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Medical File No. 001

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Name of disease: Cholera

Cause and Cholera is caused by two strains of the spiral-shaped bacteria Vibrio cholerae in
transmission the small intestine. These strains of bacteria emit a very powerful and dangerous
toxin, which is responsible for cholera’s symptoms and for severe damage to the
functioning of the small intestine. Only 10% of people infected with the bacteria
develop the fatal form of the disease. The rest, who are infected with bacteria whose
toxin takes a slightly different form, develop a less severe form of cholera, which is
sometimes even asymptomatic. Cholera is transmitted by carriers of the bacteria
who excrete it in their environment. Infection usually occurs after drinking water
contaminated by the bacteria or eating agricultural produce irrigated with sewage
water containing the bacteria.

Symptoms The incubation period of the bacteria in the body, from infection to the appearance
and of symptoms, is brief, in most cases from a few hours to three days. Symptoms break
progression out rapidly; the first is watery stool, followed shortly thereafter by vomiting and
strong stomach cramps. At the height of the disease, as much as one liter of body
fluids can be lost per hour. The body dehydrates rapidly, which leads to increased
viscosity of the blood, damage to the heart, and a drop in blood pressure. The
skin turns bluish, loses elasticity and becomes wrinkled. The sufferer subsequently
becomes apathetic and body temperature decreases, followed by death. The two
most typical characteristics of cholera are its tendency to break out quickly and its
spread to pandemic proportions.

Treatment Current medical treatment for cholera, by which more than 99% of patients are
and cured, includes fluids and salts administered intravenously or by drinking, to balance
medications their concentration in the blood. Antibiotics may be given to shorten the duration of
the illness, particularly to limit the period the bacteria is carried and thus decrease
chances of the spread of the disease and the outbreak of an epidemic.

Notes While descriptions of conditions resembling cholera are recorded as early as ancient
Greece and the Middle Ages, the modern study of cholera only began in 1817. It
was then that a local disease in the Bay of Bengal region in India, which had not
previously attracted attention in the Western world, became a pandemic. The
development of transportation, particularly steamships and railways during the 19th
century, accelerated the spread of the disease. The eight cholera pandemics over
the past 200 years have made this disease one of the most serious health risks the
world has faced since the 19th century. Cholera epidemics led to international action
to prevent the spread of the disease, thus marking a new era in disease prevention
requiring international cooperation. The principles of this cooperation – quarantine,
monitoring and sharing of knowledge to prevent outbreaks of epidemics – became
the basis for the establishment of the World Health Organization. Throughout the
20th century, and today, cholera epidemics continue to threaten the health of a large
part of the world’s population, especially in countries where sanitation and water
quality are poor.

Name of Dr Dan Barel, bacteriologist Signature
physician

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