Cholera – Diagnosis and Treatment
Cholera is a serious illness caused by bacteria that affects the digestive system. It spreads most often through water or food that has been contaminated. Many communities with poor water and sanitation systems are at higher risk of outbreaks.
Diagnosis
To identify cholera, doctors look for signs like watery diarrhea, vomiting, and severe dehydration. Common symptoms also include nausea, sunken eyes, and sometimes kidney problems. The classic “rice-water” appearance in stool can be a clue.
Doctors confirm a definite diagnosis by checking a stool sample for Vibrio cholerae bacteria. Rapid dipstick tests and lab cultures confirm the infection. In some places, PCR tests provide more accuracy and check for the bacteria’s toxin.
Treatment
Quick and effective care is important for people with cholera. The main goal is to replace fluids and electrolytes lost through severe diarrhea.
Key steps for cholera care:
Oral Rehydration Solution (ORS): Most patients take ORS, a mixture of salts and sugar in water that helps restore fluids and minerals. Use clean, boiled, or bottled water.
IV Fluids: For people with serious dehydration, healthcare providers give fluids intravenously to bring fluid levels back up faster when drinking is not enough.
Antibiotics: Doctors may prescribe these medicines to very sick patients to lessen symptoms and shorten the illness.
Zinc Supplementation: Children with cholera may receive zinc supplements, which can shorten diarrhea and help them recover quicker.
Table: Options for Cholera Treatment
| Method | When Used | Main Benefit |
|---|---|---|
| Oral Rehydration | Most patients | Restores fluids & salts |
| IV Fluids | Severe dehydration | Rapid rehydration |
| Antibiotics | Severe cases | Reduces duration/severity |
| Zinc Supplements | Children | Reduces duration of diarrhea |
Oral cholera vaccines, like Vaxchora, help prevent illness but do not treat it. Prompt treatment lowers the risk of death to less than 1%.
Getting Ready for Your Medical Visit
Questions the Healthcare Provider May Ask
When someone goes to the doctor for symptoms that could be cholera, the doctor needs clear information to make a diagnosis.
The patient should be ready to answer questions about their symptoms, such as when they started, how severe they are, and if there are signs of dehydration like thirst, tiredness, or muscle cramps.
The doctor might also ask if the person has recently been exposed to unsafe water or contaminated food, such as raw or undercooked shellfish.
Expect questions like these:
- How long have you had diarrhea or vomiting?
- Are your stools watery or unusual in any way?
- Do you notice any signs of dehydration?
- Have you been able to drink fluids or keep food down?
- Have you recently traveled, especially to places where cholera is common?
- Did you eat any foods or drink water that might have been unsafe?
- Are you currently pregnant?
- Do you know your blood type?
- Are you taking any medicine, vitamins, or supplements?
Bring a list of all prescription and non-prescription medication, vitamins, and supplements, including the amounts taken. Bring any notes on existing health problems or allergies as well.
This information gives a full picture of the patient’s health, which helps healthcare providers choose safe treatments. Doctors check for dehydration and may request a stool sample to confirm cholera. They also test the balance of salts and water in the blood.
A table can help organize the information to share:
| Information to Prepare | Example |
|---|---|
| Symptoms and when they started | Diarrhea since Monday, started after returning from trip |
| Exposure to infection sources | Drank water from a river, ate local seafood |
| Other medical issues | Diabetes, high blood pressure |
| Medications and supplements | Blood pressure medicine (10 mg), daily multivitamin |
| Questions for the provider | What tests do I need? How long is recovery? |
Mention any possible contact with people who are sick, and tell the healthcare provider about efforts at home to prevent illness, such as practicing proper hygiene and only drinking clean water.
Steps to Take Before Your Appointment
People who think they may have cholera should not wait for their appointment to start helping themselves. Staying hydrated is the most important step. If diarrhea or vomiting is present, use an oral rehydration solution (ORS) as soon as possible.
These solutions replace water, salt, and sugar lost during illness. Pharmacies often sell them in powder packets that can be mixed with clean drinking water—never with untreated water, as this might worsen the illness.
If no pre-made solution is available, a simple homemade mixture can be created:
- Use 1 quart (about 1 liter) of bottled or boiled water.
- Mix in 6 level teaspoons (about 30 ml) of sugar.
- Add 1/2 level teaspoon (about 2.5 ml) of salt.
- Stir until fully dissolved.
Drink the mixture slowly throughout the day to replace fluids and prevent dehydration. Children, older adults, and people with other medical conditions can become dehydrated faster and should be watched closely.
Other Tips Before the Medical Visit:
- Wash hands often with soap and safe water.
- Avoid preparing food for others to lower the chance of spreading infection.
- Use clean bathrooms and make sure all waste is properly disposed of.
- Do not eat raw or undercooked seafood or foods that could have been washed with unsafe water.
- Try to rest as much as possible until seeing a healthcare provider.
Write down any questions or worries before the visit. Useful questions include:
- Could my symptoms be caused by something else?
- How is cholera diagnosed?
- What treatments work best?
- How can I make sure others in my household stay safe?
- How soon can I return to regular activities, like work or school?
- What steps should I take for good sanitation or to keep the water supply safe at home?
Practicing good hygiene and using safe water are key ways to prevent the infection from spreading. Cover your mouth and nose if you cough or sneeze, and make sure all foods are cooked completely.
Clean kitchen surfaces and dishes regularly. Taking these actions before seeing the healthcare professional helps protect both the patient and the public.
