Cholera history and symptoms: Difference between revisions

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Latest revision as of 20:55, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [2]

Overview

Patient may have a history of consumption of contaminated food or water and/or travel to an endemic area. Cholera symptoms usually develop within 24-48 hour of infection. Patients present with sudden-onset, painless, odorless, rice-watery, large-volume stool; abdominal cramps; vomiting; and fever. If the severe diarrhea and vomiting are not aggressively treated, they can result in life-threatening dehydration and electrolyte imbalances within hours. The typical symptoms of dehydration include dizziness (due to low blood pressure), wrinkled hands (due to poor skin turgor), sunken eyes, muscle cramps (due to hypokalemia), and decreased urine output.^[1]^[2]^[3]

History and Symptoms

History

Cholera patients' histories may include consumption of contaminated food/water and/or recent travel to a cholera-endemic area. Symptoms usually develop 24-48 hours after infection.

Symptoms

Symptoms of cholera include the following:^[1]^[2]^[3]

Diarrhea

Sudden-onset
Painless
Odorless
Watery consistency (initially it may have some fecal matter but with disease progression stool becomes mostly watery)
It is pale white in color and thus is sometimes referred as "rice-water stool" (has a similar color and consistency as water left after washing rice)
Voluminous (stool volume during cholera is more than that of any other infectious, diarrhea-causing uncontrolled bowel movements)
- An untreated person with cholera may produce 10–20 liters of diarrhea a day (with fatal results)
Abdominal cramps (due to large volume of intestinal secretion)

Vomiting

Caused by decreased intestinal motility and acidemia

Muscle Cramp

If severe diarrhea and vomiting are not appropriately treated, they can result in life-threatening dehydration and electrolyte imbalances within hours
- Typical symptoms of dehydration include dizziness (due to low blood pressure), wrinkled hands (due to poor skin turgor), sunken eyes, muscle cramps (due to hypokalemia), and decreased urine output
Cholera has been nicknamed the blue death due to a patient's skin turning a bluish-gray hue from extreme loss of fluids^[4]

Fever

Fever is usually absent

Other minor symptoms include excessive thirst, fatigue, oliguria, and weakness. For every symptomatic person, three to 100 people get the infection but remain asymptomatic.^[5]

References

↑ ^1.0 ^1.1 Sack DA, Sack RB, Nair GB, Siddique AK (2004). "Cholera". Lancet. 363 (9404): 223–33. PMID 14738797.
↑ ^2.0 ^2.1 Weil AA, Khan AI, Chowdhury F, Larocque RC, Faruque AS, Ryan ET; et al. (2009). "Clinical outcomes in household contacts of patients with cholera in Bangladesh". Clin Infect Dis. 49 (10): 1473–9. doi:10.1086/644779. PMC 2783773. PMID 19842974.
↑ ^3.0 ^3.1 Morris JG, Wilson R, Davis BR, Wachsmuth IK, Riddle CF, Wathen HG; et al. (1981). "Non-O group 1 Vibrio cholerae gastroenteritis in the United States: clinical, epidemiologic, and laboratory characteristics of sporadic cases". Ann Intern Med. 94 (5): 656–8. PMID 7235397.
↑ McElroy, Ann and Patricia K. Townsend. Medical Anthropology in Ecological Perspective. Boulder, CO: Westview, 2009, 375.
↑ 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)

Template:WikiDoc Sources

[pmid14738797-1] 1.0 ^1.1 Sack DA, Sack RB, Nair GB, Siddique AK (2004). "Cholera". Lancet. 363 (9404): 223–33. PMID 14738797.

[pmid19842974-2] 2.0 ^2.1 Weil AA, Khan AI, Chowdhury F, Larocque RC, Faruque AS, Ryan ET; et al. (2009). "Clinical outcomes in household contacts of patients with cholera in Bangladesh". Clin Infect Dis. 49 (10): 1473–9. doi:10.1086/644779. PMC 2783773. PMID 19842974.

[pmid7235397-3] 3.0 ^3.1 Morris JG, Wilson R, Davis BR, Wachsmuth IK, Riddle CF, Wathen HG; et al. (1981). "Non-O group 1 Vibrio cholerae gastroenteritis in the United States: clinical, epidemiologic, and laboratory characteristics of sporadic cases". Ann Intern Med. 94 (5): 656–8. PMID 7235397.

[4] McElroy, Ann and Patricia K. Townsend. Medical Anthropology in Ecological Perspective. Boulder, CO: Westview, 2009, 375.

[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)

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[2]

[3]

[4]

[5]

@@ Line 1: / Line 1: @@
+__NOTOC__
+[[File:220px-Adult_cholera_patient.jpg|thumb|220px|Cholera symptoms|right]]
 {{Cholera}}
-{{CMG}}
+{{CMG}}; '''Associate Editors-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, MBBS]] [mailto:psingh13579@gmail.com]
 ==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 [[hypotension|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.<ref name=McLeod_2000>{{cite journal |author=McLeod K |title=Our sense of Snow: John Snow in medical geography |journal=Soc Sci Med |volume=50 |issue=7-8 |pages=923-35 |year=2000 |pmid = 10714917}}</ref><ref> WHO Cholera [http://www.who.int/topics/cholera/control/en/index.html]</ref>
+Patient may have a history of consumption of contaminated food or water and/or travel to an [[endemic]] area. Cholera symptoms usually develop within 24-48 hour of infection. Patients present with sudden-onset, painless, odorless, rice-watery, large-volume stool; [[abdominal cramps]]; [[vomiting]]; and [[fever]]. If the severe [[diarrhea]] and [[vomiting]] are not aggressively treated, they can result in life-threatening [[dehydration]] and [[electrolyte imbalance|electrolyte imbalances]] within hours. The typical symptoms of [[dehydration]] include [[dizziness]] (due to low [[blood pressure]]), wrinkled hands (due to poor skin turgor), sunken eyes, [[muscle cramps]] (due to [[hypokalemia]]), and [[oliguria|decreased urine output]].<ref name="pmid14738797">{{cite journal| author=Sack DA, Sack RB, Nair GB, Siddique AK| title=Cholera. | journal=Lancet | year= 2004 | volume= 363 | issue= 9404 | pages= 223-33 | pmid=14738797 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14738797  }} </ref><ref name="pmid19842974">{{cite journal| author=Weil AA, Khan AI, Chowdhury F, Larocque RC, Faruque AS, Ryan ET et al.| title=Clinical outcomes in household contacts of patients with cholera in Bangladesh. | journal=Clin Infect Dis | year= 2009 | volume= 49 | issue= 10 | pages= 1473-9 | pmid=19842974 | doi=10.1086/644779 | pmc=2783773 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19842974  }} </ref><ref name="pmid7235397">{{cite journal| author=Morris JG, Wilson R, Davis BR, Wachsmuth IK, Riddle CF, Wathen HG et al.| title=Non-O group 1 Vibrio cholerae gastroenteritis in the United States: clinical, epidemiologic, and laboratory characteristics of sporadic cases. | journal=Ann Intern Med | year= 1981 | volume= 94 | issue= 5 | pages= 656-8 | pmid=7235397 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7235397  }} </ref>
-==History and symptoms==
+==History and Symptoms==
 ===History===
-* Patient may give a history of consumption of contaminated food or water.
+Cholera patients' histories may include consumption of contaminated food/water and/or recent travel to a cholera-[[endemic]] area. Symptoms usually develop 24-48 hours after infection.
-* Symptoms usually develop 24-48 hours of consumption.
-* Recent travel to a cholera endemic area may be present.
 ===Symptoms===
-====Diarrhea====
-* Sudden onset
+Symptoms of cholera include the following:<ref name="pmid14738797">{{cite journal| author=Sack DA, Sack RB, Nair GB, Siddique AK| title=Cholera. | journal=Lancet | year= 2004 | volume= 363 | issue= 9404 | pages= 223-33 | pmid=14738797 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14738797  }} </ref><ref name="pmid19842974">{{cite journal| author=Weil AA, Khan AI, Chowdhury F, Larocque RC, Faruque AS, Ryan ET et al.| title=Clinical outcomes in household contacts of patients with cholera in Bangladesh. | journal=Clin Infect Dis | year= 2009 | volume= 49 | issue= 10 | pages= 1473-9 | pmid=19842974 | doi=10.1086/644779 | pmc=2783773 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19842974  }} </ref><ref name="pmid7235397">{{cite journal| author=Morris JG, Wilson R, Davis BR, Wachsmuth IK, Riddle CF, Wathen HG et al.| title=Non-O group 1 Vibrio cholerae gastroenteritis in the United States: clinical, epidemiologic, and laboratory characteristics of sporadic cases. | journal=Ann Intern Med | year= 1981 | volume= 94 | issue= 5 | pages= 656-8 | pmid=7235397 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7235397  }} </ref>
+====[[Diarrhea]]====
+* Sudden-onset
 * Painless
 * Odorless
-* Watery consistency (initially it may have some fecal matter but with disease progression it is mostly watery)
+* Watery consistency (initially it may have some fecal matter but with disease progression stool becomes mostly watery)
-* It is pale white in color and thus sometimes referred as 'Rice water stool'(this is so because it has similar color and consistency as water left after washing stool)
+* It is pale white in color and thus is sometimes referred as "rice-water stool" (has a similar color and consistency as water left after washing rice)
-* Voluminous (stool volume during cholera is more than that of any other infectious diarrhea causing uncontrolled bowel movements)
+* Voluminous (stool volume during [[cholera]] is more than that of any other infectious, diarrhea-causing uncontrolled bowel movements)
-* Abdominal cramp (due to large volume of intestinal secretion)
+** An untreated person with cholera may produce 10–20 liters of [[diarrhea]] a day (with fatal results)
-* Fever is usually absent
+* [[Abdominal cramps]] (due to large volume of intestinal secretion)
-* An untreated person with cholera may produce 10–20 [[litre]]s of diarrhea a day with fatal results.
-* For every symptomatic person, three to 100 people get the infection but remain asymptomatic.<ref>{{cite journal |author=King AA, Ionides EL, J.Luckhurst, Bouma MJ |title=Inapparent infections and cholera dynamics |journal=Nature |volume=454 |issue=7206 |pages=877–80 |year=2008 |month=August |pmid=18704085 |doi=10.1038/nature07084 |url=}}</ref>
-* Cholera has been nicknamed the "blue death" due to a patient's skin turning a bluish-gray hue from extreme loss of fluids.<ref>McElroy, Ann and Patricia K. Townsend. Medical Anthropology in Ecological Perspective. Boulder, CO: Westview, 2009, 375.</ref>
 ====Vomiting====
-* Causes for vomiting are decreased intestinal motility and acidemia
+* Caused by decreased intestinal motility and [[acidemia]]
-====Muscle cramp====
-* If the severe diarrhea and vomiting are not aggressively treated, they can, within hours, result in life-threatening [[dehydration]] and electrolyte imbalances. The typical symptoms of dehydration include dizziness ( due to low [[blood pressure]]), (wrinkled hands) (poor skin turgor) , sunken eyes, mucle cramps (decreased potassium), and decreased urine output.
+====Muscle Cramp====
+* If severe [[diarrhea]] and [[vomiting]] are not appropriately treated, they can result in life-threatening [[dehydration]] and [[electrolyte imbalance|electrolyte imbalances]] within hours
+** Typical symptoms of [[dehydration]] include [[dizziness]] (due to low [[blood pressure]]), wrinkled hands (due to poor skin turgor), sunken eyes, [[muscle cramps]] (due to [[hypokalemia]]), and [[oliguria|decreased urine output]]
+* [[Cholera]] has been nicknamed the '''blue death''' due to a patient's skin turning a bluish-gray hue from extreme loss of fluids<ref>McElroy, Ann and Patricia K. Townsend. Medical Anthropology in Ecological Perspective. Boulder, CO: Westview, 2009, 375.</ref>
+====Fever====
+* [[Fever]] is usually absent
+Other minor symptoms include excessive thirst, [[fatigue]], [[oliguria]], and [[weakness]]. For every symptomatic person, three to 100 people get the infection but remain [[asymptomatic]].<ref>{{cite journal |author=King AA, Ionides EL, J.Luckhurst, Bouma MJ |title=Inapparent infections and cholera dynamics |journal=Nature |volume=454 |issue=7206 |pages=877–80 |year=2008 |month=August |pmid=18704085 |doi=10.1038/nature07084 |url=}}</ref>
 == References ==
 {{Reflist|2}}
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