Like the dinosaurs, cholera is close to extinction in developed countries. There are very few cases there and one can hardly find the subject in most medical manu ¬als.
But in Africa, South Amer ¬ica and Asia, the case is quite different. Cholera remains a significant health hazard in these parts of the world.
The organism that causes cholera is called Vibrio cholerae. It"s found in the patient"s feces, urine and vomit, and is transmitted in contaminated food and water. This "bug" originated in India and spread along the trade routes in a series of epidemics that swept the globe.
By the 20th century, however, the disease disap ¬peared. Now it is no longer heard of in industrialized nations although isolated outbreaks have occurred in Japan, Australia and Europe. I wish I could say the same thing for other developing countries though. In areas with poor environmental sanitation, cholera is having a ball with dire consequences.
Diarrhea and vomiting are the main symptoms of cholera which begin two to five days after you pick up the disease. This causes massive fluid loss over the next the few days at the rate of one liter per hour which can be fatal.
"(Cholera) causes a toxic protein to attach itself to the cells that line the intestinal tract, resulting in a kind
of diarrhea you wouldn"t believe! The fluid literally pours out! This tremendous loss of water and minerals
leads to shock and collapse of the cardiovascular system. There in lies the threat to life," said Dr. Isadore
Rosenfeld of the New York Hospital - Memorial Sloan Kettering Cancer Center in "The Best Treatment."
The disease comes in three stages. The first or evacuation stage lasts from three to 12 hours and is character ¬ized by diarrhea, vomiting, abdominal cramps, cold, bluish skin and acute thirst.
Twenty-four hours later, the second stage begins in which the patient has low body temperature, purple and wrinkled skin, severe cramps, dark or absent urine, low blood pressure and a weak pulse.
If you make it to the third stage, your condition may improve as cramps and diarrhea decrease. But a secondary infection like pneumonia may occur.
To save the patient, treatment should begin as soon as possible. Lost body fluids should be replaced with the use of an oral rehydration solution. Antibiotics are effective against the cholera organism.
"The immediate treatment of cholera is the intrave ¬nous replacement of solutions that contain the various substances excreted from the bowel in these huge amounts. Such a preparation recommended by the World Health Organization (WHO) consists basically of salt, potassium, sugar and bicarbonate, and is avail ¬able wherever cholera is endemic. But if you"re stuck out in the boondocks where no one has this particular WHO formula, you can make your own mixture while waiting for more sophisticated intravenous therapy. Add two tablespoons of molasses and a teaspoonful of salt to every liter of water (boiled, naturally), and drink as much of it as you can - until it virtually comes out of your ears. Do not take any antidiarrheal medica ¬tions; they do no good in this particular situation and may actually hurt you," Rosenfeld said.
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