Recognizing Cholera Outbreak


Recognizing Cholera Outbreak

Cholera is a bacterial infection that can cause the sufferer to become dehydrated from severe diarrhea. Cholera transmission usually occurs through contaminated water. If not treated promptly, cholera can be fatal in just a few hours.

Cholera usually plague in densely populated areas without adequate sanitation. With prompt and appropriate treatment, cholera can be treated well. Cheap and simple treatments, such as oralit, can be used to prevent dehydration from cholera.


Cholera Symptoms

Unconsciously not all cholera sufferers have symptoms because they have been infected with Vibrio Cholerae or cholera bacteria. Of all people infected with cholera, only 10% of them show symptoms. Although it has no symptoms, cholera can spread to others through cholera-containing stools and contaminate water for one to two weeks. Here are some of the symptoms that can occur such as sudden diarrhea that causes a rapid loss of body fluids that is about 1 liter per hour, vomiting and nausea for several hours in the early stages of cholera infection, abdominal cramps due to loss of sodium, chloride And potassium due to prolonged diarrhea. Cholera that has caused symptoms for several hours can lead to dehydration of the sufferer due to lack of fluids in the body. Severe dehydration occurs when the body loses more than 10% of the total body weight.

At the time of dehydration due to cholera, one can feel some of the following symptoms:

1. Dry mouth

2. Arrhythmias or heart rhythm disorders

3. Concave eyes

4. Easy to get angry

5. Feel very thirsty

6. The body is lethargic

7. Hypotension or low blood pressure

8. Lethargy

9. Urine that comes out little or no

10. Skin wrinkled and dry


Causes of Cholera

There are several serological groups of Vibrio cholerae bacteria, but there are only two types that can cause epidemic diseases, namely V.cholerae O1 and V.cholerae O139. Both types have the same toxicity and the resulting symptoms are not much different. There are two different life cycles in cholera bacteria, namely in the human body and the environment.

  • Cholera bacteria in the human body. People infected with cholera bacteria can transmit disease through stools that contain bacteria. Cholera bacteria can reproduce fertile if the water and food supply is contaminated with the stool.
  • Cholera bacteria in the environment. Shore waters that have a small crustacean named copepoda is a natural place of the emergence of cholera bacteria. Plankton and certain types of algae are a source of food for crustaceans, and cholera bacteria will go with their host (ie crustaceans), following a food source scattered throughout the world.


In addition to several sources of cholera infection as mentioned above, there are also several factors that can increase the risk of contracting cholera bacteria, namely:

  • Blood Type O. People with this type of blood have a risk of contracting cholera twice as large as other blood types.
  • Living with someone who has cholera. Since cholera bacteria tend to stay in water sources, people living with cholera will be at greater risk of developing the disease because they drink from the same water source.
  • Has low levels of stomach acid. Cholera bacteria can not survive in acidic environments. Human gastric acid can be the first defense against infection.


Cholera Complications

Massive loss of fluid and electrolytes can be harmful and fatal. Shock and severe dehydration are the most dangerous cholera complications. In addition there are several other health problems that can arise due to cholera, namely:

  • Hipokalemia, or lack of potassium which can cause impaired heart and nerve function.
  • Kidney failure, which results from loss of the kidneys" ability to filter, thus releasing large amounts of fluid and electrolytes from the body. Shock often appears in cholera sufferers who have kidney failure.
  • Hypoglycemia, or low blood sugar levels that can occur if the patient is too sick to eat. This situation can be dangerous because glucose is the main body energy source. Missing awareness, convulsions, and even death can occur due to these complications. Children are more susceptible to hypoglycemia.


Cholera Treatment

Diagnosis is done to overcome cholera and determine appropriate treatment. The only way to confirm the diagnosis of cholera is to test the stool sample to see the presence of bacteria. Now medical officers in remote areas can use tests to diagnose cholera more quickly and reduce the fatal impact that can occur.

The most fatal consequences of cholera are deaths that can occur within hours. That"s why patients need fast and precise handling. Emergency measures can be:

  • Oral administration, to replace lost fluids and electrolytes. Oralite is available in powder form which can be mixed with bottled mineral water or boiled water.
  • Giving infusion, for people with severe dehydration.
  • Provision of zinc supplements, to relieve diarrhea in children with cholera.
  • Provision of antibiotics, to reduce the number of bacteria, while shortening diarrhea due to cholera.


Cholera Prevention

To prevent cholera, you should always maintain personal hygiene and food. You can reduce your risk of cholera by doing the following:

  • Avoid buying food from street vendors or street vendors, Eat foods that are completely cooked.
  • Avoid eating raw seafood or not cooked until cooked.
  • Avoid consumption of raw milk and beware of dairy products (eg ice cream), because it is often contaminated with bacteria.
  • Wash your hands with soap and water regularly, especially before meals and after using the toilet. Before washing with water, rub both hands with soap for at least 15 seconds. You can also use a hand sanitizer containing alcohol if there is no soap and water.
  • Drinking bottled water or water that has been cooked to boil. Generally, bottled drinks, cans, or warm drinks are safer. But before opening the beverage packaging, wipe the outside first.
  • Gargle with clean water after brushing your teeth.
  • Avoid eating unpeeled salads and fruits, such as grapes. Choose vegetables and fruits that can be peeled alone, such as kiwi, banana, and papaya.


Vaccination can also be done so as not to catch the cholera bacteria, but the distribution of this vaccine is still limited. Currently, there are three brands of cholera vaccine that pass WHO pre-qualification test, namely Dukoral®, Shanchol ™, and Euvichol®. This vaccine is given orally and is reserved for people who will travel to cholera outbreak areas and for those who have access to limited medical services (eg humanitarian aid workers).

Based on WHO data in 2015, several African countries such as Congo, Kenya, Malawi, Mozambique, Nigeria, Somalia, Sudan and Tanzania are areas affected by cholera endemic. Ideally, cholera vaccine is given approximately one week before someone travels to cholera-prone areas. For people over the age of six, 2 doses of cholera vaccine can protect them from cholera bacterial infection for two years. As for children aged two to six, it takes 3 doses of cholera vaccine to protect them from cholera bacteria attack for six months.