Cholera is an intestinal infection caused by the ingestion of food or water contaminated with Vibrio cholerae bacteria . In the absence of treatment, this acute and highly contagious infection can kill children and adults within hours. Africa is currently the main victim of the seventh known cholera pandemic, which started in Indonesia in 1961 and affected Asia and Europe. The World Health Organization estimates that several million people contract cholera annually. Despite the fact that the disease is easily treated, it still kills more than 100,000 people every year due to lack of access to healthcare.
Symptoms of Cholera
Cholera is a very virulent infection. After an incubation that can take only two hours (up to a few days), violent diarrhea develops, sometimes accompanied by vomiting. Between one-quarter and one-half of untreated patients die within three days of onset of symptoms, with dehydration leading to a drop in blood pressure and cardiovascular collapse.
It is striking to note that 80% of people infected with the bacterium responsible for cholera do not show any symptoms and that when they occur, these symptoms are mild to moderate in 80% of cases.
The origins of the disease
The cholera pathogen is the bacterium Vibrio cholerae , a bacillus identified as early as the mid-nineteenth century. 1817 marks the beginning of the first cholera pandemic, which until then had been confined to the Indian subcontinent. Since then, all pandemics originated in the Asian continent. Vibrio cholerae is made pathogenic by the intervention of the CTX virus which parasitizes it. Once in the gut, the bacteria are able to produce cholera toxin that causes life-threatening diarrhea. Daily losses of water and electrolytes can reach 15 liters!
The bacterium Vibrio cholerae serogroup O1 is responsible for the vast majority of cases of cholera, because it is present in all regions of the world. It is very mobile and very resistant. The risk of cholera occurs in conditions where sanitation, food security and hygiene of the population are not insured.
Cholera is not spread directly from person to person, but the stools of infected people spread the bacteria through untreated water systems and food. Thus, large outbreaks occur in environments that combine high population density and poor sanitation. For this reason, they often develop in contexts of population displacement in regions underdeveloped and war. Young children, the elderly and individuals with a fragile immune system are the most exposed to cholera.
Prevention and treatment of Cholera
It is an easy disease to treat. The treatment consists of compensating for the loss of water and electrolytes by rapidly administering rehydration salts (standard OMS / UNICEF WHO bag) to the patient orally. When dehydration is severe, rehydration is done intravenously and antibiotics are given. Generally, remission begins after a few hours and is complete after a few days.
The main levers for fighting cholera in the long term are improving sanitation and hygiene conditions. At the individual level: in countries at risk, it is advisable to wash one’s hands regularly and to observe the golden rule defined by WHOM: all that one ingests must be boiled, cooked, peeled or peeled.