Cholera - Symptoms, Diagnosis, Consequences And Treatment Of Cholera

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Symptoms, diagnosis, consequences and treatment of cholera

What is cholera?

Cholera is an infection caused by Vibrio cholerae, or Vibrio cholera, whose structure resembles a comma - it is a slightly curved stick. When it enters the human body, the small intestine is primarily affected. The cholera vibron secretes a toxin that causes watery or secretory diarrhea. This exotoxin is a trigger for a number of chemical reactions. As a result, water and electrolytes begin to actively enter the intestinal lumen, then diarrhea develops. If treatment is not started on time, then such conditions lead to: dehydration, dehydration, collapse (decrease in blood pressure and, as a result, hypoxia of tissues and organs, metabolic disorders) and oliguria (decrease in the daily dose of urine).

Referring to the "Small Academic Dictionary", you can find the definition of cholera as an acute infectious bowel disease, accompanied by vomiting, diarrhea, a decrease in body temperature and convulsions. Cholera is a contagious disease, the microorganism enters humans, most often through untreated water, as well as seafood. To diagnose it, a culture study, or more simply, culture, and serological methods, that is, taking blood for laboratory analysis, are required.

Cholera treatment consists of active rehydration, therapy with doxycycline or other antibacterial drugs, and replacement of electrolyte losses. If therapy is not carried out properly, then life-threatening conditions, and even death, can occur. That is why one should not only know the definition of cholera, but also understand its symptoms, and also be able to distinguish it from other similar diseases.

Cholera symptoms

Having overcome the gastric barrier, cholera vibrion enters the small intestine and begins to multiply actively. For microorganisms, it is a very nutritious medium, consisting of bile and food proteins. Due to their vigorous activity, toxins are released, which determine the initial stage of the disease.

Symptoms begin to appear about 3 days after infection. If a person took antibiotics shortly before infection, then the incubation period can drag on for up to a week or even more.

In ordinary situations, the body reacts as follows:

• If the disease is mild, then there is a single vomiting, as well as diarrhea with fluid loss up to 3% of body weight. If the cholera vibrio leaves the body completely, then after two days the disease stops;
• With the course of cholera, symptoms such as repeated diarrhea, up to 20 times a day, are observed in an average degree, the feces have a cloudy color. In this case, frequent sharp pains occur in the abdomen, as well as false desires to empty the intestines. A person loses up to 6% of fluid from body weight;

• If cholera is severe, then shortness of breath is added to the symptoms described above, convulsions and cyanosis of the extremities are possible. At the same time, abdominal pains are not acute, but dull, the place of their localization is the umbilical and epigastric region. Fluid loss can be up to 9% of body weight.

It is almost impossible to calculate the moment the microorganism enters the large intestine, since at this stage there are no specific signs. But nevertheless, during the incubation period, symptoms such as sweating, increased heart rate, cold extremities, a slight increase in body temperature, weakness and malaise, headache, dry mouth and rumbling in the abdomen can be noted.

But these signs do not always appear, and most often the disease has an acute onset. The first symptom to pay attention to is a sharp urge to defecate, which cannot be contained. At this time, the feces have a mushy, or immediately liquid form. As the stool becomes more frequent, the bowel movements become similar to rice water: they have a cloudy color, sometimes gray flakes are observed there. There is either no smell or there is a smell of fresh water. Fever is not one of the symptoms that characterize the onset of cholera. The prodromal period is either blurred or absent altogether.

Some atypical forms of cholera with the following symptoms are also considered the most dangerous:

• "Dry" form, when diarrhea and vomiting are not observed, at the same time, the intestines are filled with water. This is due to the paralysis of his muscles, diarrhea does not have time to develop and the disease ends in death;
• The erased form has a minimal set of symptoms, they are sluggish, but fleeting. The general condition is not disturbed and the patient poses a real threat to the health of others, since he does not seek medical help;
• Lightning-fast shape. The disease begins abruptly and reaches its peak in a few hours, all body functions are inhibited, the pressure drops rapidly. Such a course often leads to the death of a person or ends in a coma.

It is worth knowing that in addition to a sharp onset with the manifestation of any symptoms, cholera vibrio can simply reside in the human body, and the disease will proceed in a subclinical form, that is, hidden.

Cholera diagnosis

Diagnosis of the disease, as a rule, is not difficult in the presence of specific symptoms (vomiting and diarrhea without fever), but in isolated cases, cholera proceeds in a mild form with erased signs. It is in such situations, which are observed everywhere, that laboratory diagnostics are required.

In bacteriological research, both feces and vomit are needed. In laboratory conditions, vibrio-carrier is determined, this requires feces. If a person died from cholera, then a piece of the small intestine and part of the gallbladder are taken for research.

Compliance with certain conditions when determining the presence of cholera vibrio is required:

• The culture must be delivered to the laboratory as soon as possible;
• Dishes for collecting feces and vomit should not contain even the slightest traces of chemicals, since vibrio is extremely sensitive to them;
• The possibility of infection must be completely excluded.

If it is not possible to deliver the material for diagnosis within 3 hours, then preservatives should be used, in which the vibrio is able to survive. Transportation is carried out in metal containers on specialized vehicles. All samples are signed with the obligatory indication of the time of taking the material and its name. The result can be obtained after 3 hours using the express method, after 8 hours a preliminary answer will be ready, and the final one after 9 or more hours.

Consequences and complications of cholera

As a rule, with competent and adequate treatment, timely restoration of the water-salt balance, cholera does not cause complications. If dehydration has reached a critical point, then the disease can end for a person in a very deplorable - lethal outcome. Death occurs as a result of either sepsis, or hypovolemic shock, or disseminated intravascular coagulation. The pathogen does not directly affect the organ systems, therefore, after healing, they retain their functionality.

As possible complications after an illness, as well as during its course, the following can be distinguished:

• Renal failure due to organ failure. As a result, a metabolic disorder occurs;
• Convulsions of certain muscle groups;
• Development of myocardial infarction, especially in old age;
• Inflammation of the veins - phlebitis;
• Development of pneumonia is possible;
• Cerebral circulation disorder and respiratory failure;
• Drop in blood pressure;
• The risk of a permanent carrier of this microorganism without the manifestation of symptoms;

After the disease passes, antibodies to this type of pathogen continue to circulate in the body. But this does not guarantee that it is impossible to become infected with another subspecies of cholera vibron.

Cholera treatment

The main medical activities include the following actions:

• Taking antibacterial drugs to which this microorganism is sensitive;
• If dehydration of moderate and severe severity is observed, then the patient is prescribed water-salt solutions and a glucose solution, administered intravenously;
• In order to maintain the normal functioning of the gastrointestinal tract and restore its work, a course of probiotics is prescribed;
• After an illness, it is necessary to be monitored in a polyclinic at the place of residence for at least 3 months.

It is advisable to start these activities in advance, when the first symptoms appear. The promptness of taking medications guarantees a speedy recovery with minimal losses to the body. As for the diet, it is not prescribed for this disease.

In the absence of vomiting and the first degree of dehydration, patients are prescribed one of the following types of antibacterial drugs: doxycycline, ofloxacin, tetracycline, levomecitin and others. The course of treatment is 5 days, the dosage is determined by the doctor, the drugs are taken in the form of tablets.

In the presence of vomiting and severe dehydration, the following antibacterial drugs are used: amikacin, gentamicin, doxycycline, sisomycin and others. Medicines are administered intravenously, the course of treatment is also 5 days.

Even if there is a suspicion of cholera, the patient undergoes medical examination, and those in contact with him are isolated. Discharge occurs after complete recovery, in the absence of symptoms and after 3 negative culture results.

The recommendation for persons who have suffered from cholera is exemption from sports and heavy physical labor for 3 months. This applies to those patients whose illness was severe.

Cholera Prevention

Since the disease is contagious, you should know the main preventive measures aimed at eliminating the ways of its transmission:

• Compliance with all known hygiene procedures and compliance with sanitary standards, such as: washing hands, eating food after heat treatment, drinking clean high-quality water, etc.;
• It is necessary to beware of visiting those places and regions where outbreaks of the disease have been recorded;
• Foods used for food must be protected from insects. Quite often, it is flies that are carriers of cholera and other infectious diseases, especially insects that have been in landfills and in garbage cans;
• All rooms where the patient stayed must be thoroughly disinfected;
• Persons who have had contact with people infected with cholera are hospitalized until the presence or absence of cholera vibrio in the body is determined;
• Wastewater must be disinfected;
• Water in places of mass bathing, in the waters of ports should be subjected to specific research.

If a person is sent to a region where outbreaks of the disease are observed, then a single vaccination is carried out in advance. With a prolonged stay in a dangerous area, revaccination is performed 3 months after receiving the primary dose.

The international epidemiological rules require all persons arriving from disadvantaged countries to be monitored for 5 days for cholera infection.

So, cholera is an insidious disease, it can pass without a trace, leaving no memory of itself, and it can end in death, infection of a huge number of people, as well as very serious complications. It is possible to determine the presence of a microorganism only in laboratory conditions, but knowing the main symptoms of the disease and its danger, a person is able to seek medical help in a timely manner. The success of treatment directly depends on at what stage it will be started. Modern medicine has accumulated considerable experience in the fight against cholera vibrio and has a clear algorithm of action in case of its detection. That is why in developed countries, cholera outbreaks are recorded extremely rarely.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".