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Essay on Cholera

Introduction

Cholera is an infection of the small intestine by the bacterium Vibrio cholerae. The bacterium Vibrio cholerae is the agent of Cholera, a severe diarrheal disease with a high morbidity and fatality rate that is a significant public health concern (Hu et al., 2016). Symptoms of Cholera include watery diarrhea, vomiting, and muscle cramps. The symptoms can lead to dehydration and death if not treated promptly. The mainstay of treatment is rehydration with oral or intravenous fluids. Antibiotics may also be used to shorten the duration of the illness. Cholera is caused by a bacterium called Vibrio cholerae. The bacterium is found in contaminated water or food and can be spread through contact with infected people. Cholera is most common in areas with poor sanitation and a lack of clean water (Hu et al., 2016). Treatment for Cholera includes rehydration with oral or intravenous fluids. Antibiotics may also be used to shorten the duration of the illness. Cholera is a severe disease that can be deadly if not treated promptly, and therefore, the need to seek medical help upon noting the symptoms. This paper explores the health risks of Cholera, describes its transmission, points out the sources of environmental hazards of Cholera as well as recommends the most probable measures that would help alleviate the problem.

Health Risks and Exposure Effects of Cholera

The risk posed by Cholera is primarily to public health. The disease can spread rapidly in communities with poor sanitation and limited access to clean water. Cholera outbreaks often occur after natural disasters or conflict, when water and sanitation infrastructure has been disrupted. The first health risk is that Cholera results in over 100,000 fatalities per year due to severe diarrhea, dehydration, and vomiting due to cholera toxin, whereby more females are affected than their male counterparts (Balasuriya et al., 2016). People most at risk for severe cholera effects are young children, the elderly, and those with weakened immune systems. There are many instances where a Cholera outbreak has resulted in deaths and vast numbers of fatalities, some recorded and others not. For example, Yemen accounted for 84% and 41% of all cases and deaths attributable to Cholera in 2017; there were 1.2 million cholera cases and 5654 fatalities reported globally in 2017 (Deen et al .,2017). As a result of numerous nations failing to register cholera cases and deaths, the figures offer a partial picture of the condition’s global toll.

In addition, there are various exposure effects that of Cholera that increase the vulnerability of the infection among individuals. Cholera is much more likely to grow in places where malnutrition is typical, such as refugee camps, impoverished towns, and areas ravaged by hunger, war, or national calamity (Durable et al ., 2019). Individuals who are malnourished are much more susceptible to contracting the disease. Acidic conditions are not suitable for cholera bacteria to survive. The first line of defense against infection involves stomach acid. However, those with low gastric acid levels lack such justification, making them more susceptible to Cholera and its severe symptoms. Stomach acid levels are often lower than average in children and the elderly. Individuals who have undergone gastric surgery, possess untreated Pylori infestations or use antacids to treat ulcers.

Household exposure is another factor to vulnerability and health risk of Cholera. For instance, individuals living with others infected are much more likely to get the disease. In addition, compromised immunity is another risk factor such that if the individual’s immunity is altered and compromised, the person is more susceptible to getting the disease (Durable et al ., 2019). Also, individuals of type O blood origin are much more likely to get Cholera than personnel of other blood groups. In addition, the consumption of raw shellfish is another risk factor that promotes disease susceptibility. The ingestion of the natural products of shellfish originating from waterbodies where vibrio cholerae bacterium harbors and fetched and transported to consumers increases the health risks of contracting the disease.

Cholera Transmission

The cholera-causing bacteria Vibrio cholerae, which consists of members from the O1 and O139 serotypes, is a native inhabitant of the marine environment, especially brackish riverine, estuary, and shorelines. There is a need to distinguish between regional microbial pathogens and endemic Vibrio. cholerae clones that are spreading worldwide. Syndromic Cholera is caused by locally circulating strains but not pandemic Cholera (Doman et al ., 2017). The fecal-oral pathway is how Cholera is transmitted, either direct from individual to individual or indirect by infected bodily fluids from an intermittent environmental reserve, food, and maybe flies and secretions. Epidemic cholera usually appears in waterways once weather conditions are ideal for the bacteria to develop. At the same time, endemic Cholera has been linked with tidal seawater encroachments and climatological patterns.

As a result, a relationship between aquatic systems and fecal-oral cholera spread has long been recognized. The current epidemics are circulating in the population and are largely unrelated to the diverse spectrum of Vibrio. cholerae strains in the aquatic environment have been linked to only a small number of specific Vibrio. cholerae clones as per the recent genomic analyses of clinical strains. A temporary hyperreflective status of Vibrio. cholerae present in fresh feces may potentially aid in the rapid transmission of Cholera via the fecal-oral pathway (Silva & Benitez, 2016). The hyperreflectivity of stool-derived, Vibrio. cholerae persists for a few hours after dispersion, which could impact transmission, particularly in densely populated places.

Cholera outbreaks frequently occur in groups that the direct individual can cause to individual transmission, a shared source of infection, or spread via a case’s polluted surrounding environment. The spread of Cholera is greatly aided by direct exposure within the individual residence. A person who lives close to a cholera victim has a greater risk of contracting the illness (Deen et al .,2017). In addition to close interpersonal contact, cholera cases may also cluster for reasons related to the intimate alliance of risk factors among population groups, such as lack of access to safe water, unsafe food handling practices, and poor sanitation and hygiene. Cholera is transmitted between people and has clonal characteristics, which emphasizes how crucial improved sanitation is to cholera control.

Mass gatherings, especially with large crowds of individuals and inadequate clean water and sanitation, can accelerate the cholera epidemic and lead to the additional transmission when attendees go home. For instance, 42 cholera incidents among international guests at a big wedding event in the Dominican Republic were discovered and linked to eating shrimp over ice and bouillon cubes in drinks (Deen et al .,2017). Traditional burial practices like washing the dead and cooking a big meal, together with the mourners’ travel to their homes, may spread the sickness more quickly. Overcrowding also raises the risk of cholera transmission and spread, particularly in places with inadequate sanitation and light water sources, including prisons and settlements for internally displaced persons.

The potential contribution of flies and other insects to the disease’s spread is poorly understood. During an outbreak of Cholera, for instance, in Delhi in India, houseflies, Musca domestica, were captured from a socioeconomically disadvantaged neighborhood and tested for Vibrio. cholerae O1. By serving as mechanical carriers of the germs, houseflies may contribute to the spread of Cholera. At 30-minute intervals for up to 6 hours, the viability of Vibrio cholerae O1 after inoculation on various household fomites was examined (Farhana et al ., 2016). On surfaces composed of glass and aluminum, the bacteria lost their ability to grow after one hour, but on surfaces made of cloth and wood, they could grow for a maximum of four hours. The reason is probably that the porous nature of such characters allows the bacteria to stay hydrated for extended periods. Cholera may spread more easily because Vibrio cholerae O1 may survive for a longer duration of time on such fomite surfaces.

Vibrio cholerae is typically ingested, and once inside the human body, the bacterium begins to multiply in the small intestine. The toxigenic Vibrio cholerae strains produce cholera toxin (CT), a potent enterotoxin, which results in a severe secretory diarrheal disease called Cholera (Balasuriya et al ., 2016). Vibrio cholerae can cause severe dehydration within hours of ingestion, and if left untreated, Cholera can be fatal. The movement of Vibrio cholera within the human body upon entry depends on several factors, including the strain of bacteria, the level of hydration, and the individual’s age and health. Generally, Vibrio cholerae first attach to the mucosal surface of the small intestine, where they begin to multiply. The bacteria then start producing cholera toxin, responsible for the severe secretory diarrheal disease. The toxin binds to specific receptors on the mucosal cells of the small intestine, causing the cells to secrete large amounts of water and electrolytes. The action results in profuse, watery diarrhea, leading to severe dehydration and death if left untreated.

Sources of Environmental Hazards of Cholera

Various sources of environmental hazards act as grounds for Cholera to thrive and spread. Some of the environmental risks have been laid out in the transmission phase showing how their act and the role played in enhancing cholera transmission from the ground to the body of a human being. The main environmental factor contributing to the development of Cholera is contaminated water which can take several forms, including sewage contamination, animal feces in the water supply, and heavy rains that wash away protective barriers (Dureab et al., 2019). Secondly is unclean food preparation surfaces, which may include inadequate food storage and poor hygiene practices. Poor sanitation in food preparation plays a significant role in the development of the bacterium that causes Cholera. The conditions harbor and create a conducive environment for the bacterium to develop and thrive.

Conclusion and Recommendations

Cholera is a biological disease that can be fatal if proper measures are not taken. Environmental contamination, especially in water bodies, is the risk factor that leads to its development and spread. Contaminated, unhygienic food handling practices and generally poor sanitation are some of the grounds that harbor the evolution of Vibrio Cholerae, which, when it enters the body of a human being, causes Cholera. Finding ways to improve the environment and food handling would help solve the biological condition. The first recommendation would involve good sanitation and hygiene practices to reduce the risk of exposure to the bacteria. Secondly, the use of vaccines to help protect against Cholera, especially in densely populated areas and places prone to poor sanitation. However, in the case of Cholera infestation, rehydration via oral rehydration solutions or intravenous fluids and antibiotics may be used for treatment.

References

Balasuriya, G. K., Hill‐Yardin, E. L., Gershon, M. D., & Bornstein, J. C. (2016). A sexually dimorphic effect of cholera toxin: rapid changes in colonic motility mediated via a 5‐HT3 receptor‐dependent pathway in female C57Bl/6 mice. The Journal of Physiology594(15), 4325-4338.

Deen, J., Mengel, M. A., & Clemens, J. D. (2020). Epidemiology of Cholera. Vaccine38, A31-A40.

Domman, D., Quilici, M. L., Dorman, M. J., Njamkepo, E., Mutreja, A., Mather, A. E., … & Thomson, N. R. (2017). Integrated view of Vibrio cholerae in the Americas. Science358(6364), 789-793.

Dureab, F., Jahn, A., Krisam, J., Dureab, A., Zain, O., Al-Awlaqi, S., & Müller, O. (2019). Risk factors associated with the recent cholera outbreak in Yemen: a case-control study. Epidemiology and Health, 41.

Farhana, I., Hossain, Z. Z., Tulsiani, S. M., Jensen, P. K. M., & Begum, A. (2016). Survival of Vibrio cholerae O1 on fomites. World Journal of Microbiology and Biotechnology32(9), 1-8.

Hu, D., Liu, B., Feng, L., Ding, P., Guo, X., Wang, M., … & Wang, L. (2016). Origins of the current seventh cholera pandemic. Proceedings of the National Academy of Sciences113(48), E7730-E7739.

Silva, A. J., & Benitez, J. A. (2016). Vibrio cholerae biofilms and cholera pathogenesis. PLoS neglected tropical diseases10(2), e0004330.

 

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