Best Cholera Treatment in Hyderabad, India | Expert Care
PACE Hospitals is recognized as the best hospital for cholera treatment in Hyderabad, Telangana, India. Our expert team of general physicians, infectious disease specialists, gastroenterologists, pediatricians, emergency medicine physicians, and healthcare professionals is dedicated to providing the highest standard of care. We use state-of-the-art technology and advanced treatment methods to ensure effective care for cholera patients.
We understand the urgency and severity of cholera, and our team is committed to providing rapid diagnosis and treatment to help patients recover quickly and safely. At PACE Hospitals, we prioritize compassionate, patient-centered care, ensuring that every patient receives the best possible treatment in a comfortable environment.
Why Choose PACE Hospitals for Cholera Treatment?
State-of-the-art Medical Technology and Advanced Treatment Methods
Best General Physicians, Infectious Disease Specialists, Gastroenterologists & Pediatricians in Hyderabad
Rapid Response & 24/7 Emergency Care
Compassionate Personalized Treatment & Patient-Centered Care
Cholera diagnosis
Vibrio cholera diagnosis is based on clinical signs and symptoms. The characteristic severe diarrhea and travel to an endemic area can be sufficient for the diagnosis of cholera. By the isolation and culture of bacterium Vibrio cholerae from stool isolates, the diagnosis can be confirmed. Culture can be improved by using selective media with a high pH, which suppresses the growth of intestinal microflora while allowing the multiplication of vibrio cholera. Rapid diagnostic tests (RDT) are used to identify the antigens (O1 or O130) in samples. Darkfield microscopy of the stool and dipsticks are used to visualize the organism rapidly.
The general physician may consider the following before diagnosing cholera:
Initial or Clinical evaluation
- Patient History
- Clinical signs and symptoms
Patient History: The patient is inquired if they have any recent travel history to endemic areas or have been exposed to contaminated water. Individuals who travelled to the endemic regions of cholera, consumed contaminated food or water increase the suspicion of cholera
Clinical signs and symptoms: Signs and symptoms of cholera range from asymptomatic to profuse diffusion. The following are the common signs and symptoms that can distinguish cholera from other diarrheal illness:
- Diarrhea: In patients with cholera, diarrhea can be described as watery (rice watery) stools
- Severe dehydration: High volume diarrhea causes hypovolemia, resulting in excess fluid loss. Dehydration is characterized by dry oral mucosa, cool skin, and decreased skin turgor.
✅Diagnostic Tests for Cholera
Based on the above information, the following diagnostic tests are recommended for diagnosing cholera:
Laboratory testing
- Stool culture
- Polymerase chain reaction
Rapid diagnostic tests
Laboratory testing
- Stool culture: Stool or rectal swab culture is the gold-standard reference method for diagnosing cholera. Specimens are placed into an enrichment broth that enhances the sensitivity of the culture, these broths are made up of alkaline peptone water. The specimens are later subcultured on ideal culture mediums like thiosulfate citrate bile salt (TCBS) agar or taurocholate tellurite gelatin agar (TTGA). For transporting the culture from field settings to the laboratory, Cary-Blair medium is commonly used as the medium.
- Polymerase chain reaction: Diagnosis of cholera using the polymerase chain reaction (PCR) technique is highly sensitive, and this technique requires enhanced laboratory capacity. This technique can detect molecular markers of certain phenotypes with target genes such as ctxA (cholera toxin subunit A), tcpA (toxin-coregulated pilus), and ompW (outer membrane protein). The costs with PCR techniques are approximately the same as those of stool culture, but the results of polymerase chain reaction can be obtained much earlier compared to stool culture.
Rapid diagnostic tests: These diagnostic tests are performed in rural areas and in underdeveloped health care settings where culture tests and polymerase chain reactions are not employed due to scarcity of trained personnel. This diagnostic test provides an early warning to health experts when a cholera outbreak is imminent. These are available in different categories with a wide range of sensitivities and specificities.
Lipopolysaccharide (LPS) antigens of both Vibrio cholerae O1 and O139 serogroups can be detected easily by monoclonal antibodies in Crystal VC. The sensitivity of crystal VC is 97 percent, and the specificity is 76 percent.
✅Stages of Cholera
Cholera severity depends upon the rapidity and duration of fluid loss. The following are the three clinical stages of cholera:
- Stage of evacuation - In this stage, sudden onset of diarrhea, which is profuse, painless, watery (rice water) occurs, followed by episodes of vomiting.
- Stage of collapse – In this stage, the patient collapses due to dehydration. The patient may show some classical signs such as sunken eyes, hollow cheeks, scaphoid abdomen, no pulse, blood pressure which cannot be recorded, loss of skin elasticity, and shallow and quick respiration. Death may also occur with dehydration and acidosis resulting from diarrhea.
- Stage of recovery - The Patient will start to show symptoms of recovery when death does not occur. This is a classical form of severe cholera that occurs in only 5 ‐ 10 percent of cases. The blood pressure and the temperature will come back to normal.
✅Differential Diagnosis of Cholera
Differential diagnosis is a process of differentiating two or more diseases which share similar signs and symptoms with cholera. It includes the following:
- Escherichia coli infection: It is a gram-negative bacillus which is a part of normal intestinal flora but can also be the cause of intestinal and extraintestinal illness in humans. There are about hundreds of identified E. coli strains, which results in a spectrum of disease from mild, self-limited gastroenteritis to renal failure and septic shock. Watery stools, low-grade fever, loss of appetite, and stomach cramps are some of the symptoms of this infection.
- Typhoid fever: It is a life-threatening condition which is caused by the bacterium Salmonella Typhi. It usually spread through contaminated food or water, and once these bacteria are ingested, they multiply and spread into the bloodstream. Prolonged high fever, fatigue, headache, nausea, abdominal pain, and constipation or diarrhoea are some of the symptoms.
- Shigellosis: It is an acute enteric infection which is caused by shigella, a facultative gram-negative, anaerobic bacillus. It is transmitted via the fecal-oral route or by direct person-to-person contact. Mucoid bloody diarrhea, fever, and abdominal pain are some of the symptoms of shigellosis.
- Rotavirus infection: These are the leading causes of severe, dehydrating gastroenteritis in children less than 5 years of age. It is transmitted via the oral-fecal route, directly from person to person, or indirectly through contamination.
✅Cholera Treatment Goals
The primary goals of the cholera treatment plan are as follows:
- To replace the body fluids that are lost by severe diarrhea and dehydration
- To restore electrolytes lost through diarrhea and vomiting
- To prevent severe dehydration, shock, and other serious complications such as death
- To maintain normal hydration status by restoring electrolytes and fluid imbalance.
Cholera treatment
Cholera is an easily treatable disease. Treatment of cholera disease is based on the degree of dehydration of the patient: no dehydration, little dehydration, or severe dehydration. Oral rehydration therapy is recommended in patients with no signs of dehydration or some signs of dehydration, and patients with severe dehydration require intravenous rehydration. Vibrio cholera treatment includes the following:
Oral rehydration therapy
Oral rehydration salts have to be prepared with safe and clean distilled water, these solutions should not be stored for more than 12 hours or 24 hours when refrigerated. Oral rehydration salts can be prepared using ready-made sachets containing salts and minerals. These rehydration solutions should be given, when necessary, in small amounts. When the patient vomits this rehydration solution, the administration of ORS is slowed, then gradually increase again when the patient stops vomiting.
- Oral rehydration therapy for patients with no signs of dehydration: Individuals who are asymptomatic can be treated with oral rehydration salts at home. There is no need for the patient to be hospitalized. After each loose stool, oral rehydration salt is given to maintain hydration until diarrhoea stops.
- Oral rehydration for patients with little dehydration: Patients presenting with signs of dehydration have to be hospitalized for treatment. Oral rehydration salt is given according to the weight of the patient in the first 4 hours as initial treatment.
- Intravenous (IV) therapy for patients with severe dehydration: Severe dehydration is a medical emergency, and these patients must be hospitalized as they have to be treated urgently. In these patients, IV fluids are administered immediately. When the patient is able to drink, oral rehydration salt is given along with intravenous fluids. Ringer’s lactate solution is the first choice of IV fluid. Intravenous solutions such as normal saline, 5 % glucose in normal saline, and cholera saline can also be administered when Ringer’s lactate solution is not available.
Antibiotic therapy
Antibiotic therapy is indicated in patients with severe dehydration, in patients with purging (passage of at least one stool for every hour during the first 4 hours of treatment) or treatment failure or in patients with coexisting conditions. They can reduce the volume and duration of diarrhoea and the period of bacterium vibrio cholera shedding. Once the vomiting is stopped and when the patient is able for oral administration, antibiotic therapy is initiated. The drug class tetracycline is the antibiotic choice for all the patients.
Treatment of cholera in pregnancy
There is a higher risk of miscarriage in pregnant women with cholera compared to the general population of pregnant women. Regardless of the degree of dehydration, antibiotic treatment has to be given to all pregnant women with cholera. To sustain dehydration and adequate systolic blood pressure in order to ensure appropriate uterine blood flow, the degree of dehydration and treatment of pregnant women has to be monitored closely.
✅Cholera prognosis
In children, pregnant women, and elderly patients, the mortality rate is high, and the mortality rate in excess is 50 percent without hydration. With better access to healthcare, improved sanitation, and education, the mortality rates have been decreased.
Frequently Asked Questions (FAQs) On Cholera Treatment
What are the causes of cholera?
Cholera is caused by the bacterium vibrio cholera. This bacterium is a facultative, comma shaped, gram negative, oxidase positive rod that is prevalent in developing countries. It is known to spread via the fecal-oral route, and this disease is endemic in areas with inadequate food and water hygiene.
What are the symptoms of cholera?
Many patients with cholera have mild symptoms or no symptoms at all. Clinical manifestation of cholera ranges from no symptoms to profuse diarrhea. Diarrhea, abdominal discomfort, and vomiting are the common symptoms of cholera.
How is cholera transmitted?
People develop cholera from the consumption of drinking water and eating food that gets contaminated with the bacterium vibrio cholera. It spreads quickly in the areas where sewage and drinking water are not treated adequately. It can also be transmitted from the consumption of raw shellfish contaminated seafood as cholera bacteria also live in brackish (salty) and coastal waters.
How can the spread of cholera be prevented?
The prevention of cholera spread involves improving sanitation, hygiene practices, water purification, and vaccination. The following are some of the measures to prevent cholera spread:
- Consuming purified water that has been boiled, chemically disinfected, or bottled. Boiling, chlorination, ozone treatment, ultraviolet light sterilization, or antimicrobial filtration are some of the methods which are used to purify water.
- Following proper sanitation and hygiene practices. Using flush toilets and government approved septic systems to prevent contamination of water sources.
- Washing hands regularly with soap and clean water, after using the toilet and before handling food.
- Avoiding raw or uncooked food and ensuring all food is cooked thoroughly, especially seafood.
What are the complications of untreated cholera?
If cholera is left untreated, it can lead to complications such as severe dehydration, acute tubular necrosis, renal failure, severe hypotension, and even death.
What is cholera?
Cholera is an acute diarrheal illness caused by the bacterium vibrio cholera. It is transmitted by the ingestion of food and water contaminated with vibrio cholera. It remains a threat to public health and is an indicator of a lack of social development.
Who are at risk for developing cholera?
Individuals living in areas with poor sanitation, unhygienic conditions, and with no access to clean drinking water are at high risk for developing cholera. Consuming contaminated seafood can also cause cholera.
How common is cholera?
Cholera is a significant global health problem, particularly in areas with inadequate sanitation and water treatment. From many studies, it is estimated that cholera affects between 13 lakhs and 40 lakhs of people every year, resulting in 21,000 to 143,000 deaths all across the world.
How soon do the symptoms of cholera appear?
Cholera symptoms appear two to three days after the consumption of contaminated food and water. Sometimes symptoms can appear within a few hours or up to 5 days of infection.
Can cholera spread through casual contact with an infected person?
No, cholera is not likely to spread from one person to another or with casual contact with an infected person. It spreads indirectly through the consumption of contaminated food and water.
What foods are more likely to be contaminated with cholera?
Seafood such as oysters and clams which is raw or undercooked, raw fruits and vegetables that have been irrigated with contaminated water, and street foods which are prepared with contaminated water or handled improperly are more likely to pose a risk of developing cholera.
