Signs and Symptoms of Cholera

Signs and Symptoms of Cholera

Cholera is an acute and devastating gastrointestinal disease that occurs in humans. It is characterized as a diarrheal disorder that is the result of an enterotoxin produced by a bacteria called vibrio cholerae.

The bacterium is comma shaped hence the alias the V comma. The negative effects are when the bacterium is present in large numbers in the small intestines. This directly implies that a small amount or number will not have a significant ill effect on you as the host.

Some types of vibrio cholerae result in more severe diseases when compared to others. Cholera is a specific infection that occurs only to the human population. However, the bacterium vibrio cholerae can be found in populations of planktons and shellfish. Currently, cholera is classified as a pandemic. This alone shows how serious a case of the disease is, though it is rare in places with high standards of sanitation such as well-developed countries.

Signs and symptoms 

The occurrence of these symptoms to the host is dependent on the virulence factors, how infectious or deadly the vibrio cholerae is. This depends on:

• Motility: The presence of a flagella enables motion in vibrio cholerae allowing the bacterium to swim inside the small intestines searching for nutrients from the intestinal cells, and this also aids in keeping the bacterium adhered to the epithelial lining of the small intestines. This factor also enables it to overcome the mucus inside that is present in the small intestines.

• Adherence: The virulence factor also enables adherence of vibrio cholerae inside the small intestines. They have toxin co-regulated pilus that is associated with the production of cholera toxins. This toxin is necessary in the intestines and possibly, the bacterium uses this immune response to create its niche in the small intestines. Direct adherence of the pili to epithelial cells that line the small intestines result in colonization.

• Toxin mechanism: An A-B toxin that is produced by vibrio cholerae causes the affected person to excrete copious amounts of ions and water from the body. A-B toxin is a cholera toxin. This is done through creation of an ionic gradient between host cells and lumen, causing the cells to excrete more water and electrolytes into the lumen.

It is possible for an individual to be infected by cholera and the person show no symptoms at all. However, this person can still transmit the disease to a healthy person through the transmission means mentioned. They only act as carriers to the bacterium and may spread the bacterium since it is shed after one or two weeks. Cases of carriers are very rare, a percentage of less than 10% of the infected population.

Symptoms of cholera

After approximately one week of ingestion or contracting of the cholera bacterium, symptoms may begin to set in. This is serious and can result in death after a very short period of time. Early recognition is important to avoid complications that may become fatal. In this regard, it is important to be sufficiently aware of symptoms for early management.

Diarrhea: Although diarrhea may be common, especially in people with stomach upset or other ailments, diarrhea resulting from cholera is distinct. It has a whitish appearance like water used to wash rice grains. The diarrhea is very watery as explained by of one of the virulence factors.

Vomiting: Vomit involved in cholera cases is most often a clear liquid. The vomiting further worsens the water loss or fluid loss resulting from diarrhea.

Difficulty in breathing: Loss of bicarbonate through stool causes increased acidity in the blood. Loss of ions triggers increased concentration of the hydrogen present in blood, a condition called acidosis. This results in a labored breathing pattern.

Low blood pressure: Dehydration resulting from vomiting and profuse diarrhea causes significant water loss from the body. Dehydration is associated with low blood pressure since much of the blood consists of water. Reduced volumes of blood cause blood pressure that is lower than normal. Low blood pressure causes reduced flow of blood to vital organs such as the heart and brain, and these consequences may be very serious.

Muscle cramps: Poor circulation of blood can be established as the primary cause of muscle cramps in cholera patients. This is a result of loss of potassium and magnesium ions through the associated diarrhea. Also, dehydration causes muscle cramps to those experiencing it. Massaging may help reduce the cramps along with stretching, putting ice on the affected area and warming the muscle.

Thirst: The body has a means of responding to various stimuli. From dehydration, the body seeks to establish normal fluid levels by intake of more water. The urge to take in more water by the body of a patient with cholera is much stronger than the regular feeling of thirst.

Loss of elasticity of the skin: The skin of the human body is made in such a way that, when pinched or pulled, it behaves like an elastic material and returns to its original position. However, in cholera patients, the skin may take a considerably longer time to return to normal. This is associated with extreme dehydration in that inadequate water is available in the body. 

Exhaustion: From the reduced rate of flow of blood, there is an insufficient amount of blood to transport glucose to the muscle tissues to help in respiration. Blood transports oxygen and glucose to the muscles when doing work enabling eased labor. When oxygen and glucose lack or are in low quantities, the individual experiences exhaustion and tiredness. This is common in cholera patients in that they experience low blood pressure. High pressure and volume of blood is necessary to transport the oxygen and glucose.

Low urine output: Urine is attributed to excretion of excess water and mineral salts from the body. In cases involving cholera, this is more than sufficiently done. In fact, it is over-done or excessively done. It is done by vomiting and the watery diarrhea which occurs often. In this regard, it is no longer necessary to urinate. If present, the amount of urine is low and urination is in rare circumstances.

Drying of the skin: Water is the element that keeps almost all things from drying. When water is lost, as in cholera cases, through diarrhea and vomiting, the skin dies up. In some cases, the mouth and lips also dry up.

Convolutions: At times the loss of skin elasticity is further manifested through folding of the skin. The skin appears like a rugged material such as a piece of cloth.

Fever: As in many health complications, fever is also a characteristic in cholera patients. The reduced blood pressure reduces blood circulation used to cool the blood. Any condition that alters normal body conditions usually trigger fever. Here, blood supply to the head or brain may cause the fever as one of the body's responses to stimuli. As mentioned, fever can be an indication of many possible conditions. 

Bottom Line

Cholera can be made manifest in the body of an individual by a series of many signs and symptoms. However, not all cholera patients show the signs and symptoms as some may only be carriers. On observing the signs and symptoms, it is important to take back-up measures to help relieve the symptoms. This should only be a complement to seeking medical attention as soon as possible.