Cholera history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]
Overview
Choleria is a severe bacterial gastrointestinal, diarrheal disease. In its most severe forms, cholera is one of the most rapidly fatal illnesses known. A healthy person may become hypotensive within an hour of the onset of symptoms and may die within 2-3 hours if no treatment is provided. More commonly, the disease progresses from the first liquid stool to shock in 4-12 hours, with death following in 18 hours to several days without rehydration treatment.[1][2]
History and symptoms
Symptoms include those of general GA tract (stomach) upset and massive watery diarrhea. Symptoms may also include terrible muscle and stomach cramps, vomiting and fever in early stages. In a later stage the diarrhea becomes "rice water stool" (almost clear with flecks of white). Symptoms are caused by massive body fluid loss induced by the enterotoxins that V. cholerae produces. The main enterotoxin, known as cholera toxin, interacts with G proteins and cyclic AMP in the intestinal lining to open ion channels. As ions flow into the intestinal lumen (lining), body fluids (mostly water) flow out of the body due to osmosis leading to massive diarrhea as the fluid is expelled from the body. The body is "tricked" into releasing massive amounts of fluid into the small intestine which shows up in up to 36 liters of liquid diarrhea in a six day period in adults with accompanying massive dehydration.[3] Radical dehydration can bring death within a day through collapse of the circulatory system.
The primary symptoms of cholera are profuse, painless diarrhea and vomiting of clear fluid.[4] These symptoms usually start suddenly, one to five days after ingestion of the bacteria.[4] The diarrhea is frequently described as "rice water" in nature and may have a fishy odor.[4] An untreated person with cholera may produce 10–20 litres of diarrhea a day[4] with fatal results. For every symptomatic person, three to 100 people get the infection but remain asymptomatic.[5] Cholera has been nicknamed the "blue death" due to a patient's skin turning a bluish-gray hue from extreme loss of fluids.[6]
If the severe diarrhea and vomiting are not aggressively treated, they can, within hours, result in life-threatening dehydration and electrolyte imbalances.[4] The typical symptoms of dehydration include low blood pressure, poor skin turgor (wrinkled hands), sunken eyes, and a rapid pulse.[4]
References
- ↑ McLeod K (2000). "Our sense of Snow: John Snow in medical geography". Soc Sci Med. 50 (7–8): 923–35. PMID 10714917.
- ↑ WHO Cholera [1]
- ↑ Rabbani GH (1996). "Mechanism and treatment of diarrhoea due to Vibrio cholerae and Escherichia coli: roles of drugs and prostaglandins". Danish medical bulletin. 43 (2): 173–85. PMID 8741209.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5
- ↑ King AA, Ionides EL, J.Luckhurst, Bouma MJ (2008). "Inapparent infections and cholera dynamics". Nature. 454 (7206): 877–80. doi:10.1038/nature07084. PMID 18704085. Unknown parameter
|month=ignored (help) - ↑ McElroy, Ann and Patricia K. Townsend. Medical Anthropology in Ecological Perspective. Boulder, CO: Westview, 2009, 375.