cholera /kol″ərə/ [Gk, chole + rhein, to flow] , an acute bacterial infection of the small intestine. The disease is spread by water and food that have been contaminated by feces of persons previously infected. The symptoms are caused by Cholera toxin, which is produced by the infecting organism, Vibrio cholerae. The profuse, watery diarrhea, as much as a liter an hour, depletes the body of fluids and electrolytes. Complications include circulatory collapse, cyanosis, destruction of kidney tissue, and metabolic acidosis. The rate of mortality is as high as 50% if the infection remains untreated. See also Vibrio cholerae, vibrio gastroenteritis. ▪ OBSERVATIONS: Symptoms include severe watery diarrhea and vomiting, muscular cramps, dehydration, and depletion of electrolytes. ▪ INTERVENTIONS: Treatment includes, first and foremost, replacement of fluids and electrolytes (oral rehydration therapy) or IV fluids and, second, the administration of antibiotics. ▪ PATIENT CARE CONSIDERATIONS: A cholera vaccine is available for people traveling to areas where the infection is endemic but is of limited efficacy. Other preventive measures include eating only cooked foods and, when unsure about the quality of the water supply, drinking only water that has been boiled or decontaminated by iodine or that has been commercially bottled.
