-för en 'bättre värld'
Today, part number three in the series about hidden tropical disease: cholera.
Cholera is one of the worst risks when dealing with health in over-crowded areas. It spreads quickly and is deadly within hours of infection. Initially spread from India, the disease is now prevalent at all continents. Zimbabwe and Haiti has so far been the sites of the perhaps worst outbreaks of the disease in the last few years, and was reported on in all media.
Cholera is caused by the bacterium Vibrio cholerae (see the picture), which makes the cells in the small intestine (which is the first part, the thin part, of the intestines in the abdomen) release water, causing uncontrollable diarrhoea and acute dehydration. If not treated, the patient will virtually dry up and die, a process that only takes a few hours from the point that the first symptoms occur. The bacterium spreads via contaminated water and food, something which is abundant in refugee camps and over-crowded cities. The signs of the disease are abdominal cramps, severe diarrhoea, lethargy, dryness (dry skin, etc.), lack of urinal output, nausea, and vomiting. There are 3-5 million incidents of cholera per year, whereof up to 150 000 deaths. It should be noted, that only about 25% of infected people develop the disease. People with immunosuppressing conditions, e.g. measles or HIV/AIDS, are in additional danger.
Physical examinations show the main symptoms, which can confirm infection. Blood or stool (faeces) cultures and the gram stain are useful to prove the bacterium’s existence.
There are vaccines that prevent the infection, the most numerous one being Dukoral, which one can take before going to countries where the disease is considered prominent. They do not provide long-term protection and are not 100% effective, so even those vaccinated should take extreme caution when in such areas. Good hygiene and latrines can help limiting the spread of the disease in refugee camps.
Fortunately, cholera is treatable. Since electrolytes and water is lost through the faeces, they must be replaced. Fluid can be given intravenously (IV) or orally. Antibiotics can be used to further shorten the convalescence period. The WHO has developed a simple oral method to treat it, which is becoming more and more recognised as an internationally workable treatment – the SSS, the salt-sugar solution, consisting of regular sugar, table salt, and water.