Doctor's Notes on Cholera
Cholera is a highly contagious gastrointestinal infection caused by the bacterium Vibrio cholera that is characterized by dehydrating watery diarrhea. Cholera signs and symptoms may be asymptomatic or mild, but about 20% of infected people develop severe, uncontrollable watery diarrhea that is nearly clear and does not stop. Nausea and vomiting occur but with only a little abdominal pain and cramping. If the fluid and electrolytes lost in diarrhea is not quickly replaced, symptoms of dehydration (thirst, dry mouth, weakness, low urine production, fast heart rate and low blood pressure) can occur. Other severe symptoms are weight loss, sunken appearance to the eyes, loose skin, mottled purple blotches on the extremities, sleepiness and become unresponsive. Dehydration can become life-threatening as blood pressure drops (hypovolemic shock) and death occurs.
Cholera is caused by the ingestion of food or water contaminated with the bacterium Vibrio cholera. The bacteria produce an enterotoxin that triggers the intestines to excrete large amounts of fluid containing the bacteria until the body’s immune system slows and stops the toxic effects producing fluid secretion or when the patient dies.
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Dehydration in AdultsDehydration occurs when the loss of body fluids (mostly water), exceeds the amount that is taken in. Causes of dehydration include fever, vomiting, diarrhea, diseases (diabetes), impaired ability to drink, lack of access to safe drinking water, and injuries to the skin. Common symptoms of dehydration include dizziness, dry skin, headache, low urine output, tiredness, sleepiness, dry mouth, and increased thirst. Treatment of dehydration depends upon the severity of the condition.
Dehydration in ChildrenDehydration in children can result from not drinking enough liquids, vomiting, diarrhea, or combination of these conditions. Causes of dehydration in children include viral, bacterial, or parasitic infections, diabetes, and increased sweating, and others. Symptoms include sunken eyes, decrease in urination, no tears when crying, dry mouth, lethargy, and irritability. Treatment at home includes proper fluid replacement. Some cases of dehydration are so severe they may require hospitalization.
DiarrheaDiarrhea can be caused by bacterial or viral infections, parasites, intestinal diseases or conditions, reactions to medications, and food intolerance or allergies. Symptoms of diarrhea include watery stools, abdominal cramping, fever, and dehydration. Most cases of diarrhea can be treated at home. In some cases (in the elderly, small children, or those with severe or chronic medical conditions) may need to be hospitalized due to dehydration.
Foreign TravelIt is important to plan well in advance when traveling to a foreign country. Travelers should protect (and prepare) themselves from illness by obtaining the appropriate vaccinations and bringing along a traveler's medical kit that contains: prescription medications, first aid supplies, sanitary napkins/tampons (for women), sunscreen, insect repellents, motion sickness medication, pain remedies, cold remedies, and foot care products.
Vomiting and NauseaVomiting and nausea are common complaints that accompany many conditions and diseases. A few common causes of vomiting and nausea include food poisoning, viruses, vertigo, head injuries, gallbladder disease, appendicitis, migraine, brain tumors, and infections. Treatment of vomiting and nausea depend on the cause of the symptoms.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.