Cholera is a disease caused by the Vibrio cholerae bacterium and is spread through the fecal-oral route, often via contaminated food or water and unsanitary living conditions. It remains a significant public health concern worldwide.
Despite advancements in sanitation and healthcare, cholera persists particularly in regions lacking access to clean water and adequate sanitation such as refugee camps, urban slums and areas affected by natural disasters or conflict.
Contaminated water sources, such as surface or well water, seafood, raw fruits, vegetables and grains are the primary pathways for cholera infection.
The deadly effect of cholera results from a toxin that the bacterium produces in the small intestine, causing excessive water loss, severe diarrhea and rapid dehydration.
Global Prevalence
According to the World Health Organization (WHO), cholera annually affects approximately 1.3 to 4 million people, resulting in around 143,000 deaths worldwide. While cholera has been nearly eliminated in industrialized countries, it endures in several regions, including parts of Africa, Southeast Asia, and the Caribbean.
Recently, the WHO has voiced serious concerns regarding the increasing cholera cases in Nigeria, noting a disturbing rise in outbreaks. By mid-2024, Nigeria had reported over 14,343 suspected cases and 325 deaths across all 36 states. In July 2024 alone, 3,198 new cases and 102 related deaths were reported, reflecting a 192% spike in cases and a 149% increase in deaths compared to the prior month.
Cholera Symptoms
Diarrhea: Cholera-induced diarrhea appears suddenly, resulting in rapid fluid loss, sometimes up to a quart (about 1 liter) per hour, often resembling water used to rinse rice.
Nausea and vomiting: Vomiting is particularly common in the early stages of cholera and can persist for several hours.
Dehydration: This can develop within hours after symptoms appear, ranging from mild to severe. Severe dehydration is indicated by a loss of 10% or more of body weight, with symptoms including irritability, fatigue, sunken eyes, a dry mouth, intense thirst, and low urine output.
Shock: This is a severe complication of dehydration, occurring when reduced blood volume results in low blood pressure and insufficient oxygen supply. If not treated, severe hypovolemic shock can be fatal within minutes.
Risk Factors for Cholera
Poor sanitation: Cholera thrives where sanitary conditions and safe water supplies are compromised, commonly seen in refugee camps and impoverished regions affected by famine, conflict, or natural disasters.
Low stomach acid: Individuals with reduced stomach acidity such as children, older adults, or those on antacids lack a protective barrier against cholera bacteria.
Complications of Cholera if untreated:
- Kidney Failure: Impaired kidney function can cause dangerous fluid retention, electrolyte imbalances, and waste accumulation in the body.
- Electrolyte Imbalance: An electrolyte imbalance can cause serious symptoms such as muscle cramps, due to rapid losses of salts like sodium, chloride, and potassium.
- Hypovolemic shock: Severe dehydration can lead to a drop in blood volume causing organ failure, respiratory distress or cardiac arrest.
- Septicemia: Bacteria can enter the bloodstream leading to sepsis, organ failure.
- Hypoglycemia: Low blood sugar can occur due to mal-absorption of nutrients.
- Respiratory failure: Severe dehydration can cause respiratory distress or failure.
- Cardiac problems: Electrolyte imbalance and dehydration can lead to heart arrhythmias, arrest, or failure.
- Death: Cholera can be fatal within hours due to rapid fluid and electrolyte loss. Untreated cases may lead to death hours or days after symptoms manifest.
How to Prevent Cholera
- Frequently wash hands with soap and water, especially after using the restroom and before handling food. Wash hands for at least 15 seconds and rinse thoroughly. If soap isn’t available, use an alcohol-based sanitizer.
- Consume only safe drinking water. Hot beverages and commercially canned or bottled drinks are typically safe, but the outside should be wiped before opening. Avoid adding ice unless made from safe water.
- Eat fully cooked, hot food, and avoid food from street vendors.
- Protect your water, utensils and food from flies.
- Ensure environmental hygiene, practice sanitary excreta disposal and avoid open defecation.
- Opt for fruits and vegetables that can be peeled, such as bananas, oranges, and avocados, and steer clear of pre-cut salads and raw fruits that cannot be peeled.
References
World Health Organization (WHO). (2022).Cholera
Nariametrics. (2024, June).
Centers for Disease Control and Prevention (CDC). (2023).Cholera –Vibrio cholera infection.
Photo credit:
Department of Environmental Health Science,
Faculty of Health Sciences,
National Open University of Nigeria, Jabi,Abuja.
Taking these precautions is essential for preventing cholera.
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