“Is a Deadly Disease Lurking? Are You at Risk?”
Although cholera has been claiming lives as far back as 400 B.C., it did not impact the Americas until the onset of the second cholera pandemic in 1829. Subsequent pandemics have followed, resulting in the deaths of hundreds of thousands of individuals, including Presidents James K. Polk and Zachary Taylor. Today, cholera predominantly affects less developed and impoverished regions, where inadequate infrastructure, conflicts, and displaced populations hinder access to essential preventive measures such as clean water and sanitation facilities, notes Dr. Louise Ivers, director of the Harvard Global Health Institute at Harvard University. In these areas, cholera infects between one and four million people annually, leading to an estimated 21,000 to 143,000 deaths each year according to the World Health Organization.
Cholera is a bacterial infection of the intestines that causes severe diarrhea and rapid dehydration, becoming life-threatening without prompt treatment, explains Dr. Jason Nagata, a pediatrician at UCSF Benioff Children’s Hospital in San Francisco. Additional symptoms include vomiting, extreme thirst, fatigue, muscle cramps, dizziness, and severe dehydration that can prove fatal within hours without intervention. Cholera can be deadly in 30% to 50% of cases without treatment, as individuals experience severe dehydration and organ failure due to fluid and nutrient loss from diarrhea and vomiting. Contrary to severe cases, some infected individuals may have mild symptoms or remain asymptomatic as they shed the bacteria in their feces.
Cholera is caused by Vibrio cholerae bacteria present in contaminated water and food, producing a toxin in the small intestine that triggers severe diarrhea and fluid loss. Common sources of the bacteria include raw shellfish and untreated water or food prepared with contaminated water, particularly prevalent in regions with compromised water sanitation systems. Fecal and vomit contamination of water sources and food transmission to others residing in the same household or nearby presents a higher risk of infection.
Preventing cholera involves consuming safe water, preparing food with clean water, avoiding raw or undercooked seafood, and maintaining proper sanitation practices. Early treatment is crucial in managing cholera cases to prevent severe dehydration and organ failure.
“Maintaining good hygiene practices is crucial,” emphasizes Nagata. “Cholera vaccines are readily available for individuals traveling to cholera-endemic regions,” he further explains. The FDA has approved an oral vaccine called Vaxchora, which is recommended by the U.S. Centers for Disease Control and Prevention to be administered at least 10 days prior to traveling to a cholera-affected area. Cholera, a disease caused by the bacterium Vibrio cholerae, can be effectively treated by consuming ample clean fluids or through intravenous fluid administration. “The primary focus of treatment is rehydration due to dehydration being the main concern,” notes Sack. Additionally, antibiotics may be prescribed in some cases to expedite recovery and prevent further spread of the bacteria, thus reducing the transmission of the disease. Nagata highlights that immediate and appropriate treatment significantly lowers the mortality rate of cholera to less than 1%. While access to clean water and basic medical care is readily available in developed countries, Ivers points out that the main challenge lies in reaching individuals most vulnerable to cholera, who often have limited access to safe water and healthcare facilities.
