Cholera is an acute diarrheal disease of the gastrointestinal tract cause by the indigestion of Vibrio cholerae bacteria. The incubation period range from a few hours to 5 days after the bacteria is ingested. If cholera is left untreated, the victim's chances of survival are only 40%, but in cases where patients receive immediate proper treatment, the chance of survival is greatly increased. Cholera usually affects people who belongs to the lower socioeconomic groups who lives in the tropical regions where there is inadequate treatment of sewage and drinking water.

How Cholera bacteria multiply? After the cholera-producing bacteria are ingested they multiply in the middle and last portions of the small intestine where they produce a toxic substance that probably interferes with the functioning of the intestinal membrane. In normal condition this membrane allows the exchange of water and salts between the intestine and body tissues, but when this function is disturbed the water and salts are not absorbed and are eliminated from the body in a watery diarrhea. Even though the patient drinks large amount of water, the water will not be absorbed through the intestinal wall and consequently the diarrhea will not subside.

Symptoms:

• Massive diarrhea. Some cholera victims have no apparent symptoms but others may suffer severe dehydration from massive diarrhea. The diarrhea is a continuous, light-gray, watery stool but containing no blood or pus.
• Vomiting. Shortly after the onset of diarrhea most victims have sudden bouts of vomiting that may continue for hours at a time.
• Muscular cramps. About 75% of all cholera patients also suffer severe muscular cramps, usually confined to the extremities. These result from the rapid loss of salts such as sodium, chloride and potassium.
• Dehydration. Patients that suffer dehydration will appear to have a dry tongue, withered skin on the hands, face, and feet, hoarseness. The lips are bluish in color and the skin becomes cold and damp.

Diagnosis: The diagnosis of cholera largely depends on the isolation and identification of the disease-producing bacteria from the patients stools. Stool samples are placed in special culture media and within 18 hours the Vibrio colonies become apparent.

Treatment:

• Intravenous replacement of the lost fluids and salts. When the initial losses are replaced, maintenance therapy is continued by replacing the amount of stool produced with an equal amount of water and salt solutions. Prompt replacement results in a rapid improvement of all symptoms except for the continuing diarrhea.
• Oral antibiotics like tetracycline, chloramphenicol, and streptomycin, will reduce the duration and amount of diarrhea by about 50%. Tetracycline if given in adequate dosage will get rid of the bacteria.

Prevention:

• Although there is a cholera vaccine, it is only about 50% effective and its protection can lasts for three to six months only. When a vaccinated person develops cholera the illness is just as severe as in a person who has not been vaccinated.

• Since bacteria that causes cholera is transmitted through contaminated foods and drinks usually from the stools of cholera victims it always advisable to keep your hands and your surroundings clean.
• Using a high quality water purifier can also prevent cholera in areas where water supply is not clean.
• Eat only foods that have been cooked properly.
• If you like eating raw vegetables make sure you get it from a reputable store and clean it properly.
• Shellfish eaten raw is one of the main sources of cholera; therefore avoid undercooked or raw fish or shellfish. If you can't raw seafood just make sure you buy it from a reputable seller.
• When dining out its safer to order tea and coffee made with boiled water. Carbonated bottled beverage is also good and make sure there is no ice.
• Avoid street foods and beverages.