Cholera disease –The bacterial illness cholera attacks the small intestine and results in severe watery diarrhoea, vomiting, and occasionally even death. The bacterium Vibrio cholerae, which causes it and spreads through tainted food and water, is to blame.
Since ancient times, cholera has been a significant public health concern and still is today in many parts of the world, especially in places with poor sanitation and insufficient access to clean drinking water.
It has long been known that cholera exists in the Ganges Delta in India, where it is thought to have its origins. Through trade and travel, the illness spread from India to other continents, including Asia, Africa, Europe, and the Americas.
The first pandemic of cholera struck Southeast Asia, the Middle East, Africa, and Europe in 1817. Europe, North America, and Asia were all affected by the second pandemic, which started in 1829 and lasted until 1851. Africa, Asia, Europe, and South America were all affected by the third pandemic, which began in 1852 and lasted until 1860. Between 1863 to 1875, the fourth pandemic struck Europe, Asia, Africa, and South America.
Asia, Africa, Europe, and South America were all affected by the fifth pandemic, which started in 1881 and lasted until 1896. Between 1899 and 1923, the sixth pandemic struck Asia, Africa, Europe, and South America. Asia, Africa, and Latin America are still being affected by the seventh pandemic, which started in 1961.
The seventh pandemic is the largest and longest-lasting, causing three to five million cases and more than 100,000 fatalities annually. Many nations, including Bangladesh, India, and portions of Africa, Asia, and Latin America, are plagued by cholera. In places afflicted by armed conflict, natural disasters like earthquakes and floods, or human displacement, outbreaks also happen.
Virus spread and pathogenesis
Cholera is primarily spread by contaminated food and drink, which comes from sick people’s faeces. Long-lasting in water, the bacterium can infect people who drink it or use contaminated water for cooking or cleaning.
With an average of two to three days, the cholera incubation period can last anywhere from a few hours to five days. The bacteria attach to the intestinal wall in the small intestine and release an enterotoxin, which causes the cells to discharge a lot of fluid and electrolytes, causing diarrhoea and dehydration.
From an asymptomatic illness to moderate diarrhoea to severe dehydration and death, cholera can range in severity. People with compromised immune systems, malnutrition, or other underlying medical issues may experience a more severe case of the disease. Dehydration can cause organ failure and hypovolemic shock in severe cases, which can be fatal if addressed.
Diagnosis and symptoms
Stomach cramps, vomiting, and abrupt onset of watery diarrhoea are the main signs and symptoms of cholera. The diarrhoea is plentiful and watery, smells like fish, and looks milky and pale. Massive amounts of diarrhoea can cause electrolyte abnormalities and serious dehydration.
Cholera is diagnosed using clinical signs, epidemiological data, and lab tests. Stool samples can be examined for the presence of enterotoxin and the Vibrio cholerae bacterium. Blood testing can be used to identify electrolyte abnormalities and dehydration.
Rehydration therapy and antibiotic therapy are used to treat cholera. The goals of rehydration therapy are to stop dehydration and restore fluid and electrolyte balance. It entails giving fluids and electrolytes such saline, glucose, and potassium intravenously or orally.
Cholera can be treated with antibiotics to shorten its length and severity and to lessen its spread. Cholera is typically treated with antibiotics including tetracycline, doxycycline, azithromycin, and ciprofloxacin. Antibiotic resistance, however, is a growing issue, and the medicines chosen may differ based on regional patterns of resistance.
Improvements in water and sanitation, hygiene education, and increased access to clean water are all part of the cholera prevention strategy. This covers the availability of clean water resources, enhanced sanitation, and effective waste management. Cholera prevention and fostering proper hygiene practises also depend on health education and community involvement.
Another effective method for preventing cholera is vaccination. The cholera vaccines that are now on the market are secure and efficient, with a 60–70% overall efficacy rate. The vaccines can be taken orally, and two doses are needed for the best defence. Use of cholera vaccinations is advised by the World Health Organisation in endemic regions and during outbreaks.
Cholera is still a serious public health concern even though there are excellent preventative and therapeutic strategies available, especially in places with limited resources. The ongoing seventh pandemic emphasises the necessity of continued efforts to curb and eradicate cholera on a worldwide scale.
Lack of access to clean water and proper sanitation in many regions of the world is one of the major obstacles to cholera control. It takes political will and commitment, as well as ongoing investments in infrastructure and resources, to address these concerns.
The growth of antibiotic resistance, which can reduce the efficacy of available treatments, is another difficulty. This emphasises the requirement for improved resistance surveillance and tracking, as well as the creation of fresh antibiotics and alternative therapeutic approaches.
Additionally, work is being done to create fresh and improved cholera vaccines. The efficiency and cost-effectiveness of vaccination programmes could be significantly increased by the creation of a single-dose vaccine and a vaccine that offers long-term protection.
Conclusion
A serious and potentially fatal illness, cholera is still a major public health worry, especially in areas with little resources. The bacterium Vibrio cholerae is what causes the illness, and it is transmitted by tainted food and drink.
A multimodal strategy is necessary for the prevention and control of cholera, including improvements in water and sanitation, hygiene promotion, immunisation, and access to efficient treatment. It takes political will and commitment in addition to consistent infrastructural and resource investments to address these issues.
Global efforts to control and prevent cholera are essential for enhancing public health and lessening the impact of this terrible illness. Cholera is a serious hazard during humanitarian catastrophes and crises in addition to the difficulties already discussed. These conditions enhance the risk of cholera outbreaks because of things like overpopulation, a lack of clean water and sanitation facilities, and inadequate medical care.
In times of emergency, cholera prevention and control must be given top priority by humanitarian organisations and governments. This entails granting access to sanitary facilities and clean drinking water, encouraging good hygiene habits, and setting up efficient surveillance and response mechanisms.
Significant social and economic effects of cholera are also present. Due to missed productivity, medical expenses, and the strain on healthcare systems, the condition may result in severe economic losses. In addition to causing social exclusion and discrimination, the stigma attached to cholera can also harm those who have survived the disease.
The larger social and economic context in which the disease manifests itself must be considered in any efforts to manage and prevent cholera. For long-term control and prevention, it is essential to address the root causes of cholera, such as poverty, inequality, and poor healthcare.
In conclusion, cholera is a serious and sometimes fatal disease that still poses a serious threat to global public health, especially in environments with low resources. Improvements in water and sanitation, hygiene education, immunisation campaigns, access to effective treatment options, and consideration of the larger social and economic context in which the disease occurs are just a few of the many factors that must be taken into account when tackling the challenges of cholera prevention and control.
The long-term control and avertance of cholera calls for consistent investments in resources, infrastructure, and political will. While cholera’s worldwide toll has decreased, much more work has to be done to completely eradicate this terrible illness.
