (sterile) – drink bottled water or drinks in sealed cans or bottles.
  • If the water isn’t sterile, boil it for several minutes or use chemical disinfectant or a reliable filter.
  • Don’t clean your teeth with tap water.
  • Don’t have ice in your drinks because it may be made from unclean water.
  • Avoid fresh fruit or vegetables that can’t be peeled before eating.
  • Avoid food and drink sold by street vendors, except drinks in properly sealed cans or bottles.

NHS choices


Future advise especially when travelling to an infectious country:

  • Fresh foods: those that are peeled or cooked are the safest
  • Avoid high risk foods like shellfish
  • Boiling water is the best method of sterilisation
  • Chemicals are useful for preparing safe drinking water but have their limitations
  • Chlorine-based tablets are widely available and will be appropriate for most travellers
  • More intrepid travellers and those planning to use surface waters as a drinking water source should use an iodine-based product.
Panel 1: Choice of foods for the traveller
Usually safe Risky Best avoided
Freshly prepared and hot , cooked food  including meat and consume quickly. boiled dairy i.e. milk and/or indian chai. Food from street vendors unless fresh and hot Poorly stored food Cold foods left standing especially sauces Avoid buffets (hot or cold) left standing along time
Peeled fruit Unpeeled fruit and salad unless well washed in clean water Broad leafed salad i.e. lettuce due to large surface area packed with organisms- harder to wash off all
Canned food Dried food (bread, rice and pasta ) and freshly baked bread Ice cream Shellfish Rare meat and fish Unpasteurised dairy products Ice containing drinks
  • Iodine or chlorine used for water purification (as discussed later) can also be used for soaking and manufacturers of food products give recommendations for the appropriate concentrations.

There are three methods by which the traveller can prepare clean drinking water:

  • Boiling:
    • Boil water for a full five minutes at any altitude.
  • Chemical disinfection:
    • Iodine, chlorine, katedyne silver.
  • Filtration

The Pharmaceutical Journal, PJ, January 2000;():DOI:10.1211/PJ.2000.20000218


Vaccine

  • Vaccines are available but are not recommended as a routine one, only for those who visit such areas, they take two weeks to reach full effect and the effects last every two three years.

Centers for Disease Control and Prevention. Cholera – Vibrio cholerae infection. General information. Reviewed: November 17, 2022. Available at: https://www.cdc.gov/cholera/
general/index.html. Accessed May 20, 2023.

  • Zinc supplements are believed to help on young children under five years old.

World Health Organization. Cholera fact sheet. March 30, 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/cholera. Accessed May 21, 2023.


H.I.V Test

  • A H.I.V test should be offered if one has this condition if symptoms are ongoing.

This condition may show similar symptoms to:

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

Detailed Information

Please copy and paste any key words from the title: Cholera in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).

  • NHS

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