MedicineNet.com

About Us | Privacy Policy | Site Map
February 8, 2012

Cholera

Medical Author:
Medical Editor:

Cholera Outbreak in Haiti

Medical Author: Charles Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD

Again, a cholera epidemic strikes a human population. This time the cholera epidemic is in Haiti, a small country that has undergone large disasters. On Jan. 12, 2010, a huge earthquake killed over 300,000 people, leaving Haiti with a huge homeless population and its main city, Port-au-Prince, devoid of most normal services and sanitary conditions. Many city residents left, but the more rural areas were not any better at supplying people with sanitary conditions. Many Haitians simply turned to their largest river in the country for water to drink, bathe, wash clothes, and swim in. This is a perfect environment for the development and spread of cholera and other diseases. As of Oct. 26, 2010, at least 250 people have died from cholera in Haiti.

Learn more about the cholera in Haiti »


What is cholera?

Cholera is an acute infectious disease caused by a bacterium, Vibrio cholerae (V. cholerae), which results in a painless, watery diarrhea in humans. Some affected individuals have copious amounts of diarrhea and develop dehydration so severe it can lead to death. Most people who get the disease ingest the organisms through food or water sources contaminated with V. cholerae. Although symptoms may be mild, approximately 5%-10% of previously healthy people will develop a copious diarrhea within about one to five days after ingesting the bacteria. Severe disease requires prompt medical care. Hydration (usually by IV for the very ill) of the patient is the key to surviving the disease.

The term cholera has a long history (see history section below) and has been assigned to several other diseases. For example, fowl or chicken cholera is a disease that can rapidly kill chickens and other avian species rapidly with a major symptom of diarrhea. However, the disease-causing agent in fowl is Pasteurella multocida, a gram-negative bacterium. Similarly, pig cholera (also termed hog or swine cholera) can cause rapid death (in about 15 days) in pigs with symptoms of fever, skin lesions, and seizures. This disease is caused by a pestivirus termed CSFV (classical swine fever virus). Neither one of these animal diseases are related to human cholera, but the terminology can be confusing.

What are cholera symptoms and signs?

The symptoms and signs of cholera are a watery diarrhea that often contains flecks of whitish material (mucus and some epithelial cells) that are about the size of pieces of rice. The diarrhea is termed "rice-water stool" (See Figure 1) and smells "fishy." The volume of diarrhea can be enormous; high levels of diarrheal fluid such as 250 cc per kg or about 10 to 18 liters over 24 hours for a 70 kg adult can occur. People may go on to develop one or more of the following symptoms and signs:

People require immediate hydration to prevent these symptoms from continuing because these signs and symptoms indicate that the person is becoming or is dehydrated and may go on to develop severe cholera. People with severe cholera (about 5%-10% of previously healthy people; higher if a population is compromised by poor nutrition or has a high percentage of very young or elderly people) can develop severe dehydration, leading to acute renal failure, severe electrolyte imbalances (especially potassium an sodium), and coma. If untreated, this severe dehydration can rapidly lead to shock and death. Severe dehydration can often occur four to eight hours after the first liquid stool with death in about 18 hours to a few days in undertreated or untreated people. In epidemic outbreaks in underdeveloped countries where little or no treatment is available, the mortality (death) rate can be as high as 50%-60%.

Picture of rice-water stool from a patient with cholera
Figure 1: Rice-water stool from a patient with cholera; note the flecks of mucus precipitated at the bottom of the cup that resemble rice grains. SOURCE: CDC

Picture of patient with washer woman hands (loss of skin elasticity), a sign of cholera.
Figure 2: Washer woman hands (loss of skin elasticity) are a sign of cholera. SOURCE: CDC


Patient Discussions

Viewers share their comments

Cholera - Symptoms Question: What symptoms did you experience with cholera?
Cholera - Treatments Question: What treatment has been effective for your cholera?

MedicineNet Doctors

Suggested Reading on Cholera by Our Doctors

  • Related Diseases & Conditions

    • Muscle Cramps
      • Muscle cramps are involuntarily and forcibly contracted muscles that do not relax. Extremely common, any muscles that have voluntary control, including some organs, are subject to cramp. Since there is such variety in the types of muscle cramps that can occur, many causes and preventative medications are known. Stretching is the most common way to stop or prevent most muscle cramps.
    • Diarrhea
      • Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
    • Lower Back Pain
      • There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
    • Dehydration
      • Dehydration is the excessive loss of body water. There are a number of causes of dehydration including heat exposure, prolonged vigorous exercise, and some diseases of the gastrointestinal tract. The best way to treat dehydration is to prevent it from occurring.
    • Nausea and Vomiting
      • Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
    • Dry Mouth
      • Dry mouth is a common side effect of many prescription and non-prescription drugs. Symptoms of dry mouth include a sticky, dry feeling in the mouth, frequent thirst, sores in the mouth; sores or split skin at the corners of the mouth, cracked lips, a dry feeling in the throat, a b urning or tingling sensation in the mouth, and a dry, red, raw tongue.
    • Food Poisoning
      • Food poisoning is common, but can also be life threatening. The most common form of food poisoning is caused by bacteria and include symptoms such as fever, abdominal pain, diarrhea, nausea and vomiting.
    • Travelers' Diarrhea
      • Travelers' diarrhea is generally contracted by eating contaminated food or drinking contaminated water. Food is the primary source of travelers' diarrhea. Enterotoxigenic E. coli is the cause of up to 70% of all cases of travelers' diarrhea. There are five unique classes of E. coli that causes gastroenteritis. Other bacteria responsible for travelers' diarrhea include Campylobacter, jejuni, shigella, and salmonella. Viruses such as rotavirus and Norwalk virus (norovirus) and giardia lamblia a parasite may cause travelers' diarrhea. Prevention is careful eating and drinking of water.
    • Travel Medicine
      • Travelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary medication if they have a medical condition or chronic disease. Diseases that travelers may pick up from contaminated water or food, insect or animal bites, or from other people include malaria, meningococcal meningitis, yellow fever, hepatitis A, typhoid fever, polio, and cholera.
    • The Digestive System
      • Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
    • Bioterrorism
      • Bioterrorism is a form of terrorism where there is the intentional release of biological agents such as viruses, germs, or bacteria. Diseases caused by bioterrorism agents include anthrax, botulism, plague, smallpox, tularemia, brucellosis, food poisoning, Q fever, ricin toxin poisoning, cholera, epidemic typhus, viral encephalitis, XDR TB, and MDR TB.
  • Medications

  • Procedures & Tests

  • Pictures, Images & Illustrations

  • Doctor's & Expert's Views

  • Health News

  • Health Features

Women's Health

Find out what women really need.



Symptom Checker: Your Guide to Symptoms & Signs: Pinpoint Your Pain



Cholera

What Causes Dry Mouth?

There are several causes of dry mouth, also called xerostomia. These include:

  • Side effect of certain medications. Dry mouth is a common side effect of many prescription and nonprescription drugs, including drugs used to treat depression, anxiety, pain, allergies, and colds (antihistamines and decongestants), obesity, acne, epilepsy, hypertension (diuretics), diarrhea, nausea, psychotic disorders, urinary incontinence, asthma (certain bronchodilators), and Parkinson's disease. Dry mouth can also a side effect of muscle relaxants and sedatives.
  • Side effect of certain diseases and infections. Dry mouth can be a side effect of medical conditions, including Sjögren's syndrome, HIV/AIDS, Alzheimer's disease, diabetes, anemia, cystic fibrosis, rheumatoid arthritis, hypertension, Parkinson's disease, stroke, and mumps.
  • ...

Read the Dry Mouth article »






Cholera Related Supplements


Use Pill Finder Find it Now

Pill Identifier on RxList

  • quick,
    easy,
    pill identification

Find a Local Pharmacy

  • including
    24 hour
    pharmacies