Cholera is an intestinal infectious disease caused by the vibrio of the same name. It concentrates in the small intestine, causes vomiting, loose stools, and dehydration.
Cholera is a virus that has not yet been defeated. Mankind has been trying to cope with the disease for several thousand years. At the present stage of development of medicine, up to 5 million people fall ill with this disease during the year, about 150 thousand of them die.
Distribution, Facts
Until the beginning of the 19th century, only the population of India was ill with cholera. With the development of communication between countries and continents, the disease has spread throughout the world. To date, periodic outbreaks are recorded in 90 countries. Permanent foci are found in Africa, Latin America, and in some regions of Asia. The main reason for the spread of the disease is unsanitary conditions.
A sharp surge in cholera is always observed after social disasters - wars, earthquakes, natural disasters, that is, in those periods when a large number of people are deprived of clean drinking water. Cholera is epidemiological in nature, when the disease affects more than 200 thousand people at a time.
Currently, doctors are well aware of the causes and symptoms of cholera. Treatment of the disease is carried out, depending on the severity of its course.
A few facts about the infection, which every person needs to know:
- For the development of the disease, at least a million bacteria must enter the human body, which equals approximately one glass of water.
- Animals do not get cholera, except for mollusks and crustaceans that live in warm bodies of water.
- Vibrio cholerae live freely in a fresh and salty environment.
- At risk are people with the first blood group or with low acidity of gastric juice. Also, children aged 3 to 5 years are most often infected.
- Babies whose mothers have had cholera have a strong immunity to the disease.
- In 9 cases out of 10, only a small gastrointestinal upset is observed in infected people, while bacteria will actively live in the intestines and stand out during the evacuation of waste products.
- The course of the disease in each occurs individually - some patients “burn out” during the day, while others recover.
- In Russia, the disease was last detected in 2008.
- If the diagnosis is established as soon as possible, then drinking water every 15 minutes eliminates the disease for 3-5 days, while you can do without medication.
At the present stage, there are vaccines that reduce the likelihood of an outbreak of the epidemic many times over, but it has not yet been possible to completely eliminate the disease.
Pathogen
The Vibrio cholerae bacterium is a curved rod, at one end of which there is a movable flagellum, providing it with rapid movement in the liquid. The vibrio has up to 200 species, two of which cause an acute disease (Vibrio cholerae, Vibrio eltor). The main damage to the body is caused by toxins secreted by the vibrio.
Properties of toxins and their effects:
- Destroy the epithelial layer of the small intestine.
- They provoke the release of fluid into the intestine and its withdrawal with feces and vomiting.
- They cause a violation of the absorption of sodium salts, as a result of which the water-salt balance is disturbed, which causes seizures.
The bacterium is resistant to freezing and does not die during defrosting. It actively reproduces at a temperature of 36-37 degrees Celsius. The temperature corridor for the life of bacteria ranges from 16 to 40 ° C. The death of a microbe occurs upon drying, exposure to sunlight, temperatures above 60 ° C, in an acidic environment.
Classification
The most severe symptoms of cholera are observed in children and the elderly. The incubation period of the pathogen in the human body is from several hours to 5 days, from the moment the microbe enters the body. Most often, the disease manifests itself during the first or second day after infection.
The main symptoms of cholera are digestive upset and active fluid loss. In connection with dehydration, there are 4 degrees of the development of the disease:
- 1 degree (mild) - dehydration is 1-3% of the total human body weight. This condition is observed in half the cases of the disease.
- Grade 2 (moderate) - 4-6% fluid loss.
- Grade 3 (severe) - 7-9% of fluid withdrawal.
- Grade 4 (very severe) - fluid loss up to 10% of body weight. It is observed in 10% of patients.
Symptoms of cholera appear immediately, against the background of general health, at normal body temperature. At the height of the disease, body temperature drops below 36 ° C, the duration of the disease leaves up to 5 days, but can end in one day.
Symptoms
Most often, epidemiologists are faced with a moderate course of the disease. Symptoms of cholera appear as follows:
- Diarrhea. Under the influence of toxins of the cholera pathogen, swelling of the mucous membrane of the small intestine begins. A person has loose stools, bowel movements become frequent, gradually acquiring a transparent, odorless appearance, with the inclusion of white flakes. With severe destruction of the intestinal mucosa, bloody clots appear in the discharge. Patients rarely experience abdominal pain, sometimes rumbling or discomfort. Defecation in the acute phase of the disease occurs up to 10 times a day. When the stool acquires its usual appearance, doctors note the beginning of recovery.
- Vomiting Occurs from 2 to 20 times a day and occurs 3-5 hours after infection. In the first desires, the eaten food is removed from the body, later on vomiting is odorless and looks like ordinary water. Reflex occurs without muscle tension.
- Thirst. It occurs due to fast and large loss of fluid. At the first three stages of the disease, the patient consumes a lot of water, at the last stage he cannot drink on his own due to weakness.
- Urine. It gradually darkens, its amount decreases. With the advent of urination, the recovery process is ascertained.
- Dry mucous membranes (eyes, mouth). These are symptoms of cholera due to dehydration. Pronounced signs are a hoarse voice, sunken eyes, dry and cracked tongue.
- Cramps. The calf muscles, hands, feet suffer. At 3-4 degrees of the course of the disease, convulsions of all skeletal muscles are observed. These symptoms of cholera disease are associated with a lack of potassium.
- Pulse. Rapid and weak. As a result of the loss of fluid, the blood thickens, the heart increases the speed of contractions. Recovery occurs completely after the body is saturated with the necessary amount of water and the restoration of water and salt balance.
- Rapid breathing. It is observed with the onset of stage 2 and above of the disease.
- Skin condition. One of the symptoms of cholera is a change in skin turgor (loss of elasticity), pallor, and sometimes cyanosis of the integument. The skin is cold to the touch.
- General state. Apathy, lethargy, desire to sleep, irritability. There is a general breakdown, which is associated with intoxication, dehydration.
Symptoms of cholera disease can appear within a few hours after the pathogen enters the body. Diagnosis in the early stages allows you to cope with the disease with the least loss to health.
Channels of infection
Doctors have studied the causes and symptoms of cholera disease quite well. Treatment and prevention of the disease are carried out, according to the many times tested algorithm of actions and measures aimed at eliminating the likelihood of the spread of the epidemic. Every person needs basic knowledge to protect themselves from infection.
How is cholera distributed:
- A person using untreated water from open sources is likely to have cholera symptoms. Those at risk are those who use non-disinfected water for domestic purposes - for washing dishes, hygiene procedures, and washing.
- Bathing in reservoirs with dubious water and accidentally or intentionally swallowing it is one of the ways of infection with cholera. Symptoms, causes of a person’s condition in this case will be considered by doctors as a defeat by cholera vibrio.
- Contact with an infected person also leads to the disease (through contaminated objects, dirty hands, etc.).
- The transfer occurs through the use of poorly washed vegetables, fruits, food prepared with non-compliance with the thermal regime, as well as the use of expired products.
- The carriers of cholera vibrio are often insects, such as flies.
Observance of basic hygiene rules - frequent washing of hands, thorough processing of products, boiling water help reduce the risk of infection and not know what cholera symptoms and treatment are. Prevention is the best way to stay healthy.
Diagnostics
When diarrhea and vomiting occur, doctors pay attention to all other symptoms. The treatment of cholera disease is fully implemented after research.
The complex of diagnostic measures includes:
- Laboratory tests of feces, urine, vomit.
- Studies of water from the source of the alleged infection.
- The study of products, items used by the patient.
- Diagnosis of infection in people in contact with the patient.
- Samples of intestinal tissue, gall bladder are taken from those who die from cholera.
Diagnostic Methods:
- Microscopic examinations.
- Bacteriological.
- Reactive.
Relevant services are required to respond immediately to reports that any of the residents have symptoms of cholera. Treatment and prevention are implemented by the sanitary-epidemiological services in the complex, immediately after the threat of a mass disease. In critical situations, when there is a risk of an epidemic or pandemic, express research methods are used (duration no more than 30 minutes):
- Lysis (treatment of vibrio cholera with bacteriophages).
- Agglutination (gluing) of chicken red blood cells.
- Destruction (hemolysis) of red blood cells.
- Immunofluorescence method (treatment of the grown preparation with a special composition, as a result of which the cholera vibrio begins to glow).
- Immobilization of vibrios (treatment with cholera reagent).
Treatment
A patient diagnosed with cholera symptoms undergoes treatment and rehabilitation in the infectious diseases wards of hospitals. If an epidemic is observed, then a separate cholera hospital will be organized. Patients are under the supervision of infectious disease specialists, patients are prescribed medication, bed rest, diet therapy.
Medicines for treatment:
- Therapy is aimed at restoring water, electrolyte and water-salt balance in the body affected by cholera. Symptoms and causes of the disease suggest a constant assessment of the patient's condition and the prompt restoration of the lost fluid. Water-salt solution is injected into the patient’s body using a probe (in case of a severe course of the disease) or the patient consumes water on his own. Specialists use the preparations “Chlosol”, “Trisol” and analogues.
- Taking antibiotics. To suppress the multiplication of cholera vibrio, the patient must take one of the drugs: Tetracycline, Ciprofloxacin, Erythromycin. The dosage is calculated by the doctor.
The duration of drug treatment in each case is purely individual and depends on the severity of the infection, the body's immunity, and speed of recovery. On average, treatment is from 3 to 5 days. The period of medical monitoring of the recovered patient lasts 3 months, during which the patient regularly passes tests.
Diet
An integrated treatment approach requires cholera. Symptoms, causes of the disease, prevention, therapy make up the overall picture of the disease. The system of tools to overcome the consequences and successful treatment includes strict adherence to patients with the rules of a specially developed diet. The principles of nutrition, as well as acceptable and unacceptable foods, are described in the Pevzner diet (table No. 4). Eating behavior on this diet is shown in the first 3-4 days after the disease. Dishes should be cooked only steamed or boiled. Food is served in mashed or semi-liquid form.
Allowed Products:
- Cereals and vegetable soups, cooked on a low-fat broth with the addition of egg flakes, meatballs from dietary meats.
- Mucous porridge on the water, mashed buckwheat, oatmeal, rice porridge is also allowed.
- Bread - stale or crackers from premium wheat flour.
- Meat dishes - soufflé, steam cutlets, low-meat meatballs (veal, turkey, rabbit meat).
- Lactic acid products - dishes from low-fat or calcined cottage cheese (steamed soufflé).
- Eggs - soft boiled steam omelettes (up to 2 pcs per day).
- Drinks - decoctions of rose hips, blueberries, currants or quinces, weak black or green tea.
The following products are prohibited:
- Rich, fatty broths and dishes based on them.
- Flour products, fresh bread.
- Sausages, canned meat and fish, fatty meat and fish.
- Whole milk, dairy products.
- Pasta and cereals from millet, wheat, pearl barley.
- Any raw vegetables, fruits, as well as dried fruits.
- All kinds of sweets, including honey, jam.
- Invigorating and carbonated drinks.
After the acute phase of the disease (3-4 days), the patient is transferred to diet No. 5, which helps restore body functions. Proper nutrition, combined with medication helps to cope with cholera. Symptoms and treatment change as you exit a critical condition.
Treatment by folk methods
Healers have developed many recipes for the treatment of an acute disease such as cholera. Symptoms and prevention - are the basis for starting therapy and the ability to avoid complications. Since the disease can be fatal, it is unacceptable to rely only on recipes by traditional medicine in the acute phase. They are good as an addition to the methods of official medicine or are used at home after discharge of the patient from the hospital.
The following measures are recommended:
- Warming up. During illness, the patient suffers from a significant decrease in body temperature; therefore, the temperature in the room where he is located should not be lower than 25 degrees Celsius. The patient is warmed with electric blankets or heating pads.
- Periwinkle tea promotes bowel disinfection. Dry raw materials (teaspoon) are poured with a glass of boiling water and after filtering they are consumed 100 times three times a day.
- Natural red wine, taken in 50 ml every 30 minutes, prevents the growth of vibrio cholera.
- Tea from the medicinal collection (chamomile, wormwood, mint, taken in equal quantities). Dry raw materials (10 tbsp. Without a hill of spoons) are poured with 2 liters of boiling water, after straining, they are drunk during the day. Tea relieves intestinal cramps, has an antimicrobial effect.
- Malt. Decoction of 4 tbsp. tablespoons of raw materials and 1 liter of water are boiled for 5 minutes, insisted, filtered. A little sugar is added to the resulting preparation and drunk throughout the day. Biologically active components significantly reduce the manifestations of cholera, replenish the water-salt balance.
Prevention
Humanity has long known cholera. The causes, symptoms and prevention of the disease are fully studied by modern medicine. The main way to protect yourself from infection is to follow the rules of hygiene - frequent hand washing, disinfecting water, cleaning rooms and the surrounding area from rubble debris. These measures save any person from the threat of infection.
WHO also recommends vaccination during an outbreak. Vaccination is not able to completely exclude the possibility of infection, all hygiene rules must be strictly observed by vaccinated people. It is also necessary to limit contact with infected patients as much as possible, to disinfect the premises.
The following vaccines are recommended:
- Dukoral - provides up to 90% protection within 6 months from the moment of vaccination.
- Shanchol, mORCVAX - taken orally in three doses, are valid for 2 years.
Vaccinations are recommended for a limited number of people at risk - refugees, slum dwellers, and doctors.