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Cholera

Cholera bacteria 

Cholera is one of the oldest known causes of epidemics.  Cholera is rare in BC residents and is usually associated with travel to countries with poor sanitation and crowded living conditions. Some types of cholera bacteria cause severe illness and epidemics and other types cause milder illness and do not cause epidemics.

The main sources of contamination are humans and coastal waters. Food and drinking water can become contaminated and cause illness. Travelers are advised to follow the precautions as outlined in the 'Prevention' section Overview.

Information for Health Professionals

 

Cholera is a diarrheal illness caused by infection with the bacterium Vibrio cholerae. There are various strains of V. cholerae. Strains O1 and O139 have caused cholera epidemics and pandemics worldwide since the 19th century. Now, cholera epidemics are limited to developing countries.

Although most infections are mild, cholera caused by O1 and O139 can be severe in 10% of cases. In severe cases, up to 50% per cent of infected people may die due to massive loss of fluids. Treatment with rehydration and antibiotics brings the death rate down to less than 1%.


Cholera is a diarrheal illness caused by infection with the bacterium Vibrio cholerae. There are various strains of V. cholerae. Strains O1 and O139 have caused cholera epidemics and pandemics worldwide since the 19th century. Now, cholera epidemics are limited to developing countries.


Although most infections are mild, cholera caused by O1 and O139 can be severe in 10% of cases. In severe cases, up to 50% per cent of infected people may die due to massive loss of fluids. Treatment with rehydration and antibiotics brings the death rate down to less than 1%.



Symptoms start between a few hours to 5 days after exposure to a source. Clinical signs can be absent (asymptomatic) or can range from mild to severe.

 

In V. cholerae O1/O139 infection, severe illness is seen in about 10% of infections and includes the following symptoms:

·       Profuse watery diarrhea which looks like rice-water

·       Vomiting

·       Signs of dehydration like rapid heart rate, thirst, low blood pressure which can lead to coma and death

 

In V. cholerae infection caused by non-O1/O139 strains, symptoms tend to be milder and include:

  • nausea and vomiting
  • mild to severe watery diarrhea
  • wound infection

More severe illness can occur in people with weak immune systems, low stomach acidity or liver disease.


 
 

Vibrio cholerae occur naturally in coastal waters.


Cholera is caused by the ingestion of water or food contaminated by Vibrio cholerae. V. cholerae O1/O139  is a problem in parts of the world where there is little or no adequate sewage treatment and disposal and inadequate treatment of drinking water. Once it affects human, it can be spread from person-to-person through ingestion of food and water contaminated with stool.


V. cholerae non-O1/O139 is more likely to occur through consumption of raw or undercooked seafood. It can also cause skin infections if open wounds are exposed to contaminated water.

 

There are no known long-term complications associated with this infection.

 

Cholera is detected by culturing the pathogen from stool.

 

If your symptoms are severe or prolonged, see your healthcare provider. The most important treatment is rehydration. Antibiotics may also be used. 

 

Carry rehydration salts with you when you travel.


People with cholera can infect others. Therefore, workers in high risk occupations, like cooking and caregiving must not work while infected. Children in day care should not attend until they are free from infection. 

 

When traveling, visit a travel clinic and find out what diseases occur in the area you are traveling to. Most travelers are at low risk of cholera, unless they will be exposed to untreated drinking water and raw or undercooked seafood. There is a vaccine which can decrease the risk of V. cholerae O1/O139 infection. Discuss cholera vaccination with the travel clinic,.

Follow these precautions when traveling:


  • eat food from established food premises with a good reputation, if possible, and avoid street vendors
  • do not eat raw or undercooked seafood
  • avoid salads and uncooked foods, order food that will be cooked to order and well
  • use only purified or boiled water, or bottled water in a sealed container from a reliable source/vendor; use only ice made from one of these sources
  • eat only fruit that has a peel
  • wash your hands before eating and drinking; carry an alcohol-based hand gel with you in case you cannot wash your hands
  • avoid swimming in potentially contaminated water

In Canada and other developed countries, cooking shellfish and other seafood will decrease the risk of Vibrio infection (see Vibrio parahaemolyticus for more preventive advice). There is no vaccine for V. cholerae non-O1/O139 infection.




 
SOURCE: Cholera ( )
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