I know that Cholera is all over the news lately because of the outbreak in Haiti, but sadly it is still a risk in many places around the world.  Most people don’t even know what it is because it isn’t a huge risk for most in the modern world, but it still effects people in parts of Africa, Mexico, Asia, India, and Central/South America, and is still one of the world wide leading causes of death.

What is Cholera?
It is a bacterial infection in your small intestine caused by the Vibrio cholerae bacteria. The bacteria releases a toxin in your colon that causes an increase in water release, leading to large amounts of watery diarrhea.  This expelled diarrhea is filled with tons of the bacteria, and can infect the water/food source of others.

Symptoms:
The symptoms usually start one to five days after initial infection and start suddenly and all at the same time. Profuse explosive diarrhea (like EXPLOSIVE and it can smell fishy), abdominal pain, vomiting, fever, and dehydration.  The signs of dehydration can be subtle, so be aware to know when you are dehydrated:
-dry membranes in your mouth
-dry skin
-excessive thirst
-glassy/sunken eyes
-lack of tears
-lethargy
-low amounts of urine (or really dark)
-nausea
-fast heart rate
-dizziness when standing up from sitting

How do you get Cholera?
It is transmitted through water that has been infected with the bacteria, usually with feces from an infected person or vomit.  Any water that is used to wash foods or is used as drinking water that has been affected can cause the infection.  Also, shellfish that live in affected water can be infected then pass the bacteria along.  People who take antacids are at a higher risk because stomach acids can kill off the ingested bacteria, as well those with weakened immune systems due to chronic diseases and those that are malnourished are at risk. People die all of the time during cholera outbreaks due to the dehydration, and it is a serious risk.

How will I be Diagnosed?
If you suspect cholera, or just have really vile smelling diarrhea, your HCP will draw some blood to culture and test for bacteria. As well, you will be asked to bring in a stool (poop) sample and they will study for various parasites and culture for cholera bacteria.

What is the treatment?
Depending on how far along the infection is, you might need IV fluids, but usually oral replacements of fluids are suitable (this is one time where coconut water is the BEST treatments). And, oral antibiotics (tetracycline) are usually acceptable as treatment. In extreme cases, IV antibiotics would be needed to treat the infection.

How do I prevent it?
There is an injectable vaccine that is good for 2-3 years ad an oral vaccine as well but they are not available in the US and the CDC does not recommend their use. The best prevention is to be aware of where you are and where you are traveling; check with the CDC and if you are traveling to an area with a recent or current outbreak, and make sure to drink bottled water, and eat fruits and veg that you peel the skin off of, so there isn’t a risk of bacteria on the skin.  If you are helping someone with the infection make sure to clean all clothes/bed linens in boiling hot water and bleach (if possible), and boil (to sterilize) anything that comes in contact with them.  Also wash your hands thoroughly after touching them and anything they have come in contact with until the infection is treated.

So, read up before you travel abroad, and just be really careful about what you eat and drink (lay off the ice) and if you think you have any of the symptoms, drink lots of fluids (preferably coconut water, if available) and go see your HCP ASAP to prevent the spread to your fellow travelers!!

Yours in Good Health
B