Clinical features and management of cholera Custom Search Cholera is an infectious disease caused by a bacterium called Vibrio cholerae. The disease can sometimes cause such severe watery diarrhea with or without vomiting that within a few hours the patient can become seriously dehydrated and suffer from shock and electrolyte imbalance which may be life threatening. Transmission of the disease occurs through contaminated water or food. It is not common before 1 year of age. The organism produces a toxin which binds to cells lining the cavity of small intestine and causes sodium, chloride and water to be moved from the cells into the cavity of small intestine in large quantity. The disease will be more serious in malnourished children. Clinical features: The disease has a short incubation period of about 1 to 3 days. Sudden onset of frequent watery stools of large volume is characteristic of cholera. The color of stools which may be yellow in the beginning soon changes to light gray (hence the name rice water stools). There may be vomiting. The explosive diarrhea leads to reduction in blood volume and the levels of sodium, chloride and potassium in blood. The fall in blood pressure results in decreased blood supply to kidneys leading to renal failure if immediate treatment is not available. Laboratory findings: The concentration at sodium in stool is higher compared to other causes of diarrhea. The bacteria may be identified by examining a drop of stool under microscope by its characteristic mobility. Culture can confirm the diagnosis. Treatment: Intravenous fluids should be given immediately if there are signs of dehydration to prevent irreversible shock. Tetracycline may be given to children above 9 years of age in a dose of 50 milligram per kilogram of body weight per day in 4 divides doses for 5 days. Azithromycin is another effective drug in a dose of 10 milligram per kilogram of body weight per day in a single dose and can be used in children below 9 years also. Prevention: Water and milk should be well boiled. Food should be kept covered to prevent contact with flies as these can carry bacteria on their bodies. Vaccine is available against the disease but is not highly effective. Custom Search
Page last reviewed on 30th June 2010
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