Cholera: A Waterborne Disease & Its Seasonal Patterns - Essay Sample

Introduction

Cholera is a water-borne diarrheal disease caused by the motile and gram-negative bacterium Vibrio Cholerae belonging to serogroup O1 and O139 (Silva and Benitez 1). The condition is fatal if not treated at the right time and can cause an epidemic in society. In a region where the disease is endemic, the occurrence of cholera follows a seasonal pattern depending on the changes in the climate and weather patterns. V.cholerae and other members of the bacteria from the same family commonly inhabit the aquatic ecosystem. The transfers of V. cholera O1 from one point to another take place through a fast-oral route where the bacteria take advantage of its transient highly infective stage in the stool (Silva and Benitez 1). Consequently, the rate of cholera infection is high in places where toilet hygiene is lacking, because flying organisms such as flies can directly transmit the bacteria from infected stool to food. If the condition is not treated on time, it can kill a person within a short period. The seriousness of the cholera is because of the anatomical and physiological components of the disease.

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Anatomical Components of Cholera

The central part of the human body affected by cholera in the small intestine (Almagro-Moreno et al. 1). The cholera causing bacteria colonizes the gut, thus affecting the disease through a series of stages. For the bacteria to colonize the small intestine, it needs to travel from the mouth to the stomach, where it should successfully withstand the presence of digestion and body protection agents such as antimicrobial peptides and bile in the intestinal mucus and lumen. Upon reaching the small intestine, the V. cholerae then penetrates the layer of viscous mucus that covers the epithelium before attaching and multiplying on its surface (Almagro-Moreno et al. 1). The bacteria travel, attach and colonize the small intestine through a complex process that facilitated the unique chemical and physical properties of the V. cholerae.

V. cholerae is a bacteria with a complex acid tolerance ability that involve many factors such as OmpU, ToxR regulated porin, the glutathione synthetase GshB, the transcriptional regulators CadC and HepA and the DNA recombination and repair enzyme RecO among others. The cholera causing bacteria is sensitive to the low PH in the digestive system (Almagro-Moreno et al. 1). As a result, the bacteria strive among patients whose digestive system is characterized by low production of gastric acid. The pathogenesis of cholera in the small intestine is also dependent on the production of V.Cholerae of type IV pilus, TCP, whose presence is because of the regulation of cholera toxin. TCP is critical in the bacteria's colonization of the small intestine by promoting aggregation of bacteria and formation of microecology that permit the bacteria to adhere to mucus on the gut (Millet et al. 1). However, depending on the physiological stage at which the bacteria entered the body of the host, it can survive low survived the acidity of the digestive system. For example, if the bacteria VBNC cells are ingested, the bacteria can effectively colonize the small intestine (Almagro-Moreno et al. 1). The same case applies if the bacteria are introduced into the body of the person as a biofilm.

Once the bacteria serve the low pH, it has to penetrate the thick mucus layer in the small intestine and cause damage in the epithelium layer. The mucus layer acts as a barrier that the bacterial must overcome to cause harm to the small intestine. V.cholerae use mucinase complex to penetrate the layer (Almagro-Moreno et al. 1). Upon reaching the epithelium layer, the bacteria use strain deletion to attach to the layer and begin to reproduce. The bacteria then release toxins that permit the epithelium layer to discharge an excess amount of water, thus causing diarrhea.

Physiological Components

Cholera has a profound impact on the normal functioning of the human digestive system. One of the critical functions of the small intestine is to regulate fluid absorbed by human cells. The SI achieve this function by absorbing most fluid ingested, thus allowing the excretion of small amount in the feces. In abnormal conditions, such as well the body is responding to the pathogenic attack, the cells may fail to absorb fluid, thus resulting in the excretion of fluids that enter the digestive system without absorption. This condition results in excretion of watery stool called diarrhea. Diarrhea may be beneficial to the heath of a person because it helps to clean the gastrointestinal tract of pathogens and harmful bacteria.

In the case of cholera, the bacteria release ADP-ribosylating toxins that promote diarrhea. The toxin is not required for the colonization of the intestine; however, it helps to promote the dissemination of the bacterial to new hosts (Millet et al. 1). However, in this condition, the diarrhea is beneficial because of the severe and persistent loss of water from the body. Instead of absorbing fluid from the stomach to be used by the cells of the body, it pulls water from the cells, particularly in the small intestines, and release them to the intestinal lumen where they are excreted as diarrheal feces. Apart from the loss of water, the body also loses some vital electrolytes such as bicarbonate, chloride, potassium, and sodium. The deficit of water and electrolytes in the body results in a condition called dehydration. If diarrhea caused by cholera is not managed at the early stage, it quickly leads to dehydration. Water serves a lot of functions in the body of a person. The lack of water to perform to function is evident in the symptoms of cholera. Some of the functions of water include protection of the spinal cord, maintenance of optimum moisture levels in sensitive areas such as the brain, bones, and blood. It also helps cushion and lubricates the joints. As a result, a person experiencing dehydration because of cholera may experience: (1) low blood pressure because of lack of enough water to make blood. (2) Loss of skin elasticity because of lack of water (Coleman and Alcamo 57). (3) Irritability, restlessness, and seizes due to lack of enough water in the brain. (4) Muscles cramps because of the rapid loss of potassium, sodium, and chloride (Coleman and Alcamo 57). Lastly, shock often occurs as a result of dehydration. Shock occurs when a low volume of blood due to lack of water leads to a drop in both blood pressure and the amount of oxygen in the body. If shock is not treated, it can cause death in minutes. Other symptoms include severe vomiting, abdominal pain, rectal pain, dry mucous membrane, unusual tiredness and sleepiness, and thirst (Coleman and Alcamo 59). Failure to treat severe dehydration can cause death. In most cases, severe dehydration starts between four to eight hours after first diarrhea, leading to death after 18 hours if untreated.

Conclusion

The number of cases of cholera has continued to increase in the last few years. Most people living in places where cholera has been reported are at risk of contracting the disease. Young children and the elderly are at high risk of contracting the disease if they live with infected persons. The best way to prevent being infected is by using and drinking safe water as well as washing hands with soap and clean water before eating. In terms of food, all food, especially seafood, should be cooked well and eaten while hot. People should wash fruits with clean water before consuming them. Since the primary way of transmitting the disease is from feces to food, then people should use latrines or bury their feces. Besides, under no condition should people defecate on water bodies. However, in case of the occurrence of symptoms such as diarrhea, an individual should start taking oral rehydration solution (ORS) and go to the nearest health facility as soon as possible for further specialized treatment. From the above discussion, it is evident that cholera is a serious medical condition that can cause death within a short time. It is, therefore, better to take preventive measures against the disease instead of relying on the treatment.

Works Cited

Almagro-Moreno, Salvador, et al. "Intestinal Colonization Dynamics of Vibrio cholerae." PLoS Pathog, vol. 11, no. 5, May 2015, pp. 1-5, doi:10.1371/journal.ppat.1004787.

Coleman,, William, and Edward Alcamo. Cholera. Infobase Publishing, 2009.

Millet, Yves, et al. "Insights into Vibrio cholerae Intestinal Colonization from Monitoring Fluorescently Labeled Bacteria." PLoS Pathog, vol. 10, no. 10, Oct. 2014, pp. 1-15, doi:10.1371/journal.ppat.1004405.

Silva, Anisia, and Jorge Benitez. "Vibrio cholerae Biofilms and Cholera Pathogenesis." PLOS Neglected Tropical Diseases, vol. 10, no. 2, 2016, pp. 1-25, DOI:10.1371/journal.pntd.0004330.