How does cholera affect our body?

This is a article from WHO which is dated 20 March 2024, See the heading,its 2024 ,still people are at risk of Cholera.WHO article

After reading this article, I wondered why people are not concerned about this disease. Millions are at risk, and we are not even concerned about this. Most people don't even know how cholera affects our bodies. Its not even that hard to understand, lets find out in this article.

Cholera is not new to our society; it's been happening in this world since 1817. There are a total 7 outbreaks of cholera, and coincidentally, the 7th one is going on. 

That's why it's very important for us to understand, the cholera bacteria and how it affects our body.

So, lets start:

What is cholera? 

The term "cholera" is originally derived from the word "khole," which means "bile." It was historically believed that cholera was caused by an imbalance of the body's liquid, particularly an excess of bile. However,with modern understa nding, we get to know that cholera is due to the bacterium Vibrio cholerae and its toxin, which primarily affects the intestines.

Vibrio cholerae is a comma or curved shaped microorganism,which comes under Non halophilic vibrio group. On the basis of antigen it is divided into various groups ranges from O1 to O139. But O1 is the most important and most infective varient.

It basically causes severe diarrhea and dehydration due to infection with the bacterium, leading to electrolyte imbalances and potentially life-threatening.

It is usually transmitted through contaminated water or food and is more common in areas with poor sanitation and limited access to clean water.

How does cholera affect our body?

Firstly,i want to inform you that  cholera has a distinct clinical feature, it cause rice water diarrhoea.So, my goal here is to explain how the bacteria cause this rice water stool. 

Rice water stool:

It is a Mucus flaky turbid water having fishy odor and sudden in onset. It resembles water that has been used to rinse rice, appearing cloudy and often without significant fecal matter.

Vibrio cholera, the bacteria responsible for cholera, can produce many toxins, i.e., mucinase, disintegrate mucus, and Zona occuludens toxin, which disrupts tight junctions. But mainly, I am going to explain the mechanism of cholera toxin, which causes the main symptoms.

Cholera Toxin:

Cholera toxin is coded by CTx gene of the bacteria and it has two fragments.

Fragment A, which is resposible for main action and Fragment B which helps in the binding of bacteria to the surface of intestine(GM1 Ganglioside).

A has two parts-A1 and A2 ,helps in activating various mechanism responsible for Cholera.

B has 5 subparts, which generally helps in binding to the surface.

Now you know the structure , lets understand the mechanism:

Vibrio cholerae releases cholera toxin into the small intestine after ingestion of contaminated food or water.

This Cholera toxin binds to receptors on the surface of intestinal cells, allowing it to enter the cells.

 Once inside the intestinal cells, cholera toxin activates adenylate cyclase, an enzyme that stimulates the production of cyclic AMP (cAMP).

Increased levels of cAMP trigger a signaling cascade within the intestinal cells, leading to the opening of chloride ion channels and the secretion of chloride ions into the intestinal lumen.

The secretion of chloride ions into the intestinal lumen creates an osmotic gradient, drawing water out of the body's cells and into the intestine. This results in the characteristic watery diarrhea or rice water diarrhea (due to color of excess chlorine) seen in cholera cases.

 The massive loss of fluid and electrolytes through diarrhea leads to dehydration and electrolyte imbalances.

Cholera has a high infectivity dose, meaning a quite high amount of bacteria is needed to cause the disease, as most of the bacteria are killed by acid in the stomach. But if it reaches the intestine, it can cause severe diarrhea.

Cholera spreads primarily through the ingestion of contaminated food or water. When a person consumes food or water contaminated with Vibrio cholerae bacteria, they can become infected with cholera. Additionally, cholera can spread indirectly through the contamination of food or water by fecal matter containing the bacteria. Poor sanitation, lack of access to clean water, and crowded living conditions can facilitate the spread of cholera, particularly in areas with inadequate hygiene practices and infrastructure.

 

Cholera can be treated very easily, though mostly it needs supportive treatment, like ORS (oral rehydration salts) with or without IV fluids. And if needed, the doctor can give doxycycline in adults and azithromycin in children or pregnant women; both are antibiotics. 

For prevention, we can also take the vaccine, which is available in live oral mode. It is very necessary for people traveling to an endemic area to take the vaccine.

If you want to know various forms of Diarrhea: 

What cause Dysentery?

And if you have any suggestion or complaints,  please contact me on my contact us page.

Thank you