Cholera

Cholera is an acute contagious disease characterized with damage of small intestine, water-salt metabolism failure, different desiccation rate because of liquid loss during vomiting and watery feces.  Cholera belongs to quarantine infections. The agent is bacterium Vibrio cholerae in form of hooked bacillus. During boiling the bacterium dies in a minute. Some bacteria types may persist for a long period of time and multiply in iodine, silt and in organisms that live in ponds. Source of infection is diseased person. Vibrio cholerae is released with feces and vomit mass. Cholera outbreaks may be watery, alimentary, household and combined. Susceptibility to cholera is high.

Symptoms and signs
Cholera may course without symptoms or may show with severe symptoms leading to death.  Incubation period lasts from 1 to 6 days. The disease starts acutely. First sign is sudden diarrhea, mostly  in the evening and in the morning.

At the beginning feces are watery, then smell disappears and may appear blood. Then appears vomit that occurs suddenly. Diarrhea and vomit are not followed with abdomen pains. When patient loses great amount of liquid, the symptoms of digestive tract damage drops back. Most important sign of failure in activity of major body systems, severity of which is determined by degree of dehydration:
 - first degree: dehydration is slightly frank
 - second degree: body weight lowering by 4 – 6%, lowering of erythrocytes number and drop in hemoglobulin level. Patient complains on sudden weakness, dizziness, dry mouth, thirst. Lips and fingers turn blue, appears hoarseness of voice, occurs jactitation of gastrocnemius muscles, fingers and chewing muscles.
 - third degree:  body weight lowering by 7 – 9% and all symptoms of dehydration are aggravated. Blood pressure drop may lead to collapse. Body temperature lowers up to 35.5C. Urine may stop releasing. Blood becomes more concentrated because of dehydration.
 - forth degree: body loses 10% of liquid. Facial features do sharpen, appear dark spots around eyes. Skin is blue. Patient is in state of exhaustion. Blood pressure suddenly drops. Body temperature lowers up to 34,5C. Frequently all these symptoms lead to death.

Complications
Pneumonia, abscesses, phlegmon, erysipelas, phlebitis.

Treatment
Hospitalization of all patients. First of all it is necessary to fight dehydration and restore water-salt balance. It is recommended to take solutions containing sodium chloride, potassium chloride, sodium bicarbonate, glucose. In menu should be included products containing potassium salt (tomatoes, potatoes). Antibiotics are used only in case of 3 – 4 degree of dehydration - tetracycline and laevomycetin are used in average daily doses. The prognosis in adequate treatment is favorable.

Prevention
Protection and deintoxication of potable water. Active supervision of people who were in contact with diseased people during 5 days.