Cholera is an acute, infectious, often fatal disease caused by the micro organism Vibrio cholerae. It is endemic in India and some other tropical countries and occasionally spreading to temperate climates. The symptoms of cholera are diarrhoea and the loss of water and salts in the stool.
In its more ordinary form it commences with sickness, vomiting, or perhaps two or three loose evacuations of the bowels; after which follow a sense of burning at the praecordia, an increased purging and vomiting of a white or colourless fluid, great prostration of strength, spasms at the extremities, which increase in violence with the vomiting and purging. Such cases may last from twelve to thirty- six hours; after this the patient generally sinks into a state of extreme collapse, and this stage in most cases passes by a gradualtransition into a febrile one, which in a majority of instances proves fatal. Sometimes the patient is suddenly stricken down and dies, collapsed within a few hours without diarrhoea or vomiting.
In severe cholera, the patient develops violent diarrhoea with characteristic 'rice-water stools,' vomiting, thirst, muscle cramps, and sometimes circulatory collapse. Death can occur as quickly as a few hours after the onset of symptoms. The mortality rate is more than 50 percent in untreated cases, but falls to less than 1 percent with proper treatment. Treatment consists mainly of intravenous or oral replacement of fluids and salts. Packets for dilution containing the correct mixture of sodium, potassium, chloride, bicarbonate, and glucose have been made widely available by the WHO. Most patients recover in three to six days. Antibiotics such as tetracyclines, ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole can shorten the duration of the disease, but have their own long term risks in damage to the immune system.
Cholera first appeared (in recognised form) in Europe in 1829, and reached Britain in 1831, spreading thence to America. Western Europe was again visited by it in 1847, 1853, 1865, 1873, 1875, and in 1885. In 1892 Russia and Western Europe suffered severely.
By 1905 it was ascertained that the primary and essential element in the production of cholera was a constituent of the excreta of cholera patients. At the time it wasn't known what the agent was, but that it is an organism capable of propagating itself when it is taken into the alimentarycanal in food, impure water, or the like, was beyond a doubt. Dr. Koch asserted that the essential cause was a bacillus, having the form of a curved rod, hence then called the comma bacillus, and that the disease was caused by the multiplication of this organism in the small intestines.
A method of protective inoculation against cholera was tried in India, with some success around 1900. At the same time it was established that the contagion of cholera is not so likely to be conveyed by personal intercourse as by residence in an infected district. Sanitary measures proved to be the only efficacious means of arresting an epidemic; insanitary conditions decidedly favour it - quite obvious as the disease is spread through contact with infected faeces.
What is called British cholera is a bilious disease, long known in most countries, and is characterized by copious vomiting and purging, with violent griping, cramps of the muscles of the abdomen and lower extremities, and great depression of strength. It is most prevalent at the end of summer or the beginning of autumn. Cholera infantum (infants' cholera) is the name sometimes given to a severe and dangerous diarrhoea to which infants are liable in hot climates or in the hot season. Research Cholera
Glanders is a disease attacking horses, due to a bacillus (Bacillus mallei), which affects the lungs and sometimes the membrane of the nose and throat. The disease may be passed to man by contagion. In man the incubation period is from one to five days. The symptoms may be acute or chronic. In the former type there is an eruption of papules on the face and some of the joints, which soon become pustular, with fever and malaise; later ulcerating nodules develop in the nose and cause a foul discharge. The disease was formerly sometimes mistaken for smallpox. Abscesses are formed in the muscles and skin (farcy) and the patient collapses with high fever and often bronchopneumonia. Death follows within ten days in a high proportion of cases. In the chronic type of the disease the same sequel of rash and abscesses is seen, but the condition becomes chronic and new abscesses form as healing takes place; even after apparent cure, recurrence is common and may be fatal. The diagnosis is often difficult in the early stages. Research Glanders
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Matt and Leela Probert
Abbreviations
Research Cholera
