More than a hundred new cases of cholera, including two deaths, were recorded in the health area of Uvira (South Kivu) in the Democratic Republic of the Congo since January, according to a Radio Okapi report (computer translated).
Cholera is an acute bacterial intestinal disease characterized by sudden onset, profuse watery stools (given the appearance as rice water stools because of flecks of mucus in water) due to a very potent enterotoxin. The enterotoxin leads to an extreme loss of fluid and electrolytes in the production of diarrhea. It has been noted that an untreated patient can lose his bodyweight in fluids in hours resulting in shock and death.
It is caused by the bacterium, Vibrio cholerae. Serogroups O1 and O139 are the types associated with the epidemiological characteristics of cholera (outbreaks).
The bacteria are acquired through ingestion of contaminated water or food through a number of mechanisms. Water is usually contaminated by the feces of infected individuals. Drinking water can be contaminated at the source, during transport or during storage at home. Food can get contaminated by soiled hands, during preparation or while eating.
Beverages and ice prepared with contaminated water and fruits and vegetables washed with this water are other examples. Some outbreaks are linked to raw or undercooked seafood.
The incubation for cholera can be from a few hours to 5 days. As long as the stools are positive, the person is infective. Some patients may become carriers of the organism which can last for months.
Treatment of cholera consists of replacement of fluids lost, intravenous replacement in severe cases. Doxycycline or tetracycline antibiotic therapy can shorten the course of severe disease.
There is an oral vaccine available in some countries but it is not available in the U.S. Cholera prevention is the same as in other causes of traveler’s diarrhea.
Cholera, according to the World Health Organization, still infects between 3 million and 5 million people each year, killing between 100,000 and 120,000.