Cholera is an intestinal infectious disease caused by the vibrio of the same name. Concentrates in the small intestine, causing vomiting, loose stools and dehydration.
Cholera is a virus that has not yet been defeated. Mankind has been trying to cope with the disease for several thousand years. At the present stage of development of medicine, up to 5 million people fall ill with this disease during the year, about 150 thousand of them die.
Distribution, facts
Until the beginning of the 19th century, only the population of India suffered from cholera. With the development of communication between countries and continents, the disease has spread throughout the world. To date, periodic outbreaks of the epidemic are recorded in 90 countries. Permanent foci are located in Africa, Latin America, and in some regions of Asia. The main reason for the spread of the disease is unsanitary conditions.
A sharp surge in cholera is always observed after social cataclysms - wars, earthquakes, natural disasters, that is, in those periods when a large number of people are deprived of clean drinking water. Cholera is epidemiological in nature, when the disease covers more than 200 thousand peopleat the same time.
The causes and symptoms of cholera are now well known to physicians. Treatment of the disease is carried out, depending on the severity of its course.
A few facts about the infection that every person needs to know:
- For a disease to develop, at least a million bacteria must enter the human body, which is equal to about one glass of water.
- Animals do not get cholera, with the exception of molluscs and crustaceans that live in warm waters.
- Vibrio cholerae live freely in fresh and s alty environments.
- At risk are people with the first blood group or with low acidity of gastric juice. Children aged 3 to 5 are also most commonly infected.
- Babies whose mothers had cholera have strong immunity to the disease.
- In 9 out of 10 cases, infected people have only a slight gastrointestinal upset, while the bacteria will actively live in the intestines and be released during the evacuation of waste products.
- The course of the disease is individual for everyone - some patients "burn out" during the day, others recover.
- In Russia, the disease was last detected in 2008.
- If the diagnosis is established in the shortest possible time, then drinking water every 15 minutes relieves the disease within 3-5 days, while you can do without drug treatment.
At the present stage, there are vaccines that reduce the likelihood of an outbreak many times over, but it has not yet been possible to completely eliminate the disease.
Pathogen
The Vibrio cholerae bacterium is a curved rod, at one end of which there is a movable flagellum, which ensures its rapid movement in the liquid. Vibrio has up to 200 varieties, two of which cause acute disease (Vibrio cholerae, Vibrio eltor). The main damage to the body is caused by toxins secreted by the vibrio.
Properties of toxins and their effects:
- Destroy the epithelial layer of the small intestine.
- Provoke the release of fluid into the intestines and its excretion with feces and vomiting.
- They cause malabsorption of sodium s alts, as a result of which the water-s alt balance is disturbed, which causes convulsions.
The bacterium is resistant to freezing and does not die when defrosted. It actively reproduces at a temperature of 36-37 degrees Celsius. The temperature corridor for the life of bacteria ranges from 16 to 40 ° C. The death of a microbe occurs when dried, exposed to sunlight, temperatures above 60 ° C, in an acidic environment.
Classification
The most severe symptoms of cholera occur in children and the elderly. The incubation period of the pathogen in the human body ranges from several hours to 5 days, from the moment the microbe enters the body. Most often, the disease manifests itself within the first or second day after infection.
The main symptoms of cholera are indigestion and active fluid loss. In connection with dehydration, there are 4disease progression:
- 1 degree (mild) - dehydration is 1-3% of the total body weight of a person. This condition occurs in half of the cases.
- 2 degree (moderate) - 4-6% fluid loss.
- 3 degree (severe) - 7-9% fluid output.
- 4 degree (very severe) - fluid loss up to 10% of body weight. Observed in 10% of cases.
The symptoms of cholera appear immediately, against the background of general he alth, at normal body temperature. At the height of the disease, body temperature drops below 36 ° C, the duration of the disease leaves up to 5 days, but can end in one day.
Symptoms
Most often, epidemiologists are faced with a moderate course of the disease. The symptoms of cholera are as follows:
- Diarrhea. Under the action of toxins of the cholera pathogen, swelling of the mucous membrane of the small intestine begins. A person develops loose stools, bowel movements become frequent, gradually acquiring a transparent, odorless appearance, with the inclusion of white flakes. With a strong destruction of the intestinal mucosa, blood clots appear in the secretions. Patients rarely experience abdominal pain, sometimes there is rumbling or discomfort. Defecation in the acute phase of the course of the disease occurs up to 10 times a day. When the stool becomes normal, the doctors state the beginning of recovery.
- Vomiting. Occurs from 2 to 20 times a day and occurs 3-5 hours after infection. In the first urge, the food eaten is excreted from the body, infurther vomiting is odorless and looks like ordinary water. The reflex occurs without muscle tension.
- Thirst. Occurs due to rapid and large loss of fluid. In the first three stages of the disease, the patient consumes a lot of water; in the last stage, he cannot drink on his own due to weakness.
- Urine. It gradually darkens, its quantity decreases. With the advent of urination, the recovery process is ascertained.
- Dry mucous membranes (eyes, mouth). These are symptoms of cholera due to dehydration. Pronounced signs are a hoarse voice, sunken eyes, dry and cracked tongue.
- Convulsions. Calf muscles, hands, feet suffer. At 3-4 degrees of the course of the disease, convulsions of all skeletal muscles are observed. These symptoms of cholera disease are due to a lack of potassium.
- Pulse. Weak and weak. As a result of fluid loss, the blood thickens, the heart increases the rate of contractions. Recovery occurs completely after saturation of the body with the necessary amount of water and the restoration of water and s alt balance.
- Short breathing. It is observed at the onset of stage 2 and above of the disease.
- Skin condition. One of the symptoms of cholera is a change in skin turgor (loss of elasticity), pallor, and sometimes cyanosis of the integument. Feels cold to the touch.
- General condition. Apathy, lethargy, desire to sleep, irritability. There is a general decline in strength, which is associated with intoxication of the body, dehydration.
Symptoms of cholera disease can appear within hours of being hitpathogen in the body. Diagnosis in the early stages allows you to cope with the disease with the least loss to he alth.
Infection channels
Doctors have studied the causes and symptoms of cholera quite well. Treatment and prevention of the disease are carried out according to the many times proven algorithm of actions and measures aimed at eliminating the likelihood of the spread of the epidemic. Every person needs basic knowledge to protect themselves from infection.
How cholera spreads:
- A person who uses untreated water from open sources is more likely to develop symptoms of cholera. Those who use non-disinfected water for domestic purposes are at risk - for washing dishes, hygiene procedures, laundry.
- Bathing in pools of questionable water and accidentally or deliberately swallowing it is one way of contracting cholera. Symptoms, causes of a person's condition in this case will be considered by physicians as a defeat by cholera vibrio.
- Contact with an infected person also leads to illness (through contaminated objects, dirty hands, etc.).
- Transmission occurs through the consumption of poorly washed vegetables, fruits, food cooked with non-compliance with the thermal regime, as well as the use of expired products.
- Vebrio cholerae are often carried by insects such as flies.
Compliance with basic hygiene rules - frequent hand washing, careful handling of food,boiling water helps reduce the risk of infection and does not know what cholera symptoms and treatment are. Prevention is the best way to stay he althy.
Diagnosis
When diarrhea and vomiting occur, doctors pay attention to all other symptoms. The treatment of cholera disease is fully implemented after the research.
The complex of diagnostic measures includes:
- Laboratory tests of feces, urine, vomit.
- Investigation of water from the source of alleged contamination.
- Research of products, objects used by patients.
- Diagnosis of the presence of infection in people in contact with the patient.
- From those who died of cholera, samples of tissues of the intestines and gallbladder are taken.
Diagnostic methods:
- Microscopic examinations.
- Bacteriological.
- Reactive.
Relevant authorities are required to immediately respond to reports that any of the residents have symptoms of cholera. Treatment, prevention are implemented by the sanitary and epidemiological services in a complex, immediately after the threat of a mass disease. In critical situations, when there is a risk of an epidemic or pandemic, express research methods are used (duration no more than 30 minutes):
- Lysis (treatment of Vibrio cholera with bacteriophages).
- Agglutination (gluing) of chicken erythrocytes.
- Destruction (hemolysis) of red blood cells.
- Immunofluorescent method (processinggrown preparation with a special composition, as a result of which Vibrio cholerae begins to glow).
- Vibrio immobilization (treatment with anti-cholera reagent).
Treatment
A patient diagnosed with symptoms of cholera is being treated and rehabilitated in the infectious diseases departments of hospitals. If there is an epidemic, then a separate cholera hospital will be organized. Patients are under the supervision of infectious disease specialists, patients are prescribed medication, bed rest, diet therapy.
Medicines for treatment:
- Therapy is aimed at restoring water, electrolyte and water-s alt balance in the body affected by cholera. Symptoms and causes of the disease require a constant assessment of the patient's condition and prompt restoration of the lost fluid. A water-s alt solution is introduced into the patient's body using a probe (in case of a severe course of the disease) or the patient drinks water on his own. Specialists use drugs "Chlosol", "Trisol" and analogues.
- Taking antibiotics. To suppress the reproduction of cholera vibrio, the patient must take one of the drugs: Tetracycline, Ciprofloxacin, Erythromycin. The doctor calculates the dosage.
The duration of drug treatment in each case is purely individual and depends on the severity of the infection, the body's immunity, and the speed of recovery. On average, treatment is from 3 to 5 days. The period of medical control for a recovered patient lasts 3 months, during which the patient regularlytaking tests.
Diet
Cholera requires an integrated approach to treatment. Symptoms, causes of the disease, prevention, therapy make up the overall picture of the disease. The system of tools for overcoming the consequences and successful treatment includes strict adherence to the rules of a specially designed diet by the patient. The principles of nutrition, as well as acceptable and unacceptable foods, are described in the Pevzner diet (table No. 4). Eating behavior on this diet is shown in the first 3-4 days after the disease. Dishes should only be steamed or boiled. Food is served pureed or semi-liquid.
Approved Foods:
- Cereal and vegetable soups cooked in fat-free broth with egg flakes, meatballs from dietary meats.
- Mucoid porridge on the water, mashed buckwheat, oatmeal, rice porridge is also allowed.
- Bread - stale or crackers made from premium wheat flour.
- Meat dishes - soufflé, steam cutlets, lean meat meatballs (veal, turkey, rabbit).
- Lactic acid products - dishes from low-fat or calcined cottage cheese (steamed soufflé).
- Eggs - Soft-boiled steam omelets (up to 2 per day).
- Drinks - decoctions of wild rose, blueberries, currants or quince, weak black or green tea.
The following foods are prohibited:
- Rich, fatty broths and dishes based on them.
- Flour products, fresh bread.
- Sausages, canned meat and fish,fatty meat and fish.
- Whole milk, dairy products.
- Pasta and cereals from millet, wheat, pearl barley.
- Any raw vegetables, fruits, and dried fruits.
- All kinds of sweets, including honey, jam.
- Invigorating and carbonated drinks.
After the acute phase of the course of the disease (3-4 days), the patient is transferred to diet No. 5, which helps restore body functions. Proper nutrition, combined with drug treatment, helps to cope with cholera. Symptoms and treatment change as the critical condition progresses.
Treatment by folk methods
Healers have developed many recipes for the treatment of such an acute disease as cholera. Symptoms and prevention are the basis for starting therapy and the ability to avoid complications. Since the disease can be fatal, it is unacceptable to rely only on traditional medicine prescriptions during the acute phase. They are good as an addition to the methods of official medicine or are used at home after the patient is discharged from the hospital.
The following measures are recommended:
- Warming up. The patient during the illness suffers from a significant decrease in body temperature, so the temperature in the room where he is located should not be lower than 25 degrees Celsius. The patient is kept warm with electric blankets or heating pads.
- Periwinkle tea promotes bowel disinfection. Dry raw materials (a teaspoon) are poured into a glass of steepboiling water and after straining, use 100 ml three times a day.
- Natural red wine, taken at 50 ml every 30 minutes, prevents the growth of Vibrio cholera.
- Medicinal tea (chamomile, wormwood, mint, taken in equal amounts). Dry raw materials (10 tablespoons without a slide of spoons) are poured with 2 liters of boiling water, after filtering they drink during the day. Tea relieves intestinal spasms, has an antimicrobial effect.
- M alt. A decoction of 4 tbsp. tablespoons of raw materials and 1 liter of water boil for 5 minutes, insist, filter. A little sugar is added to the resulting preparation and drunk throughout the day. Biologically active components significantly reduce the manifestations of cholera, replenish the water-s alt balance.
Prevention
Cholera has long been known to mankind. The causes, symptoms and prevention of the disease have been fully studied by modern medicine. The main way to protect yourself from infection is to follow the rules of hygiene - frequent washing of hands, disinfection of water, cleaning of premises and the surrounding area from debris. These measures relieve any person from the threat of infection.
WHO also recommends vaccination during outbreaks. Vaccination is not able to completely eliminate the possibility of infection, all hygiene rules must be strictly observed by vaccinated people. It is also necessary to limit contacts with infected patients as much as possible, to disinfect the premises.
The following vaccines are recommended:
- Dukoral – providesup to 90% protection within 6 months of vaccination.
- Shanchol, mORCVAX - taken orally in three doses, effective for 2 years.
Vaccinations are recommended for a limited number of people at risk - refugees, slum dwellers, doctors.
