Re-Emerging Disease Cholera

flood or earthquake in a developing country, we hear once again about cholera. Cholera has been very rare in industrial nations, such as the USA, for the last 100 years, however, what we do not realize is that cholera is endemic in many small countries which have limited drinking water and sewage treatment facilities. Caused by an infection of bacterium Vibrio Cholerae in the intestine, a cholera infection is often mild or without symptoms, but sometimes is severe. Symptoms appear 2 to 3 days after initial exposure. Approximately one in 20 infected persons display symptoms of water diarrhea, vomiting, and leg cramps; this rapid lose of body fluids leads to dehydration and sometimes shock. These fluids must be replaced either intravenously or by drinking liquids such as fruit juice, soup, or fluids called oral rehydration salts, which replace electrolytes.

Antibiotics may be proscribed to shorten the duration of diarrhea and excretion of bacteria in feces. Without treatment, death may occur in hours. Although cholera can be life-threating, it can easily be prevented and treated. A vaccine for cholera is available; however, it confers only brief, 2 to 6 months, and incomplete immunity, only about 50% effective. It is not recommended.

Since cholera is still common in other parts of the world, everyone, especially travelers, should be aware of how the disease is transmitted and what can be done to prevent it. The disease is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk for becoming ill. A person may get cholera by drinking water or eating food contaminated with the Vibrio cholerae bacterium. In an epidemic, the source of the contamination is usually the feces of an infected person entering the main water source. The cholera bacterium may also live in brackish rivers and coastal waters. Shellfish from infected waters can cause infection.

Unwashed fresh fruits and vegetables irrigated with tainted water can also infect. Prevention of cholera is easy. When in a possibly infected area: cook the food properly, eat foods promptly after their preparation including shellfish, fruits and vegetables, avoid drinking untreated water, and wash your hands thoroughly with soap often. Cholera will not have great impact on me as a surgical technologist. It is not common in the United States, and since it is not transmitted directly from person to person, there is no risk of the Operating room staff transmitting the disease from the patient.

If an ill patient is scheduled, elective surgery will be postponed, and in the case of emergency surgery on someone with cholera, their fluids will be monitored meticulously. In closing, cholera, although not prevalent, is a threat to world travelers. Education of the causes, treatment, and prevention are a travelers first line of defense.

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