Cholera Treatment

Males are often the first cases as they are more exposed to various risk factors. Women get sick in second place and as food handlers they become sources of infection for the rest of the family members. Children who are breastfed are more resistant to illness and severe diarrhea –Chertorivski Woldenberg.

Treatment of cholera should be carried out immediately to ensure the improvement of the patient and avoid a fatal outcome. Generally, the infection is caused by the consumption of seafood and contaminated water, although it can also be caused by the consumption of other foods contaminated with feces.

According to experts, ” cholera is endemic in some areas of Asia, the Middle East, Africa, South and Central America, and the Gulf Coast in the United States,” while in other parts of the world, there may be outbreaks occasionally.

Whether you live in an area where cholera is endemic or not, it is important that you know some relevant information about this disease and why it is so dangerous for humans, so that you are encouraged to apply the necessary prevention measures to take care of yourself.

Facts about cholera

The first cases of cholera occurred on the island of Sulawesi, Indonesia, and later spread to other continents. Cholera is an epidemic disease caused by the bacterium  Vibrio cholerae that lives in the intestines of people.

The Vibrio cholerae is classified into two biotypes: classic and El Tor. Which in turn are subdivided into two serotypes: Ogawa and Inaba. This bacterium is capable of producing heat labile enterotoxin and acid labile.  It causes, above all, vomiting and watery diarrhea.

The bacteria grow in many culture media in the blood. For this reason, the TCBS selective medium is the most used to identify colonies. For its part, the Tor survives in water, human feces, stagnant waters and drains. However, it is also independently housed in aquatic plants and animals.

Transmission

The most common way is through the ingestion of a high number of microorganisms (either in liquids or in food). You must bear in mind that cholera is not easily transmitted; that is, from person to person, a high amount is needed to overcome the heartburn barrier.

Especially relevant is that the bacteria have a preference for water, since it keeps it alive. Similarly, food is also a route of transmission when washed with a contaminated water. The most susceptible foods are:

• Fish and shellfish from contaminated waters.
• Leafy vegetables grown or washed with contaminated water.
• Handled foods that are not sanitized or refrigerated.

Attack method

From the moment the person eats the bacteria, the Vibrio cholerea addresses the small intestine and adheres to the epithelial surface, there multiply and releases enterotoxin. This protein is made up of a substance called the B subunit and another called the A subunit.

The B subunit activates the secretory mechanism of chlorine and, therefore,  blocks the absorption of sodium. This causes an isoosmotic excess of water to accumulate combined with sodium, chlorine, bicarbonate and potassium.

In short, diarrheal evacuation can be up to 2 liters per hour. However, despite these changes, the small intestine continues to absorb glucose, sodium, and water. Therefore, in the treatment of cholera, the patient is recommended to drink a solution containing glucose to rehydrate.

Cholera treatment

The first thing to do to counteract the symptoms of cholera is to drink water and electrolytes that contain: sodium, potassium, chlorine or bicarbonate. These can be administered orally or intravenously, depending on the conditions of the affected person.

If you show signs of severe dehydration, the following symptoms may appear:

• Pallor.
• Cold sweating
• Rapid pulse
• Low blood pressure.

In the event of suspected cholera, contact a medical center immediately. The patient will be hospitalized and hydrated intravenously. Given the complexity of this disease, the administration of antibiotics is necessary.

In the treatment of cholera, an immediate intravenous infusion of physiological saline is essential. At least two liters in a period of 30 minutes. Subsequently, an infusion of the polyelectrolyte solution is applied to achieve 4 liters in the next three hours.

The requirement to indicate oral medication is that the patient is conscious; that is to say, that you recover quickly from the state of shock. In case of nausea, the nasogastric tube is used.

As soon as the patient can tolerate the oral serum without vomiting, for at least one hour, it is possible that they can hydrate in this way. The objective of the treatment is that intravenous hydration is not necessary for no more than 3 hours, then it is continued orally.

Another aspect to take into account in the treatment of cholera is that the patient can eat soft foods as soon as they feel hungry. Likewise, mothers who breastfeed can do so again as long as they have proper nipple hygiene.

Medicines not recommended

• Diuretics
• Anti-diarrhea.
• Corticosteroids
• Antispasmodics.
• Parenteral antibiotics.

Non-pharmacological treatment

Rehydration

• Oral hydration with solutions rich in electrolytes and glucose.
• Intravenous isotonic saline solutions.

Diet

• Eat small amounts of food several times a day.
• Astringent diet to promote the functioning of the intestinal tract.
• Avoid foods with lactose: milk, cheese, cream. As well as those that contain caffeine.

It is important that the patient follow the recommendations of the treating physician not only in terms of hydration and medication, but also in terms of rest and diet, since it is the whole that can lead to improvement.

If you have any questions, the idea is to discuss it with the professional. Do not self-medicate or resort to any other measure that may be counterproductive.