SCRIPT NUMBER 110
CHOLERA - 2
(TWO SPEAKERS)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE: CHOLERA - 2
PROGRAM NUMBER: 110
SUBJECT: CAUSES, SYMPTOMS, TREATMENT, PREVENTIPON OF
CHOLERA
KEY WORDS: BACTERIAL INFECTION, SEWAGE, EPIDEMIC, DIARRHEA,
DISINFECTED, BLEACH, SHELLFISH, SUSHI, OYSTERS
DATE OF SCRIPT: MAY 3, 2013
AUTHOR: RICHARD YUKL, MD, FACS
SPEAKER 1:
A 58 year-old man traveled by airplane on a ten-hour flight
from the Philippines to Hawaii where he was employed. Approximately 90
minutes into the trip, he developed severe diarrhea that continued for the
duration of the flight. Flight attendants were unable to help him replace the fluids
he was losing. By the time the plane arrived in Hawaii, the man had developed
nausea, vomiting and dizziness in addition to his diarrhea. A governmental
quarantine officer met the man immediately upon arrival, and when questioned
about his recent activities, the traveler stated he had eaten raw clams in a
restaurant two days earlier. The quarantine officer thought the man might be
suffering the symptoms of cholera, so he took him by ambulance to a hospital for
admission to an intensive care unit. He had lost so much fluid that his blood
pressure was extremely low. The man required massive amounts of fluid
replacement by vein for five days, as well as antibiotics by vein for what proved
to be a cholera infection. He recovered and was discharged from the hospital on
the seventh day.
SPEAKER 2:
Today, we want to talk about cholera. It remains an
important disease around the world. An estimated three to five million new cases
of cholera are diagnosed every year, and approximately one hundred thousand
of those people die of the disease.
SPEAKER 1:
What exactly is cholera?
SPEAKER 2:
Cholera is a bacterial infection of the small bowel. It spreads
to humans through contaminated water and food. The infecting bacterium, or
germ, is dangerous because it releases a poison that causes sudden, severe
diarrhea. Left untreated, it can kill even previously healthy people within a matter
of hours. Modern sewage and water treatment plants have virtually eliminated
cholera in industrialized countries, but epidemics continue to be a significant
problem in parts of Asia and Africa, the Middle East, Latin America and in India.
SPEAKER 1:
What are the risk factors for developing cholera?
SPEAKER 2:
The risk is highest when poverty, war or natural disasters
force people to live in crowded conditions without adequate sanitation. A recent
example is the catastrophic earthquake in Haiti that injured perhaps 300,000
people and displaced up to 1,000,000 others into refugee camps. Unsanitary
conditions in those camps resulted in the rapid spread of cholera, sickening
nearly one hundred thousand people, and killing well over twenty five hundred.
SPEAKER 1:
Describe the symptoms of a cholera infection.
SPEAKER 2:
Symptoms include the sudden development of diarrhea with
a pale, milky appearance. The diarrhea may be as much as one liter an hour.
Because of the massive fluid loss, patients develop extreme thirst and a dry
mouth along with dry and shriveled skin, sunken eyes, little or no urine output,
low blood pressure and an irregular heartbeat. Nausea and vomiting can develop,
making the situation even worse. Only about one person in ten who becomes
infected develops symptoms. Because most don’t become sick, they don’t know
they are infected. Yet, they spread the bacteria in their stool for one to two weeks,
infecting others through water and sewage contamination.
SPEAKER 1:
How is cholera treated?
SPEAKER 2:
Cholera treatment is straightforward. Deaths are the result of
severe fluid loss from the body, so life-saving treatment only requires
replacement of the fluids and salts that have been lost through the diarrhea and
vomiting. An effective treatment can be made at home as simply as by adding
one-half teaspoon of table salt and six teaspoons of sugar to one liter of boiled or
bottled water, stirring until the ingredients dissolve. Drink sips of the solution
every five minutes until your urination returns to normal – that’s four to five times
a day. Most people can be successfully treated by mouth alone with simple
solutions such as this. People who have severe symptoms, however, may need
fluids to be given by vein. Antibiotics are not necessary, but they may reduce the
amount of diarrhea and the length of time the diarrhea lasts.
SPEAKER 1:
How can I prevent becoming infected by the cholera
organism?
SPEAKER 2:
Avoid drinking tap water, fountain drinks and ice cubes. Use
only bottled water, water that you have boiled, or water you have disinfected by
adding two drops of household bleach to a liter of water. Also, wash your hands
frequently with soap and water, especially after using the toilet and before
handling food. Rub your wet, soapy hands together for at least 15 seconds
before rinsing. An alcohol-based hand sanitizer is also effective. Eat food that
has been thoroughly cooked and is still hot. The bacterium that causes cholera is
found in fish and shellfish, especially raw oysters, so avoid raw or improperly
cooked fish and seafood of any kind - avoid foods such as sushi. And, if you buy
food from a street vendor, make sure it is cooked in your presence and is served
hot. Eat only fruits and vegetables that you can peel, foods such as bananas,
avocados and oranges. Stay away from salads and fruits such as grapes and
berries that can’t be peeled.
SPEAKER 1:
Summarize what we should remember concerning cholera.
SPEAKER 2:
Cholera is a bacterial infection. Focus on basic health
principles to avoid the infection and its complications. Drink only boiled, bottled or
treated water. Wash your hands after using the toilet and before preparing food.
Eat food that is thoroughly cooked and served hot. Avoid raw or undercooked
fish such as sushi, and shellfish such as oysters. Eat fruits and vegetables that
you can peel yourself, foods such as bananas, avocados and oranges. Finally,
stay away from salads and fruits such as grapes and berries that can’t be peeled.
SPEAKER 1:
Health Nuggets is written by Dr. Richard Yukl, a medical
doctor working in the United States. The medical views expressed in this
program are his and may differ for your particular health needs. If you need
medical advice, please consult a medical professional in your area.