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Determine the Symptoms of Cholera
An infective dose of around one million organisms should be ingested to cause illness. The bacteria adhere to the small intestine wall, where they secrete the cholera enterotoxin, choleragen. As a result, there is hyper secretion of water and chloride ions, while inhibiting absorption of sodium ions. The patient experiences an outpouring of fluid and electrolytes with associated abdominal muscle cramps, vomiting, fever and watery diarrhoea. The diarrhoea can be so profuse that a person can lose 10-15 liter of fluid during the infection. Death may result from the elevated concentration of blood proteins, caused by reduced fluid levels, which leads to circulatory shock and collapse. Onset of the illness is generally sudden, with incubation periods varying from 6 hours to 5 days.
The first step should be to determine the status of dehydration. We have already talked about the mild, inoderate and severe dehydration. In mild to moderate cases fluid, electroly
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