It is considered one of the scourges of humanity: cholera. The bacterial infectious disease has claimed many lives, especially in the 19th century. Thus, in the last major cholera epidemic in Hamburg in 1892 nearly 10, 000 people died before the disease could be contained. However, cholera is not a disease of the past: regardless of place and time, it always breaks out where poor hygienic conditions prevail.
Bacteria develop toxin
Cholera is a bacterial disease caused by smear infections with feces. The starting point of a cholera disease is always an infected person who does not have to be ill himself. In bad hygienic conditions, ie where clean water and sewage disposal can not be adequately guaranteed, it can cause a cholera outbreak.
If the bacterium "Vibrio cholerae" reaches the intestine via smear infections, contaminated food or drinking water, it multiplies there and produces a poison, which causes the cells of the intestinal mucosa to excrete huge amounts of water.
That is, cholera sufferers can lose up to 1 liter of fluid per hour through this very watery diarrhea. The color and consistency of the chair is reminiscent of rice water - hence the name "rice water chair". This is usually vomiting. Because the fluid loses vital minerals and electrolytes, the disease can lead to life-threatening circulatory failure within hours.
Treatment of cholera
The incubation period for cholera is short: usually only one to two days pass from the infection to the onset of the disease. Decisive for a successful treatment is that the disease is recognized quickly and the loss of water and mineral is compensated.
Cholera patients are treated with an oral rehydration solution called ORS (oral rehydration solution). The solution is a mixture of glucose and electrolytes (such as sodium and potassium), which is dissolved in water. Patients who can not be treated orally because of concurrent severe vomiting receive an infusion composed accordingly.
The major challenge facing physicians and nurses in cholera patients is that the body's excessive dehydration often causes the veins to collapse, making it extremely difficult to even find venous access to an infusion. In most cases it is possible to reduce the mortality rate by treatment to 1 percent. Without treatment, it depends on the general condition of the patient - up to 70 percent. In addition, antibiotics can be used to help.
Vaccination against cholera
The risk of cholera is minimal. In 2004, 3 cases of imported cholera were reported in the Federal Republic of Germany, in the years before the numbers were even lower. The best protection against cholera is the adherence to elementary hygiene measures, such as hand washing after using the toilet and before eating, drinking only boiled and bottled water, and abstaining from already peeled fruit and vegetables.
Cholera vaccination is officially not required by any country at entry and is no longer recommended by the World Health Organization (WHO). However, when traveling through a country with a cholera epidemic, it may be necessary to present a vaccination certificate at the border of the country of entry. This should be considered, for example, when traveling by ship. For humanitarian operations in crisis areas, vaccination is recommended.
However, the currently available cholera vaccines are less effective than other known vaccines such. B. against tetanus. In addition, they do not protect against a new group of cholera pathogens (Vibrio cholerae O139), which has spread from India now to Thailand and Pakistan.
If you want to be vaccinated against cholera, usually a dose is given. Adults and children over 6 years receive 2 doses of vaccine at least 1 week apart, children from 2 to 6 years 3 doses at intervals of at least 1 week. Booster vaccinations are available for adults and children from 6 years of age two years after the first vaccination, in children from 2 to 6 months.