Cholera is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae.
Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae. The infection is often mild or without symptoms, but sometimes it can be severe. Approximately one in 20 infected persons has severe disease characterized by profuse watery diarrhea, vomiting, and leg cramps. In these persons, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.
Cholera Treatment And World's Healthiest Tips
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Cholera: Symptoms, diagnosis, treatment and prevention
Cholera outbreak The news is rife with reports of the ever increasing cases of cholera in the city this year. 
  • With the numbers increasing alarmingly, state health authorities are flummoxed with the sudden trend. So, how is cholera caused? How does it spread? Can it be prevented? How is it treated? 
  • Cholera is an acute infectious disease caused due to a bacteria called Vibrio cholerae. The bacteria has the ability to produce toxins within the human body which leads to painless, watery diarrhoea also called ‘rice water stools’ because of its appearance. In some cases patients might also have vomiting associated with the disease.
  • Other symptoms are closely related to rapid loss of fluids from the body like mild fever, body ache, abdominal pain and cramps, lethargy and fatigue, excessive thirst, headaches, loss of elasticity of the skin etc. The biggest risk in cholera is the possibility of the patient getting  dehydrated.
  • The disease is transmitted through contaminated water and food. During the monsoons this problem is further compounded by the overflowing of sewers and water logging. Vibrio cholera  is present in a patient’s stools, and when this stool is not properly disposed, it leads to contamination of common water bodies.
Diagnosis:
A doctor usually diagnosis cholera through either a blood or stool sample in combination with the symptoms of the patient.  
Treatment:
Apart from prescribing antibiotics, a doctor will advice the patient to constantly replace the fluid lost using oral re-hydration solutions. Depending on the severity of the condition a patient might need to be rehydrated intravenously.  
Complications:
Cholera is a self limiting condition, and the greatest risk that a patient faces is severe dehydration. Dehydration can lead to multi-organ failure, coma and even death.
Precautions:
Although there is a vaccine available in the countries like the United States, India still does not have a vaccination program in place. That being said, the vaccine is not very effective in preventing the disease in the case of an outbreak.
Tips to keep cholera at bay:
Keep your surroundings clean.
Drink only boiled and filtered water, the best way to stay safe is to wash your utensils in boiled water as well. Avoid drinking tap water.
Avoid eating food from road side stalls.
Always wash your hands well with water and soap, after you have visited the bathroom and before eating.
Use boiled water to wash utensils.
The disease is most common in places with poor sanitation, crowding, war, and famine. Common locations include parts of Africa, south Asia, and Latin America. If you are traveling to one of those areas, knowing the following cholera facts can help protect you and your family.
Cholera Causes
Vibrio cholerae, the bacterium that causes cholera, is usually found in food or water contaminated by feces from a person with the infection. Common sources include:
  • Municipal water supplies
  • Ice made from municipal water
  • Foods and drinks sold by street vendors
  • Vegetables grown with water containing human wastes
  • Raw or undercooked fish and seafood caught in waters polluted with sewage
  • When a person consumes the contaminated food or water, the bacteria release a toxin in the intestines that produces severe diarrhea.
  • It is not likely you will catch cholera just from casual contact with an infected person.
Cholera Symptoms

Symptoms of cholera can begin as soon as a few hours or as long as five days after infection. Often symptoms are mild. But sometimes they are very serious. About one in 20 people infected have severe watery diarrhea accompanied by vomiting, which can quickly lead to dehydration. Although many infected people may have minimal or no symptoms, they can still contribute to spread of the infection.
What is the treatment for cholera?
The CDC (and almost every medical agency) recommends rehydration with ORS (oral rehydration salts) fluids as the primary treatment for cholera. ORS fluids are available in prepackaged containers, commercially available worldwide, and contain glucose and electrolytes. The CDC follows the guidelines developed by the WHO (World Health Organization) as follows:
  • WHO Fluid Replacement or Treatment Recommendations (as per the CDC)
  • Patient condition
  • Treatment Treatment volume guidelines;
  • age and weight
  • No dehydration  Oral rehydration salts (ORS)
  • Children < 2 years: 50 mL-100 mL, up to 500 mL/day
  • Children 2-9 years: 100 mL-200 mL, up to 1,000 mL/day
  • Patients > 9 years: As much as wanted, to 2,000 mL/day
  • Some dehydration                                                                                                                       Oral rehydration salts (amount in first four hours)
  • Infants < 4 mos (< 5 kg): 200-400 mL
  • Infants 4 mos-11 mos (5 kg-7.9 kg): 400-600 mL
  • Children 1 yr-2 yrs (8 kg-10.9 kg): 600-800 mL
  • Children 2 yrs-4 yrs (11 kg-15.9 kg): 800-1,200 mL
  • Children 5 yrs-14 yrs (16 kg-29.9 kg): 1,200-2,200 mL
  • Patients > 14 yrs (30 kg or more): 2,200-4,000 mL
  • Severe dehydration                                                                                                                          
  • IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within one hour*, then 70 mL/kg over five hours
  • Age > 1 year: 30 mL/kg within 30 min*,
  •  then 70 mL/kg over two and a half hours
  • Repeat once if radial pulse is still very weak or not detectable
  • Reassess the patient every one to two hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200 mL/kg or more may be needed during the first 24 hours of treatment.
  • After six hours (infants) or three hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink.
  • In general, antibiotics are reserved for more severe cholera infections; they function to reduce fluid rehydration volumes and may speed recovery. Although good microbiological principles dictate it is best to treat a patient with antibiotics that are known to be effective against the infecting bacteria, this may take too long a time to accomplish during an initial outbreak (but it still should be attempted); meanwhile, 
Rehydration
The WHO has provided recommendations for fluid replacement in patients with dehydration[16] (see Table 2). The recommendations include recommendations for fluid replacement for severe hydration, some dehydration, and no dehydration.
Severe dehydration
Administer intravenous (IV) fluid immediately to replace fluid deficit. Use lactated Ringer solution or, if that is not available, isotonic sodium chloride solution. If the patient can drink, begin giving oral rehydration salt solution (ORS) by mouth while the drip is being set up; ORS can provide the potassium, bicarbonate, and glucose that saline solution lacks.
  • For patients older than 1 year, give 100 mL/kg IV in 3 hours—30 mL/kg as rapidly as possible (within 30 min) then 70 mL/kg in the next 2 hours. For patients younger than 1 year, administer 100 mL/kg IV in 6 hours—30 mL/kg in the first hour then 70 mL/kg in the next 5 hours.
  • Monitor the patient frequently. After the initial 30 mL/kg has been administered, the radial pulse should be strong and blood pressure should be normal. If the pulse is not yet strong, continue to give IV fluid rapidly. Administer ORS solution (about 5 mL/kg/h) as soon as the patient can drink, in addition to IV fluid.
  • Reassess the hydration status after 3 hours (infants after 6 h), using Table 1. In the rare case that the patient still exhibits signs of severe dehydration, repeat the IV therapy already given. If signs of some dehydration are present, continue as indicated below for some dehydration. If no signs of dehydration exist, maintain hydration by replacing ongoing fluid losses.
Routes for parenteral rehydration

Accessing a peripheral vein is relatively easy, despite the severe dehydration. If a peripheral vein is not readily accessible, scalp veins have been used for initial rehydration. As the vascular volume is reestablished, a larger needle or catheter can be introduced in a peripheral vein.
Intraosseous routes have been used successfully in young children when veins cannot be accessed. The intraperitoneal route has been tried, but is not recommended.
ORS solution can be administered via nasogastric tube if the patient has some signs of dehydration and cannot drink or if the patient has severe dehydration and IV therapy is not possible at the treatment facility.
Overhydration
A risk of overhydration exists with intravenous fluids; it usually first manifests as puffiness around the eyes. Continued excessive administration of intravenous fluids can lead to pulmonary edema and has been observed even in children with normal cardiovascular reserve. Thus, it is important to monitor patients who are receiving intravenous rehydration hourly. Serum-specific gravity is an additional measure of the adequacy of rehydration.
Some dehydration
Administer ORS solution according to the amount recommended in Table 3. WHO ORS contains the following:
Sodium – 75 mmol/L
Chloride – 65 mmol/L
Potassium – 20 mmol/L
Bicarbonate – 30 mmol/L
Glucose – 111 mmol/L
A homemade equivalent is 6 teaspoons of sugar and one half teaspoon of salt in a liter of water; a half cup of orange juice or some mashed banana can provide potassium.
Use the patient's age only when weight is unknown. The approximate amount of ORS required (in mL) also can be calculated by multiplying the patient's weight (in kg) times 75.
If the patient passes watery stools or wants more ORS solution than shown, give more. Monitor the patient frequently to ensure that the ORS solution is taken satisfactorily and to identify patients with profuse ongoing diarrhea who require closer monitoring.
Reassess the patient after 4 hours, using Table 1. In the rare case where signs of severe dehydration have appeared, rehydrate for severe dehydration, as above. If some dehydration is still present, repeat the procedures for some dehydration and start to offer food and other fluids. If no signs of dehydration are present, maintain hydration by replacing ongoing fluid losses.
Most patients absorb enough ORS solution to achieve rehydration, even when they are vomiting. Vomiting usually subsides within 2-3 hours, as rehydration is achieved.
Urine output decreases as dehydration develops and may cease. It usually resumes within 6-8 hours after starting rehydration. Regular urinary output (ie, every 3-4 h) is a good sign that enough fluid is being given.
No signs of dehydration
Patients who have no signs of dehydration when first observed can be treated at home. Give these patients ORS packets to take home, enough for 2 days. Demonstrate how to prepare and give the solution. The caretaker should give the patient the amount of ORS solution shown in Table 4.
Instruct the patient or the caretaker to return if any of the following signs develop:
Increased number of watery stools
Eating or drinking poorly
Marked thirst
Repeated vomiting
Any signs indicating other problems (eg, fever, blood in stool)
Medication
First Line
Oral rehydration therapy for mild disease:
  • Oral rehydration solution (ORS) commercial brands available (Pedialyte, Rehydralyte, Resol, Rice-Lyte) or
  • Oral rehydration solution formula from World Health Organization, per liter:
  • Sodium chloride 3.5 g
  • Potassium chloride 1.5 g
  • Glucose 20 g
  • Trisodium citrate 2.9 g
  • Parenteral rehydration
  • Rehydration for severely dehydrated patients:
  • IV rehydration (Ringer lactate) is followed by oral or nasogastric administration of glucose or sucrose-electrolyte solution.
  • Antibiotics:
  • For older children and adults: Doxycycline (Vibramycin): 300 mg once or 100 mg b.i.d. for 3 days or tetracycline 50 mg/kg/d for 3 days
  • For young children: Trimethoprim-sulfamethoxazole (SMX-TMP, Bactrim, Septra) 8 mg/kg trimethoprim plus 40 mg/kg sulfamethoxazole per day, divided q.12 h. This dosage is equivalent to 1 mL/kg of trimethoprim-sulfamethoxazole suspension.
  • In pregnant patients: Furazolidone 100 mg q.i.d. for 7–10 days
  • Contraindications:
  • Tetracycline: Not for use in pregnant patients or children <8 years old
  • Furazolidone and alcohol in combination may cause disulfiram-like reaction
  • Precautions:
  • Tetracycline: May cause photosensitivity; sunscreen recommended
  • Significant possible interactions:
  • Tetracycline: Avoid concurrent administration with antacids, dairy products, or iron.
Cholera Treatment

Cholera TreatmentCholera is a serious bacterial disease and caused by Vibrio cholera bacteria as per name. In this disease patient get infection in small intestine and that cause diarrhea and vomiting frequently. For cholera, Amritdhara a patent medicine has been used in old ages. Now this medicine has been replaced with Naveen Amritdhara which is a combination of equal amount of Sat (Infusion) Piplamint, Ajwain (Carom/thymol) and karpoor (Camphor). In Cholera treatment, we can use this Naveen amritdhara medicine. Right dose is very necessary in this Cholera epidemic. It is in liquid form and for adults 4 drops with one sugar spoonful 4 times a day. In case of children,a dose of 2 drops with one sugar spoonful 3 times a day. Ayurveda suggest some more home remedies for Cholera. These are as:
Cholera Treatment
Give the solution of Loaf sugar with water to Cholera patient. After that prepare the powder of Jaiphal (Nutmeg) and mix with Gur (Treacle) to make small pills of 2-3mg. Use these pills one by one after every 30 minutes. This will help to stop diarrhea and cure cholera.
  • Take 5 gram Hing / Hingu (Asafoetida, Ferula Foetida), 10 gram kapoor (Camphor), 10 gram Catechu powder and 10 shoots of Neem/nimb (Azadirachta indica) and grind all these in Tulsi (Holy basil, Ocimum sanctum) extract to prepare small pills. Cholera patient use these pills one by one in 3-4 times a day in Cholera treatment.
  • Cholera patients have excessive thirst so they have to use warm water by mixing some black salt in place of normal water.
  • Mix some black salt in the extract of onion and warm a little. This is used to cure Cholera. For better results in onion extract add Pudina (Mint, Peppermint) extract and take every 10-15 minutes.
  • Take the extract of Saunf/Sanchal (Fennel seed) and Pudina (Mint, Peppermint) and prepare syrup to use.
  • Prepare mixture of Mirch (chilli, pepper) 1-2 gram arhar (Cajanus indicus) leaves 1gram and 1/10th part of Black salt. Use this solution in Cholera treatment.
  • Take the peel of Aak/ Madaar (Calotropis procera) root and mix with black salt. Warm this mixture and use this mixture when cooling 2 spoonfuls one time every after 3-4 hour to cure cholera.
  • Apply some kalmi shora / Pitkari (Potassium nitrate) in Urine sense (Mutra-Indri). It will immediately passing out urine and cure Cholera.
  • Prepare the powder of Lahsun (Garlic), Hing and camphor and mix with lemon extract. Use this mixture to cure cholera.
  • Mix equal amount of Hing and Kali Mirch (Peppercorns) and double amount of Kapoor (Camphor). Prepare small pills of and take pills one by one in Cholera treatment.
  • Mix lemon extract with half amount of onion and Pudina (Mint, Peppermint) to cure cholera.
  • Mix some black salt in Horse stool (Ghode ke leed) extract and use 2-3 spoons every after one hour in Cholera treatment.
  • In cholera treatment, boil 25 gm shoots of Mango powder in one glass of water. Boil till the half solution remains behind and filter it. Drinks twice a day warm solution to cure Cholera.
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