cólera

Cholera, or cólera in Portuguese, is an acute diarrheal illness caused by infection with the bacterium Vibrio cholerae, most often serogroups O1 and O139. The disease is typically transmitted through ingestion of water or food contaminated with feces from an infected person, especially in areas with poor sanitation and limited access to clean water.

Pathophysiology and clinical features: V. cholerae produces cholera toxin, which disrupts the normal movement of electrolytes and water in the small intestine. This leads to rapid loss of fluids and electrolytes, resulting in profuse, pale and odorless watery diarrhea described as “rice-water stools,” along with vomiting. Dehydration can be severe and progress quickly, especially in young children and older adults. Other signs may include thirst, dry skin, rapid heartbeat, and low blood pressure. Onset is usually hours to five days after exposure.

Diagnosis and treatment: Diagnosis is based on clinical presentation and exposure history; laboratory confirmation is by stool culture or rapid diagnostic tests. Treatment focuses on rapid rehydration, using oral rehydration solution for mild to moderate dehydration or intravenous fluids for severe dehydration. Zinc supplementation is beneficial for children. Antibiotics may shorten the duration of illness and reduce stool volume in some cases and are recommended in severe disease or during outbreaks.

Prevention: Prevention relies on safe water, sanitation, and hygiene, along with proper food safety. Vaccines against cholera exist and are used in some settings, particularly during outbreaks or in endemic areas, as part of a broader public health strategy.