Medical Info

Quote startCholera can quickly leads to dehydration, shock and death if treatment is not promptly administered. The infection can kill a victim in less than 2 hours but can easily be treated and is preventable if one understands how it occurs and spreads Quote end


3.  Everyone must know how one becomes infected with Cholera

Cholera is contracted by ingesting the cholera bacterium. The cholera bacterium must be swallowed either with water or food contaminated with vomit or stool of cholera victims. Anything contaminated with the cholera bacterium, including dirty hands, that goes into the mouth must pass through the stomach to infect the small intestine.

 

4.    Everyone should know how to stay alive and save lives during a cholera epidemic

The treatment of cholera is extraordinarily simple. Treatment should be started without or before confirming the diagnosis. The water and salt lost in the cholera stool must be replaced, ounce for ounce, in comparable amount and concentration. Except in most severe cases, the replacement can be accomplished by allowing the patient to drink fluid. The earlier the treatment begins, the better the prognosis and the less chance for complications; this means that one should never stop giving fluid to the affected individual at home, while on the way to the hospital or clinic and while waiting to be seen in the waiting area of the hospital or clinic. Every household should have a regimen of salts to mix with water to enable them to initiate treatment as soon as it becomes apparent that someone contracted cholera, and the diarrhea is of sufficient severity to be life threatening.

Initiating treatment does not require a physician, a nurse or health worker of any sort. It demands that a person who may be at risk, as is the case for every Haitian living in Haiti, have sufficient knowledge to do the appropriate thing. If the regimen of salt is not available, table salt and sugar may be added to the water and used for treatment. Except for the “full blown” cases, most cholera victims can be managed with treatment with this fluid alone. 
Intravenous treatment is needed when a cholera victim is unconscious, muscle cramps exist, or for a patient who has been rapidly purging. This exists when volume of stools output exceed 100ml/Kg/24 hours or 7 liters per day in a 70 Kg person.

When the initial hydration is successful, the fluid loss must match. In Haiti, administration of Tetracycline, Ciproflaxin, and Kanamycin will reduce fluid loss. Pregnant women should use other safer antibiotics. 
 
The most important life-threatening complications of cholera to recognize is hypoglycemia (low blood sugar). Any alteration in the state of consciousness particularly in small children or babies must be presumed to be due to hypoglycemia and must be treated immediately. 
Electrolyte abnormalities, the next common problems, usually manifest as alteration in the state of consciousness or as convulsions, especially when the plasma sodium is low. When kidney failure exists, it should be treated conservatively. Dialysis is rarely necessary.         

 
5.    Everyone should understand that it is not essential to confirm Cholera with laboratory test to start treatment

It is not necessary to confirm the diagnosis of cholera with laboratory tests to initiate treatment of cholera. Diagnosis of cholera must rest on the history of symptoms that present as acute, and the presence of watery stool in the absence of fever or belly pain. Treatment is based solely on estimating the degree of dehydration.

 
6.    Everyone should understand how Cholera spreads

It is essential for every one to understand how cholera spreads. Cholera epidemics are characterized by multiple outbreaks. During the periods between outbreaks, which could last many months, there is no evidence of the bacterium in water or food. Although flies can carry the bacterium from stool to food and water, there are no animal carriers or vectors known.

 
During outbreaks, there are many individuals purging large volume of the cholera bacterium in their stool, which usually finds its way on the soil and in the water that is used for washing, swimming, cooking or drinking. Food such as shellfish is often implicated in the epidemic, but it is often through the use of contaminated water. Shellfish have played a role in outbreaks in the Philippines, Thailand, and Italy.

Humans that carry the El Tor bacterium can shed the cholera bacteria for at least two weeks in their stools. People with no symptoms and those with mild illness shed the bacterium in their stool; those in convalescence also continue to shed the bacterium as well. They are all important contributors of the epidemic spread of cholera.

Haiti cholera epidemic is spreading quickly and could easily ………….

  All water used for drinking, cooking, washing (specially the face, the teeth, the hands, food prior to their consumption) should be sterilized in any area where cholera may be present. Public health education and adherence to appropriate sanitation practices are of primary importance to help prevent and control transmission of cholera and other diseases.

Perhaps, the simplest and most overlooked measure during an epidemic of cholera is effective hand washing, which can curtail cross contamination within a household where cholera cases exist.

As outlined, the primary focus is to remain alive, save lives, and limit the spread of the disease by promoting education, ensuring the availability of clean water, promoting good personal hygiene and food handling practices, including hand washing and prevent defecation in open areas.

 

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7.    Everyone should pay particular attention to sanitation and hygiene to prevent cholera

It is clear that if there existed no opportunity for water or food to be contaminated with cholera bacteria, there would be no spread of the disease. Applying preventive strategies with particular attention to sanitation and hygiene appears to be the only way to abort the epidemic. With adequate attention paid to sanitation and hygiene, cholera is not a problem.

Effective sanitary practices, if adhered to in time, are usually sufficient to abort the epidemic. Proper disposal and treatment of water contaminated with stool produced by cholera victims and all contaminated materials such as clothing and bedding should be sterilized by washing them in hot water using chlorine bleach if possible. Hands that touch cholera patients or their clothing and bedding should be thoroughly cleaned and disinfected with chlorinated water or other effective agents. Sewage should be treated with chlorine, ozone, ultraviolet light or other effective forms of treatment before it enters the underground. 
Warnings about possible cholera contamination should be posted around contaminated water sources with direction on how to decontaminate the water for possible use.

                                                        
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