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Diseases & Vaccines / More Vaccine Preventable Diseases / Cholera / Clinical Disease
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CLINICAL DISEASE: CHOLERA
Cholera is an acute, intestinal disease caused by the bacterium Vibrio cholerae and is transmitted by the faecal-oral route mainly through the ingestion of contaminated food and water. Infection with V. cholerae results in a wide spectrum of illness ranging from asymptomatic to mild moderate diarrhoea to severe dehydrating illness. The majority of infections results in asymptomatic illness.
Where illness does occur, it is characterised by profuse watery diarrhoea of 1 or a few days duration. In an adult patient, the fluid loss can be as much as 20 litres in 24 hours. Within 3-4 hours of the onset of symptoms, a previously healthy person may become hypotensive, and may die within 6-8 hours. More commonly, fatal cases progress to shock within 6-12 hours with death following in 18 hours to several days.
The acutely ill patient usually appears in a state of shock, with soiling of clothes by excessive faecal discharge. The faeces are usually clear without odour and may contain flecks of mucous that impart a “rice-water” appearance. Vomiting without nausea usually follows the onset of diarrhoea. Fever if present is of low grade. The skin of the hands may have a characteristic appearance resembling wrinkled “washer woman’s hands” in persons with severe dehydration.
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