Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Who is at risk for cholera, and where do outbreaks occur?
Everyone who drinks or eats food that has not been
treated to eliminate V. cholerae (liquids need to be chemically treated, boiled,
or pasteurized, and foods need to be cleaned and cooked), especially in areas of
the world where cholera is present, is at risk for cholera. The CDC says in regard to cholera risk as of
November 2010, "There has been an ongoing global pandemic in Asia, Africa, and
Latin America for the last four decades." Outbreaks occur when there are
disasters or other reasons for a loss of sanitary human waste disposal and the
lack of safe fluids and foods for people to ingest. Haiti, a country that had
not seen a cholera outbreak in over 50 years, had such circumstances develop in
2010 after a massive earthquake destroyed sanitary facilities and water and
food treatment facilities for many Haitians. V. cholerae bacteria eventually
contaminated primary water sources, resulting in over 4,100 deaths from cholera
as of February 2011. There is some evidence that V. cholerae can survive in
saltwater and have been isolated from shellfish; eating raw oysters is
considered a risk factor for cholera, especially in underdeveloped countries and
occasionally even in developed countries. A few people are diagnosed with
cholera every year in the U.S. Most of the individuals diagnosed are travelers
who were exposed to cholera outside the country, but occasionally, isolated
cases are traced to contaminated seafood, usually from states that border the
Gulf of Mexico.
It takes about 100 million bacteria to infect a healthy adult. Because of
this high number, significant contamination of food or water is required to
transmit the disease and person-to-person transmission is thought to be
uncommon.
Some individuals are at higher risk to become infected than others. People
who are malnourished or immune-compromised are more likely to get the disease.
Children ages 2-4 seem more susceptible than older children, according to some
investigators. In addition, researchers have noted that patients with blood type
O are twice more likely to develop cholera than others. The reason for this
blood type susceptibility is not completely understood. People with achlorhydria
(reduced acid secretion in the stomach) and people taking medicines to reduce
stomach acid (H2 blockers and others) are also more likely to develop cholera
because stomach acid kills many types of bacteria, including V. cholerae.
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 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.
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 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 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 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 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 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.
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.
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 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.
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