Cholera is one of the most severe diseases of the intestines. It is a serious affliction that involves the lower part of the small bowel. It is a waterborne disease that is most common during the monsoon season. The original home of cholera is Bengal in India. It spread from this country during the 19th century in a series of epidemics along the trade routes. It reached Japan and Astrakhan, Russia in 1817. It spread to Moscow in 1826, Berlin in 1831 and London and Paris in 1832. Subsequently, it spread to Canada and several more countries in Europe, by 1895, cholera had disappeared from Europe.

Cholera, caused by the bacteria Vibrio cholerae, is rare in the United States and other industrialized nations. Globally, cholera cases have increased steadily since 2005 and the disease still occurs in many places including Africa, Southeast Asia, and Haiti. Cholera can be life-threatening but it is easily prevented and treated. Travelers should be aware of areas with high rates of cholera, how the disease spreads and what to do to prevent it.

Symptoms
Cholera appears in three stages. In the first stage, the patient suffers from mild diarrhea and vomiting, which worsens rapidly. The bowel movements are watery, containing no solid fecal matter. The patient feels severe cramps in the abdominal muscles and limbs are affected due to a lack of salts in the body. The temperature rises but the skin is generally cold and blue and the pulse is weak. Taking water to quench thirst further dilutes the body’s sodium content and makes the cramps worse.

In the second stage, the body becomes colder, the voice weak and husky and the skin gets dry, wrinkled and purple. Urine becomes dark in color and decreases until there is no expulsion at all. It is this stage of collapse in cholera, known as the ‘algid’ stage, that the patient may die as early as 24-hours after the onset of the symptoms.

In the third stage, recovery follows in favorable cases. All the changes seem to reverse themselves - the fluid loss decreases and there is an improvement in the general condition. However, a relapse may occur or the patient may sink into a condition resembling typhoid fever. The condition may deteriorate over a period of two or three weeks. During this stage of the reaction the temperature may rise and the patient may be in danger from pneumonia.

Causes
Cholera is caused by a short, curved, rod-shaped germ known as vibrio cholera. This germ produces a powerful poison or endotoxin. It is spread by flies and water contaminated by the germs. The real cause of the disease is the body’s inability to fight the toxic invaders due to nutrient deficiencies or deprivation. This condition facilitates an invasion of cholera bacteria.

Treatment