Tag: Cholera

The neck is part of a long flexible column, known as the spinal column or backbone, which extends through most of the body. The cervical spine (neck region) consists of seven bones (C1-C7 vertebrae), which are separated from one another by intervertebral discs. These discs allow the spine to move freely and act as shock absorbers during activity. ​(1)​ 

What does the cervical spine do?

Your cervical spine has several functions, including: (2)

• Protecting your spinal cord. The nerves of your spinal cord pass through a large hole (called the vertebral foramen) that passes through the center of all of your vertebrae — from the base of your skull through the cervical vertebrae, the thoracic (middle back) vertebrae and ending between the first and second lumbar (lower back) vertebrae. Taken together, all the stacked vertebrae of your spine form a protective central canal that protects your spinal cord.
• Supporting your head and allowing movement. Your cervical spine supports the weight of your head (average weight of 10 to 13 pounds). It also allows your head and neck to tilt forward (flexion), backward (extension), turn from side to side (rotation), or bend to one side (ear-to-shoulder; lateral flexion).
• Providing a safe passageway for vertebral arteries. Small holes in cervical spine vertebrae C1 to C6 provide a protective pathway for vertebral arteries to carry blood to your brain. This is the only section of vertebrae in the entire spine that contains holes in the bone to allow arteries to pass through.

Cervical spondylosis

Cervical spondylosis (Arthritis of the Neck) is a general term for age-related wear and tear affecting the spinal disks in your neck. As the disks dehydrate and shrink, signs of osteoarthritis develop, including bony projections along the edges of bones (bone spurs). (3)

Cervical spondylosis is very common and worsens with age. More than 85% of people older than age 60 are affected by cervical spondylosis.

Symptoms

Most people experience no symptoms. When symptoms do occur, they typically include pain and stiffness in the neck.

Sometimes, cervical spondylosis results in a narrowing of the spinal canal within the bones of the spine (the vertebrae). The spinal canal is the space inside the vertebrae that the spinal cord and the nerve roots pass through to reach the rest of the body. If the spinal cord or nerve roots become pinched, you might experience: :​(3)​ 

• Pain in the neck that may travel to your arms or shoulders
• Headaches
• A grinding feeling when you move your neck
• Weakness in your arms and legs
• Numbness in your shoulders, arms, or hands
• Stiff neck
• Trouble keeping your balance, especially when walking
• Trouble controlling your bladder or bowels

Causes of cervical spondylosis

As you get older, your spine changes due to decades of normal wear and tear. Starting in middle age, the disks between your vertebrae start to change. These changes can include: (4)

• Degeneration: The spinal disks in your neck may slowly wear down (degenerate). With time, the disks become thinner, and the soft tissue has less elasticity. If you or your parents measure in a little shorter in height than you did years ago, this is normal collapsing or settling of your disks.
• Herniation: Normal aging can cause part of your spinal disk to tear or crack. This is called a herniated disk. The herniation can allow the disk to bulge out, pressing on nearby tissue or a spinal nerve. This pressure can cause pain, tingling, or numbness.
• Osteoarthritis: Osteoarthritis is a progressive (ongoing) condition that causes the cartilage in your joints to degenerate (wear down with time). With osteoarthritis, cartilage degenerates faster than normal aging.
  
• Bone spurs: When cartilage in the joints of the vertebrae in your spine starts to degenerate and bone tissue rubs directly against other bone tissue, abnormal bone growths develop along the edges of vertebrae. These growths (called osteophytes or bone spurs) are common as you age. Often, they cause no symptoms.

Diagnosis

Your healthcare provider will likely start with a physical exam that includes:(5)​​ ​(6)​ 

• Checking the range of motion in your neck
• Testing your reflexes and muscle strength to find out if there's pressure on your spinal nerves or spinal cord
• Watching you walk to see if spinal compression is affecting your gait

Imaging tests

Imaging tests can provide detailed information to guide diagnosis and treatment. Examples include:

• Neck X-ray. An X-ray can show changes in the spine, such as bone spurs, that indicate cervical spondylosis. Neck X-rays can also rule out rare and more serious causes of neck pain and stiffness, such as tumors, cancer, infections, or fractures.
• MRI. Using radio waves and a strong magnetic field, MRI can produce detailed images that can help pinpoint areas where nerves might be pinched.
• CT myelography. In this type of CT scan, a dye is injected into the spinal canal to provide more-detailed imaging. This test makes it easier to see the details of the spinal cord, spinal canal, and nerve roots.

Nerve function tests

You may need tests to determine if nerve signals are traveling properly to your muscles. Nerve function tests include:

• Electromyography. This test measures the electrical activity in your nerves as they transmit messages to your muscles when the muscles are contracting and at rest.
• Nerve conduction study. Electrodes are attached to the skin above the nerve to be studied. A small shock is passed through the nerve to measure the strength and speed of nerve signals

Treating cervical spondylosis

Treatments for cervical spondylosis focus on providing pain relief, lowering the risk of permanent damage, and helping you lead a normal life.

Nonsurgical methods are usually very effective.

Physical therapy

Your doctor might send you to a physical therapist for treatment. Physical therapy helps you stretch your neck and shoulder muscles. This makes them stronger and ultimately helps to relieve pain. (7)

You might also have neck traction. This involves using weights to increase the space between the cervical joints and relieve the pressure on the cervical discs and nerve roots.

Medications

Your doctor might prescribe certain medications if over-the-counter (OTC) drugs don’t work. These include: (7)​ 

• muscle relaxants, such as cyclobenzaprine, to treat muscle spasms
• narcotics, such as hydrocodone, for pain relief
• anti-epileptic drugs, such as gabapentin, to relieve pain caused by nerve damage
• steroid injections, such as prednisone, to reduce tissue inflammation and subsequently lessen pain
• prescription nonsteroidal anti-inflammatory drugs (NSAIDs), such as diclofenac (Voltaren-XR), to reduce inflammation

Surgery

If your condition is severe and doesn’t respond to other forms of treatment, you might need surgery. This can involve removing bone spurs, parts of your neck bones or herniated discs to give your spinal cord and nerves more room.

Surgery is rarely necessary for cervical spondylosis. However, a doctor may recommend it if the pain is severe and it’s affecting your ability to move your arms.

Home treatment options

If your condition is mild, you can try a few things at home to treat it: (7)

• Take an OTC pain reliever, such as acetaminophen or an NSAID, which includes ibuprofen and naproxen sodium.
• Use a heating pad or a cold pack on your neck to provide pain relief for sore muscles.
• Exercise regularly to help you recover faster.
• Wear a soft neck brace or soft collar to get temporary relief. However, you shouldn’t wear a neck brace or collar for long periods because that can make your muscles weaker.

Makkah Pharmacy recommends:

5 easy-to-follow at-home exercises to reduce cervical spondylosis pain: (8)​ 

Push forward

This exercise is very easy to follow and also helps better flexibility in the neck. Here's how to perform the neck push-forward exercise:

• Stand straight
• Try to push your neck forward as far as possible
• At this point, your neck would be protruding forward ahead of the rest of your body
• Hold this stretch for a few snoods and release
• Repeat it a few times daily

Neck tilts

Neck tilts as the name suggests helps in stretching the neck in different directions and help relieve pain and stiffness. Here is how you can practice neck tilts.

• Try to place your head on your right shoulder
• At this point, your right ear should be touching your right shoulder
• Hold this position for a few seconds
• Now witch, with your head resting on your left shoulder
• Repeat this at least 4-5 times, a few times a week, or whenever you feel discomfort

Neck bowing

Similar to the pushing the neck forward exercise, neck bowing focuses on stretching the neck out as far as possible. A combination of these two regularly can ensure better flexibility and a reduction in pain in the neck. Here's how you perform the neck-bowing exercise:

• Try to rest your neck on your chest
• In this position, your chin should be touching your chest
• Hold this position for a few seconds and release
• Repeat this along with push forward exercise, alternatively
• Repeat at least 3-4 times

Look behind

As the name suggests, the looking behind neck exercise focuses on stretching the neck behind. For this exercise, the motive is to turn your neck around in an attempt to see behind you. Here's how to practice the look behind the exercise:

• Stand straight and turn your neck to the left as far behind as you comfortably can
• Hold for a few seconds
• Repeat on the other side
• Repeat this set 4-5 times or more, however comfortable
• Please note that your body must stay in the same position and angle throughout

Raised shoulders

This is another easy-to-follow exercise for cervical spondylosis. It also helps release tension from the neck and promotes a calming feeling. This is how to practice raised shoulders:

• As the name suggests, try to raise your shoulders as you normally would
• At this point, your shoulders might be touching your ears
• Hold this position for a few songs and release
• You can practice this position 10-15 times daily to reduce pain and stiffness

References:  

​​1. Cervical Spine – Anatomy, Diseases, and Treatments [Internet]. [cited 2023 Feb 21]. Available from: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Cervical-Spine 

​2. Cervical Spine (Neck): What It Is, Anatomy & Disorders [Internet]. [cited 2023 Feb 21]. Available from: https://my.clevelandclinic.org/health/articles/22278-cervical-spine 

​3. Cervical spondylosis - Symptoms and causes - Mayo Clinic [Internet]. [cited 2023 Feb 21]. Available from: https://www.mayoclinic.org/diseases-conditions/cervical-spondylosis/symptoms-causes/syc-20370787 

​4. Cervical Spondylosis: Symptoms, Causes, Treatments [Internet]. [cited 2023 Feb 21]. Available from: https://my.clevelandclinic.org/health/diseases/17685-cervical-spondylosis 

​5. Theodore N. Degenerative Cervical Spondylosis. New England Journal of Medicine. 2020 Jul 9;383(2):159–68.  

​6. Cervical spondylosis - Diagnosis and treatment - Mayo Clinic [Internet]. [cited 2023 Feb 21]. Available from: https://www.mayoclinic.org/diseases-conditions/cervical-spondylosis/diagnosis-treatment/drc-20370792 

​7. Cervical Spondylosis: Causes, Symptoms, Home Treatments, and More [Internet]. [cited 2023 Feb 21]. Available from: https://www.healthline.com/health/cervical-spondylosis#treatment 

​8. Cervical Spondylosis: 5 Exercises To Reduce Neck Pain [Internet]. [cited 2023 Feb 21]. Available from: https://www.ndtv.com/health/cervical-spondylosis-5-exercises-to-reduce-neck-pain-2988112 

Keeping your body in good health is a difficult task. No one can be in good health for long if he/she does not monitor the core vital signs of good health. Eating healthy and exercising are not the only essentials to maintaining good health but, monitoring vitals using a health monitoring device regularly is also essential.

Health monitoring

It is the use of IT and telecommunications to monitor the health of patients in their homes and to help ensure that appropriate action is taken. Patients are provided devices that measure vital signs, such as blood pressure, glucose level, pulse, blood oxygen level and weight, and then transmit the data to clinicians. Other devices are used for messaging — gathering information from patients on their symptoms, cognitive state, and behavior, and sending them information and advice.,(1)

Key Benefits of Regular Health Monitoring

Health monitoring is very important in terms of prevention, particularly if the early detection of diseases can reduce suffering and medical costs. Diagnosis and prompt treatment of various diseases can radically improve alternatives for the patient's medical treatment. This is particularly true in cardiovascular diseases and diabetes; the use of sensors can identify patients at risk by monitoring and transmission of vital signs to medical professionals, who may subsequently determine the actions needed to safeguard the patient's health. (2)

While regular monitoring of one’s health is essential, it can also be very challenging if you prefer to go only to hospitals for check-ups because (3)

• There is always overcrowding in hospitals
• Lack of doctors
• Huge number of patients with complicated conditions
• Unavailability of monitoring devices

Traditionally, you needed to go to a hospital to see a doctor for health checkups, which was a time and money-consuming task. However, with the technological advent, of all this has changed significantly.  Nowadays remote health monitoring is helping patients in recording their health vitals in non-clinical set-ups or on the go. Easy-to-use devices can be operated in the home with no technical knowledge to prevent multiple illnesses. Decreased cost, less hassle, improved experience, and better results are key benefits of regular home monitoring. These devices;(3)

• Reduce hospitalization related cost, time and efforts
• Reduce time needed for taking appointment
• Detect serious illness early for quick treatment
• Rapid diagnosis that helps to reach a logical conclusion
• Better adherence to prescribed medications

Health monitors devices

1-Blood sugar

Home glucose monitors can help you keep tabs on your diabetes and lower your risk of complications. Along with treatment, using a home monitor can help you identify the things that make your blood sugar increase or decrease, from exercise to illness, stress to dehydration, and more.

The Centers for Disease Control and Prevention (CDC), Trusted Source recommends checking your blood sugar as advised by your doctor. How often you should check depends on a number of things, including:(4)

• the type of diabetes you have
• what medications you’re currently taking
• how many meals you eat each day

Some doctors may recommend you test only a few times a day, while others may think continuous monitoring is more appropriate — each situation is unique and may change over time.

Below are tips for how to use a blood sugar meter:(5)

1. Make sure the meter is clean and ready to use.
2. After removing a test strip, immediately close the test strip container tightly. Test strips can be damaged if they are exposed to moisture.
3. Wash your hands with soap and warm water. Dry well. Massage your hand to get blood into your finger. Don’t use alcohol because it dries the skin too much.
4. Use a lancet to prick your finger. Squeezing from the base of the finger, gently place a small amount of blood onto the test strip. Place the strip in the meter.
5. After a few seconds, the reading will appear. Track and record your results. Add notes about anything that might have made the reading out of your target range, such as food, activity, etc.
6. Properly dispose the lancet and strip in a trash container.
7. Do not share blood sugar monitoring equipment, such as lancets, with anyone, even other family members. For more safety information.
8. Store test strips in the container provided. Do not expose them to moisture, extreme heat, or cold temperatures.

Makkah Pharmacy recommends:

2-Blood pressure

Blood pressure monitoring means taking your blood pressure on a regular or continuous basis. Blood pressure monitoring helps assess your overall health and your condition when you are sick or injured. Blood pressure monitoring can occur at a doctor’s appointment, at home on a regular basis, and in the hospital continuously if you are seriously ill or injured. (6)   

Blood pressure is the force exerted on the walls of your arteries as your heart pumps blood through your body. Your blood pressure consists of two numbers followed by the units of pressure, such as 120/80 mmHg (millimeters of mercury): (6)

• The top number is the systolic pressure—the highest pressure in your arteries as the heart is pumping blood.
• The bottom number is the diastolic pressure—the lowest pressure in your arteries when the heart is at rest between beats.

What is the correct way to measure blood pressure?(7)

Learn the correct way to have your blood pressure taken, whether you’re getting it checked at the doctor’s office or checking it yourself at home. Use this checklist:

• Don’t eat or drink anything 30 minutes before you take your blood pressure.
• Empty your bladder before your reading.
• Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
• Put both feet flat on the ground and keep your legs uncrossed.
• Rest your arm with the cuff on a table at chest height.
• Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
• Do not talk while your blood pressure is being measured.

How to measure your blood pressure at home using a home monitor?(8)

1. Follow the instructions that came with your monitor. Make sure you place the cuff around your arm as described in the instructions.
2. Place the arm cuff just above your elbow. The cuff should be about 2cm above your elbow to make sure it can detect the artery in your arm, just under the skin. 
3. Keep still and quiet while you take your reading. Moving, chewing, talking and laughing can affect your reading. Make sure you don't cross your legs, as this will raise your reading too.
4. Take two or three readings, each about one to two minutes apart. If your first reading is much higher than the next, ignore it and take an extra reading. Once you have two to three readings, you can work out the average. 
5. Keep a record of your measurements. Record all your readings in the memory of your monitor, on your computer or phone or on paper – whichever you prefer. Write them down exactly as they appear on screen. 

Makkah Pharmacy recommends:

3-Pulse oximeter

Pulse oximetry is a noninvasive test that measures the oxygen saturation level of your blood.

It can rapidly detect even small changes in oxygen levels. These levels show how efficiently blood is carrying oxygen to the extremities furthest from your heart, including your arms and legs.(9)

The pulse oximeter is a small, clip-like device. It attaches to a body part, most commonly to a finger.

Medical professionals may use pulse oximeters to monitor the health of people with conditions that affect blood oxygen levels, especially while they’re in the hospital.(10)

These can include:

• chronic obstructive pulmonary disease (COPD)
• asthma
• pneumonia
• lung cancer
• anemia
• heart attack or heart failure
• congenital heart disease

To take a reading with a pulse oximeter, you will:(9)

1. Remove any jewelry or fingernail polish on your finger if measuring from this location.
2. Make sure your hand is warm, relaxed, and below heart level if attaching the device here.
3. Place the device on your finger, earlobe, or toe.
4. Keep the device on for as long as needed to monitor your pulse and oxygen saturation.
5. Remove the device once the test is over.

Makkah Pharmacy recommends:

4- Thermometer

Checking your body’s temperature with a thermometer is an easy way to see if a fever is present. A fever, which is a rise in the body’s temperature, is usually caused by an infection. Though fevers can be uncomfortable, they are a sign that the body is fighting off infection.

What is a normal body temperature?

Normal body temperature is about 98.6 degrees Fahrenheit (°F) or 37 degrees Celsius (°C). Normal temperature often varies from 1° to 2°F (½° to 1°C). A normal temperature is usually lower in the morning and increases during the day. It reaches its high in the late afternoon or evening.(11)

What temperature is considered a fever?(11)

In adults, a fever is considered to be a temperature of 100.4°F (38°C) or above. You can treat this at home with a fever reducer medication and fluids to make yourself more comfortable, or let it run its course. But if it reaches 102°F (38.8°C) or higher and home treatment doesn’t lower it, call your healthcare provider.

How to use a digital thermometer?(11)

A digital thermometer can be used in three different ways. These include:

• Oral: For this method, the thermometer is placed under the tongue. This method is used for adults and children 4 and over who are able to hold thermometers in mouth.
• Rectal: For this method, the thermometer is inserted gently into the rectum. This is mostly done in babies but can use in children up to 3 years of age. You can take rectal temperatures in children older than 3 years, but it might be difficult to keep them as still as they need to stay.
• Axillary: For this method, the thermometer is placed in the armpit of young children or adults whose temperature can’t safely be done orally. This method is not as accurate as oral or rectal but can be used as a quick first check. You can follow this with an oral or rectal reading.

Other types of thermometers (young children and adults):

Tympanic (ear): This type of thermometer measures the temperature inside of the ear by reading the infrared heat there. For best results, make sure to follow the instructions on the device about placing the tip correctly. For older babies and children, ear thermometers can be quicker and easier to use. However, they are not recommended if your baby is three months old or younger. They should not be used if your child has too much earwax, or if they have an earache.

Temporal artery (forehead): Forehead thermometers are also used to measure temperature, but may not be as reliable as the digital thermometers and are usually more expensive. They are placed on the temporal artery of the forehead and measure the infrared heat that comes off of the head. 

Makkah Pharmacy recommends:

Using a digital rectal thermometer (for babies and children up to 3 years old)(11)

1. Wash the rectal thermometer with soap and warm water. Don’t use an oral thermometer.
2. Put a small amount of lubricant (petroleum jelly or Vaseline®) on the sensor (tip) of the thermometer.
3. Place your child belly down on your lap or table, with one palm on their back. Or place them face-up, with legs bent toward their chest and hold the back of their thighs with one hand. Put a diaper or cloth under your child as he or she may poop immediately after removal of the thermometer.
4. Using your other hand, gently insert the thermometer into the anus until the tip is completely inside the rectum. DO NOT force it if you feel resistance.
5. Keep the thermometer steady with your hand until you hear the beep (around 30 seconds).
6. Gently remove. Record temperature and time.
7. Clean the thermometer thoroughly with soap and water. You may want to clean it off again with alcohol and then rinse it again.

Using a digital axillary (same as oral) thermometer(11)

1. Remove the child’s shirt and place the thermometer tip into your child’s armpit. Make sure your child’s armpit is dry to get the most accurate reading.
2. Keep the axillary thermometer in place by folding your child’s arm across his or her chest.
3. The thermometer will beep when reading is done (this method may take longer than 30 seconds).
4. Remove and record temperature and time.
5. Clean the thermometer with soap and water or with alcohol, always rinsing as a last step.

• You should not use your old glass thermometer that contains mercury. These types of thermometers were found in nearly every house and hospital at one time before digital thermometers were available. The mercury thermometers were difficult to read and so did not always provide accurate information.

The main reason they are no longer recommended is that mercury can poison you. This can happen when the glass breaks and mercury is released.

Makkah Pharmacy recommends:

References:

1. Definition of Home Health Monitoring - Gartner Information Technology Glossary [Internet]. [cited 2022 Aug 26]. Available from: https://www.gartner.com/en/information-technology/glossary/home-health-monitoring
2. Pramanik PKD, Pareek G, Nayyar A. Security and privacy in remote healthcare: Issues, solutions, and standards. Telemedicine Technologies: Big Data, Deep Learning, Robotics, Mobile and Remote Applications for Global Healthcare. 2019 Jan 1;201–25. 
3. Health Monitoring Devices: Why They Are Important and How They Will He [Internet]. [cited 2022 Aug 26]. Available from: https://drtrust.in/blogs/news/regular-health-monitoring-devices-why-they-are-important-and-how-they-will-help-you
4. 7 Best Glucose Monitors 2022: From Affordable to Continuous [Internet]. [cited 2022 Aug 26]. Available from: https://www.healthline.com/health/diabetes/best-glucose-monitors#A-quick-look-at-the-best-home-glucose-monitors-and-meters
5. Monitoring Your Blood Sugar [Internet]. [cited 2022 Aug 26]. Available from: https://www.cdc.gov/diabetes/managing/managing-blood-sugar/bloodglucosemonitoring.html
6. Blood Pressure Monitoring: Why It’s Done, What to Expect [Internet]. [cited 2022 Aug 26]. Available from: https://www.healthgrades.com/right-care/high-blood-pressure/blood-pressure-monitoring
7. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2020 update a report from the American Heart Association. Circulation. 2020;141(9):E139–596. 
8. Measure Your Blood Pressure | cdc.gov [Internet]. [cited 2022 Aug 26]. Available from: https://www.cdc.gov/bloodpressure/measure.htm
9. Jubran A. Pulse oximetry. Crit Care. 2015 Jul 16;19(1). 
10. Pulse Oximetry: Uses, Readings, and How It Works [Internet]. [cited 2022 Aug 26]. Available from: https://www.healthline.com/health/pulse-oximetry#readings
11. How To Use A Thermometer To Take Your Temperature [Internet]. [cited 2022 Aug 26]. Available from: https://my.clevelandclinic.org/health/articles/9959-thermometers-how-to-take-your-temperature

Cholera is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholera.(1)

History

During the 19th century, cholera spread across the world from its original reservoir in the Ganges delta in India. Six subsequent pandemics killed millions of people across all continents. The current (seventh) pandemic started in South Asia in 1961 and reached Africa in 1971 and the Americas in 1991. Cholera is now endemic in many countries. (2)

A person can get cholera by drinking water or eating food contaminated with cholera bacteria. In an epidemic, the source of the contamination is usually the feces of an infected person that contaminates water or food. The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. The infection is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk factor for becoming ill.(3)

Symptoms:

Cholera is an acute diarrheal illness caused by infection of the intestine with Vibrio cholerae bacteria. People can get sick when they swallow food or water contaminated with cholera bacteria. The infection is often mild or without symptoms but can sometimes be severe and life-threatening. (4)

About 1 in 10 people with cholera will experience severe symptoms, which, in the early stages, include:(4)

• Profuse watery diarrhea, sometimes described as “rice-water stools”
• Vomiting
• Thirst
• Leg cramps
• Restlessness or irritability

Healthcare providers should look for signs of dehydration when examining a patient with profuse watery diarrhea. These include:

• Rapid heart rate
• Loss of skin elasticity
• Dry mucous membranes
• Low blood pressure

People with severe cholera can develop severe dehydration, which can lead to kidney failure. If left untreated, severe dehydration can lead to shock, coma, and death within hours. (4)

Management and treatment

The most important part of cholera treatment is preventing or reversing dehydration. Anyone with cholera should immediately replace the fluids and salts they’ve lost. A healthcare provider may prescribe:(5)

• Oral rehydration solution (ORS): You may have to drink large amounts of a prepackaged mix of sugar, salts, and water.
• Intravenous fluids: For a severe case of dehydration, a healthcare provider may use a needle to pump fluids directly into your veins.

Other treatments may include:(5)

• Antibiotics.
• Zinc in children younger than 5.

1. cholera bacteria usually disappear from the body within two weeks.

Makkah Pharmacy recommends:

Prevention and Control

To prevent cholera, you should wash your hands often and take steps to ensure your food and water are safe for use. Following these simple steps greatly reduces your risk of getting cholera in areas where cholera is spreading:(6)

1. Be sure you drink and use safe water.

• Use bottled water to brush your teeth, wash and prepare food, and make ice or beverages.
• If bottled water is not available, use water that has been properly boiled, chlorinated, or filtered using a filter that can remove bacteria.
• Use bottled water with unbroken seals.

Water from pipes, drinks sold in cups or bags, and ice may not be safe.

If you think your water may not be safe—treat it with a chlorine product, boil it, treat it with bleach, or filter it.

Treat with Chlorine Product

• Treat your water with one of the locally available chlorine treatment products and follow the label instructions.

Or boil it

• If a chlorine treatment product is not available, boiling is an effective way to make water safe. Bring your water to a rolling boil for 1 minute. Note: Boiled water is at risk for re-contamination if not stored and used safely.

Or Treat with Bleach

• If you cannot boil water, treat water with household bleach. Add 8 drops of household bleach for every 1 gallon of water (or 2 drops of household bleach for every 1 liter of water) and wait 30 minutes before drinking.

Or Filter It

• If filtering, use a device with a pore size less than or equal to 0.3 microns and treat the water with a disinfectant such as chlorine, chlorine dioxide, or iodine.
• Always store your treated water in a clean, covered container.

2. Wash your hands often with soap and safe water.

• Before, during, and after preparing food.
• Before and after eating food or feeding your children.
• After using the toilet.
• After cleaning your child’s bottom.
• After taking care of someone who is sick with diarrhea.

If you don’t have access to soap and water, use an alcohol-based hand rub with at least 60% alcohol.

3. Use toilets

• Use toilets or safely managed sanitation facilities to get rid of feces (poop). This includes the disposal of children’s poop.
• Wash hands with soap and safe water after going to the bathroom.

If you don’t have access to a toilet:

• Poop at least 30 meters (98 feet) away from any body of water (including wells) and then bury your poop.
• Dispose of plastic bags containing poop in latrines or at collection points if available or bury them in the ground.
• Do not put plastic bags in chemical toilets.
• Dig new latrines or temporary pit toilets at least a half-meter (1.6 feet) deep and at least 30 meters (100 feet) away from any body of water.

4. Boil it, cook it, peel it, or leave it.

• Cook food well, keep it covered, eat it hot, and peel fruits and vegetables.
• Eat foods that have been thoroughly cooked and are still hot and steaming. Be sure to cook seafood, especially shellfish, until it is very hot all the way through.
• Avoid raw vegetables and fruits that cannot be peeled.

5. Clean up safely.

• Clean food preparation areas and kitchenware with soap and treated water and let dry completely before reuse.
• Bathe and wash clothes or diapers 30 meters (100 feet) away from drinking water sources.
• Clean and disinfect toilets and surfaces contaminated with poop: clean the surface with a soap solution to remove solids; then disinfect using a solution of 1 part household bleach to 9 parts water.
• When finished cleaning, safely dispose of soapy water and dirty rags. Wash hands again with soap and safe water after cleaning and disinfecting.

Vaccine

Vaxchora

In December 2020, the maker of this cholera vaccine temporarily stopped making and selling it. This vaccine is currently unavailable. (7)

Vaxchora (lyophilized CVD 103-HgR) is a single-dose, oral vaccine FDA-approved in the United States for use in people aged 2–64 who are traveling to an area of active cholera transmission.

Vaxchora should be taken at least 10 days before travel to an area of active cholera transmission.

The vaccine manufacturer reports Vaxchora reduces the chance of moderate and severe diarrhea in people by 90% at 10 days after vaccination and by 80% at 3 months after vaccination. It is unknown how long protection lasts beyond 3–6 months after vaccination.

Dukoral, ShanChol, and Euvichol-Plus(7)

Three other oral cholera vaccines have been prequalified by the World Health Organization (WHO). They are:

• Dukoral
• ShanChol
• Euvichol-Plus/Euvichol

Where can a traveler get information about cholera?

• The global picture of cholera changes periodically, so travelers should seek updated information on countries of interest. CDC has a Travelers’ Health Website with information on cholera and other diseases of concern to travelers.

References:

1. Cholera: Causes, Symptoms, Treatment, and Prevention [Internet]. [cited 2022 Nov 6]. Available from: https://www.webmd.com/a-to-z-guides/cholera-faq
2. Ali M, Nelson AR, Lopez AL, Sack DA. Updated global burden of cholera in endemic countries. PLoS Negl Trop Dis. 2015 Jun 4;9(6).
3. General Information | Cholera | CDC [Internet]. [cited 2022 Nov 6]. Available from: https://www.cdc.gov/cholera/general/index.html
4. Illness and Symptoms | Cholera | CDC [Internet]. [cited 2022 Nov 6]. Available from: https://www.cdc.gov/cholera/illness.html
5. Cholera: Symptoms, Causes, Treatment & Prevention [Internet]. [cited 2022 Nov 6]. Available from: https://my.clevelandclinic.org/health/diseases/16636-cholera
6. Five Basic Cholera Prevention Steps | Cholera | CDC [Internet]. [cited 2022 Nov 6]. Available from: https://www.cdc.gov/cholera/preventionsteps.html
7. Vaccines | Prevention and Control | Cholera | CDC [Internet]. [cited 2022 Nov 6]. Available from: https://www.cdc.gov/cholera/vaccines.html