Cholera, an infectious disease, was discovered 200 years ago, what is the treatment?

 Cholera, an infectious disease, was discovered 200 years ago, what is the treatment?

There have been regular reports of cholera infection since a month. During this period, cholera infection has been confirmed in 36 people across the country, out of which 26 have been found infected in Lalitpur. One person has died from cholera.

Cholera has brought epidemics seven times

Cholera is an ancient infectious disease that was discovered about 200 years ago. So far, it has caused an epidemic seven times worldwide.

In the context of Nepal, it was seen in Jajarkot district in 2009 on a larger scale. Where cholera was found in about 30 thousand people. Out of which 500 people lost their lives. Then in Rautahat district in 2014 there were more than 600 cholera patients.

What is cholera that can bring people to the mouth of death?

Cholera is a waterborne infectious diarrheal disease. Which is called 'Cholera' in medical language. A bacterium called 'Vibrio cholera' is active in the rains and summers. These bacteria are transmitted to humans through contaminated water and food.

It can be cured if treated on time. But if not treated, it can even lead to death.

Why do you feel cholera?

The flow of water increases during the rainy season. The overflowing river channels are mixed with unorganized sewage. Because of this, the bacterium called 'Vibrio cholera' becomes active and spreads rapidly in places where there is a high density of people.

Contaminated water and contaminated stale, rotten food, vegetables grown in water containing bacteria are not washed properly or washed in contaminated water, drinking unboiled water, many bacteria are absorbed by the intestinal cells. Bacteria release toxins into the cells and also remove other substances from the intestines.

As a result, the balance of the digestive process is disturbed and diarrhea occurs. Excess water is removed from the body through vomiting and diarrhea.

Along with the diarrhea, excessive amount of salt, salts and liquids are sent out from the body, which the body cannot absorb. Due to which there is no energy in the body.

How do you know?

Cholera symptoms can be moderate in some people and very severe in others. If the treatment of a person with severe symptoms is delayed, it can even lead to death.

Symptoms appear two hours to five days after the bacteria enter the body. It also causes serious condition in some.

Its main symptoms are continuous loose stools like chaulani, frequent vomiting, electrolyte imbalance, loss of skin elasticity, sunken eyes, muscle aches and body weakness.

Likewise, blood pressure drops rapidly, heart rate accelerates, and death can occur due to excessive dehydration (dehydration).

What time to go to the hospital?

If the symptoms are normal, if the symptoms are reduced by drinking water mixed with boiled and cooled water, there may be no need to go to the hospital. If you drink sufficient water and eat digestible food at home, you will gradually get better.

If there is no improvement after 24 hours from the onset of diarrhea, it can be considered as a serious condition. If you see such symptoms, you should go to the hospital.

Testing and treatment

Cholera can be identified by examining the stool of an affected person. After the onset of diarrhea, the body will stay hydrated by drinking vital water and resting. As a result, the situation is improving.

But if you have diarrhea and don't eat any other food than drinking water, the situation can be serious. Because the amount of water in the body of critically ill patients is very low, water should be given intravenously.

Similarly, in some cases, antibiotics may also be used to destroy the bacteria. Although antibiotic drugs can reduce its symptoms, it should be taken only under the advice of a doctor. Because some antibiotic drugs have now developed resistance.

That is, if the bacteria develop resistance against the antibiotic, the medicine will not work. Therefore, taking antibiotics without the advice of an experienced doctor can have the opposite effect.

Complexity

If there is continuous excessive defecation and if it is not stopped, the condition of fainting due to excessive fluid leakage from the body can be 'hypo volumic sock'. In this way, death can also occur due to the complications of cholera.

When the blood goes to the cells, then oxygen and nutrition also reach. But in case of persistent cholera, 15 percent of the body's fluids such as salt and water are excreted through stool and vomiting, and the heart cannot pump blood actively when the amount of water in the body decreases. There is no blood circulation in the cells. Lack of blood supply leads to lack of oxygen and nutrition. The main organ that keeps the body moving cannot work. If the blood circulation is not done by the heart, if the blood does not reach the head in sufficient quantity, the brain tissues will die, and even death may occur due to kidney damage. This serious effect is called 'hypo-volumic acid'.

There is no solution to get rid of cholera?

It is not that the cholera vaccine has not been developed to prevent cholera, but the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) do not recommend it.

Because this vaccine only protects the recipient for a few months. Therefore, since this infection occurs every year, caution should be taken to avoid it.

The role of government

This risk that spreads every year cannot be eliminated forever. But since this kind of epidemic continues to spread because of contaminated water, it seems that the government should take concrete steps to prepare for it.

In order to control the risk of death, the government will spread public awareness in places considered to be dangerous, open defecation-free campaign It seems that cholera medicine and vital water should be sent from time to time with the onset of summer to empowering and critical areas where there is a lack of medicine.

Apart from that, clean drinking water should be provided in every house. The government should measure the quality of the water in the jar to see how pure and healthy it is and bring it under the scope of action if quality results are not obtained. Also, attention should be paid to the proper management of sewage.

what to do

- Whether it is water from a spring or a jar, drink it only after boiling or purifying it, wash the vegetables thoroughly with clean water and cook them in a clean pot.

- Wash your hands and feet with soap and water after work, sports, coming outside, urinating.

- Do not eat rotten stale food, keep the body hydrated and pay attention to toilet cleanliness.

How is cholera transmitted from one person to another?

Cholera outbreaks often occur in Nepal every year with the onset of the rainy season. This year too, the Ministry of Health and Population confirmed cholera infection in two members of the same family living in Baghbazar, Kathmandu on June 2. The first two cholera cases reported at Shukraraj Tropical and Communicable Disease Hospital were from the same family. Preliminary investigations have indicated that the infection was caused by drinking unboiled tap water. A total of 34 cholera cases have been reported till 8th July.

Looking back at the history of cholera in Nepal

Cholera was first recorded in Nepal in 1823. After that, there was a series of epidemics in Kathmandu Valley in 1831, 1843, 1856, 1862 and 1887. In 2009, the largest cholera outbreak (epidemic) occurred in Jajarkot, a central-western region of Nepal, affecting more than 30,000 people and killing more than 500. Similarly, in the rainy season of 2014, more than 600 people were infected in an epidemic in Rautahat.

What is cholera?

Cholera is an acute, diarrheal disease caused by infection with the virulent bacterium Vibrio cholerae serogroup O1 or O139. Vibrio are microscopic, gram-negative (pink colored when viewed under a microscope), comma-shaped bacteria (bacteria). An estimated 1.3 million to 4 million people worldwide are infected with cholera each year, and 21,000 to 143,000 people die from it. It is estimated that about 20 percent of people in Nepal are at risk of cholera infection.

What are the symptoms of cholera?

Passing of watery loose stools 20-25 times a day suddenly and intermittently. Frequent stools and vomiting.

In the beginning, the stools are brown or chalky in color, and later, the stools start to show traces of mucus and blood.

Dehydration due to frequent stools and vomiting and dry mouth, throat and thirst.

leg pain

Restlessness or irritability.

How is cholera transmitted from one person to another?

Preliminary investigations indicate that the infection was caused by unboiled tap water being used for drinking. A total of 34 cases of cholera have been reported till 8th July.

Cholera patients produce watery stools, which contain large numbers of cholera germs. Cholera germs enter the body (intestine) through contaminated food or water (contaminated with cholera germs) in a healthy person. Symptoms appear 12 hours to 5 days after consuming contaminated food or water.

Cholera is more likely to occur and spread in places with inadequate water treatment, poor or inadequate sanitation. However, direct contact with an infected person is not a risk factor for infection as the disease is unlikely to be transmitted directly from one person to another.

How serious is cholera?

Cholera patients usually recover without long-term sequelae if treated promptly. Cholera patients usually do not become carriers of the cholera bacteria after recovery, but become ill if re-exposed.

Cholera affects both children and adults and can be fatal if left untreated. People with severe cholera can develop severe dehydration, which, if not treated in time, can lead to shock, coma, and death within hours. About 1 in 10 cholera patients develop severe symptoms.

How to test for cholera?

A stool sample or rectal swab is taken and Vibrio cholerae is identified in the laboratory (by stool culture).

How is cholera treated?

Cholera can be treated simply and successfully by immediate replacement of fluids and salts lost in diarrhea. Patients are treated with oral rehydration solution (ORS), a prepackaged mixture of sugar and salt mixed with 1 liter of water, and repeated large doses. Severe cases may require intravenous fluid replacement. Less than one percent of cholera patients die if prompt and appropriate fluid replacement (rehydration) is performed.

Antibiotics reduce the severity of the illness, but this is not as important as rehydration. Cholera patients with severe diarrhea and vomiting should immediately go to a health facility and be treated according to the doctor's advice.

For children under 5 years of age, zinc serves as an important adjunctive therapy. It also helps prevent other causes of acute diarrhea by shortening the duration of diarrhea.

What are the measures to prevent cholera?

Drink only pure, clean, boiled or purified water.

Wash hands thoroughly with soapy water.

Only defecate in toilets, do not defecate around water sources.

Eating only after cooking food, eating raw food and salad after cleaning it well.

Pay special attention to the cleanliness of the kitchen and toilets.

Proper handling of stools of cholera patients and care givers should pay special attention to personal hygiene.

How to control cholera?

A multipronged approach is critical to controlling cholera and reducing mortality. A combination of surveillance, clean water, sanitation and hygiene, social mobilization, treatment and oral cholera vaccines are used for this.

There are currently three WHO pre-qualified oral cholera vaccines (OCVs) available (Dukoral®, Shanchol™, and Euvichol-Plus®). All three vaccines require two doses for complete protection (WHO). Water and sanitation for controlling cholera outbreaks and for prevention in areas considered to be at high risk of cholera Oral cholera vaccines should be used in conjunction with improved sanitation. Because the cholera vaccine does not provide complete protection, vaccination should never be considered a standard prevention and control measure (CDC).

The use of antibiotics is not recommended because it does not play a role in preventing the spread of cholera and can instead lead to the development of antimicrobial resistance.

A long-term solution to cholera control is only possible through economic development, safe drinking water and adequate sanitation.