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Because V. cholerae bacteria are sensitive
to acid, most cholera-causing bacteria die in the acidic environment
of the stomach. However, when a person has ingested food or water
containing large amounts of cholera bacteria, some will survive to
infect the intestines. As would be expected, antacid usage or the
use of any medication that blocks acid production in the stomach
would allow more bacteria to survive and cause infection.
In the small intestine, the rapidly multiplying
bacteria produce a toxin that causes a large volume of water and
electrolytes to be secreted into the bowels and then to be abruptly
eliminated as watery diarrhea. Vomiting may also occur. Symptoms
begin to appear between one and three days after the contaminated
food or water has been ingested.
Most cases of cholera are mild, but about one in
20 patients experience severe, potentially life-threatening symptoms.
In severe cases, fluids can be lost through diarrhea and vomiting at
the rate of one quart per hour. This can produce a dangerous state
of dehydration unless the lost fluids and electrolytes are rapidly
replaced.
Signs of dehydration include intense thirst,
little or no urine output, dry skin and mouth, an absence of tears,
glassy or sunken eyes, muscle cramps, weakness, and rapid heart rate.
The soft spot on an infant's head will appear to be sunken or drawn
in. Dehydration occurs most rapidly in the very young and the very
old because they have fewer fluid reserves. A doctor should be
consulted immediately any time signs of severe dehydration occur.
Immediate replacement of the lost fluids and electrolytes is
necessary to prevent kidney failure, coma, and death. |
