Modes of Infection
Essay- Cholera
The essay is prepared with the focus on discussing cholera and its associated aspects such as mode of infection, mythologies of diagnosis, treatment procedures available, and other healthcare aspects related to it. It will also demonstrate the modes of infection that caused cholera and also the mythologies associated with the diagnosis of the illness or disease. It will also present information and knowledge about the treatment interventions that can help in dealing with the illness, furthermore, ensuring the betterment of health and wellbeing of individuals too.
Weil and LaRocque (2020) state that cholera was prevalent in the 80s in the United States even before there were modern water and sewage treatment system that should have prevented the spread of the disease and virus by contaminated water. With the improvement of healthcare systems. The outbreak of cholera has dwindled since then, though in some other parts of the world, cholera still seems prevalent with around 1.3 million to 4 million cases, occurring every year (Cdc.gov 1982). The disease has been most common in areas that consist of poor sanitation methods. Crowding, war and famine, and most of the locations include the various regions of South Asia, Africa, and Latin America (Gaffga et al. 2007). The essay will also present information and knowledge about the probable measures and interventions undertaken nowadays to prevent the occurrence of cholera and make sure to diagnose and treat the disease or illness properly.
According to Holmgren (2021), cholera was most prominent in the 80s in the US, where many of the people were suffering from depression and undue anxiety, as they were afraid of the imminent peril that was going to happen. Moreover, there was a lack of knowledge and information about the nature of the cause of cholera, and no knowledge of the circumstances as well. The intemperate habits and behaviors, bad drinking habits, personal uncleanliness, and poorly prepared food all were considered to be the causes of this disease (Ripoll and Wilkinson 2018). These investigations in London, New York, though there was a lack of treatment interventions for managing the disease properly during that time. Nowadays, even there are few cases of cholera, mostly prevalent in poorly developed nations and in regions that have lower income and lack proper facilities to maintain hygiene (Usmani et al. 2021). Cholera is a severe illness associated with diarrheal symptoms, which is caused by the intestinal infections due to contaminated water and food. Though this disease is mild and without symptoms, it could be fatal, if not treated in the right manner. The major symptoms of cholera include diarrhea, dehydration in the body and even there could be an occurrence of shocks and seizures, in severe cases (Weil and LaRocque 2020).
There are various modes of infection for cholera and it has been found that a person might suffer from cholera through consumption of food and water that has been contaminated by cholera bacteria or viruses. It often occurs as a pandemic, and the source of this contamination of water is the use of feces of a person, who has been infected and that has contaminated the water or food severely (Jones et al. 2020). This disease has often spread rapidly in those areas that have inadequate and inappropriate treatment of drinking water and sewage systems. Also, the areas that possess poor sanitation, inadequate hygiene measures, and improper water treatment methods, have seen large evidence of cholera and these bacteria live in the environment in coastal waters and brackish rivers too. Often eating raw shellfish has been the source of infection, while people washing their dirty hands in the water of rivers and ponds have been used by other individuals for cleaning purposes and also drinking in the rural areas (Legros 2018). The name of the bacteria is Vibrio cholera that caused cholera and it has been mostly found in contaminated food and water the major modes of infection result from various sources including the supplies from the municipal water system, food and drinks that have been sold by individuals roadside, the vegetables kept open and grown in water contaminated or polluted due to the presence of by human wastes and also consumption of raw food items, especially the food sourced from seas and oceans such as fishes that are found in waters polluted by wastes from sewage system (Kolaye et al. 2019). The contaminated water and food gradually release the bacteria, which release a toxin further and this affects the intestine of the human body, by producing severe diarrhea.
Symptoms of Cholera
Considering the healthcare context, there are both mild as well as severe symptoms of cholera, such as the diarrhoea, vomiting and also lead to quick dehydration of the body, i.e., loss of water from the body (Richterman et al. 2018). The heart rate becomes faster along with loosing elasticity and firmness of skin and the mucous membranes present inside the mouth, throat, nose, and eyelids, which become dry as well. The blood pressure also lowers to a large extent while people often feel thirsty most of the time along with happening muscle cramps in the entire body are other symptoms of cholera (Nadri et al. 2018). The immense dehydration could also be the cause of shocks and fatality in severe cases, if not treated at an earlier stage. Therefore, it could be easily believed that the individuals staying in the unsafe regions, including the contaminated drinking water, inappropriate sanitation, and lack of hygiene measures also contribute to higher risks of cholera among the individuals. Thus, there is the mode of infection and also related symptoms of cholera that have happened among individuals, even leading to epidemic earlier (Wei et al. 2018).
Based on the evidence presented by Kenneth Field, there was mythology around John Snow, which ultimately fetched the discovery or diagnosis of cholera. The myth highlighted the occurrence of cholera due to getting spread by water, and the role of the famous cholera map was to revolutionize disease mapping, The mythology surrounding the work of the author, about the 1845 epidemic, represented facts and evidence about what really happened and also created an interesting story that provided knowledge about the true nature of events (Field 2020). There were other myths as well including the socio-cultural factors such as the knowledge and awareness of principle among men and every healthcare professional needs to consider this duality for achieving the goal or objective of optimizing human health. The concept of the disease represented the germ theory that laid the platform for management of modern medicinal attributes, as considered from the biomedical science perspective as well as broadened the cultural definition largely too (Yang and Wang 2019). The gem theory was considered as a major myth that has been derived from various assumptions made regarding the specific cause of the disease and also how the treatment has to be managed mitigating the source of this cholera disease with the use of a biomedical framework (Kim et al. 2020). To be precise, in Nigeria, few cases were considered as natural, which represented malnutrition while there were preternatural aspects too such as belief in witchcraft and mythological beliefs including those of supernatural powers that affected the wellbeing of people. There were a scarcity of data and information regarding the perceptions of individuals, myths, and even socio-cultural beliefs regarding the cause of this wide range of endemic infectious diseases that happened over time, during this period (Okosun et al. 2019).
Cholera has still been considered as a “myth associated with the source of good epidemic” as it helped in management of good water within the community and regions at present. Many believed that the cholera epidemics were the main causes, rather acted as stimuli to the procurement of safe water and sanitation activities. The cholera epidemic drove the sanitary revolution throughout the industrialized world, as stated by Cohn (2018), which benefited humanity as well as brought awareness among people regarding the deficiencies in basic procedures and systems that must be improved and changed upon for tackling such disease or illness appropriately. The cholera force, as a myth helped in the diagnosis of the problem or issue, from the healthcare context and ensured bringing beneficial changes in public health. The myth of a good epidemic resulted in improving public health infrastructure as well as made these flourish in tough conditions, which improved public sanitation systems as well (Awofeso and Aldbak 2018). A few examples include public supplies of pure water happened, water closeting, sewer, and sewage treatment along with bringing a sanitary revolution, which enabled commitment towards environmental causes that had been largely appreciated as a public responsibility (Mahheidari et al. 2020).
Mythologies and Diagnosis of Cholera
The cholera force, as a mythology of diagnosis also was considered as a major case in healthcare aspect that has been associated with the application of history to policy and bringing appropriate results, which seemed appealing to history in political conversations (Ivers 2018). Though most of the historians did not believe the generalization that cholera enabled sanitation and hygiene measures to be improved. Though there were criticisms, still, the improvement of sewage facilities and urban water systems has been a moral good, which not only transformed the historical generalizations into self-fulfilling prophecies but also achieved greater good (Liu et al. 2019).
When the disease outbreak, i.e., cholera, people considered cholera to be caused by polluted air that has poisonous smell or odour, formed due to decayed matter. Considering the germ theory of cholera, the organism has been shaped like a comma, which has been the main source of cholera, thus resulted in multiple risk factors associated with the disease or illness (Bhandare et al. 2019). The myths, just as many were false and unnatural, such as supernatural powers causing harm to people and even local beliefs, which were wrong, rather the entire matter was related to poor health and wellbeing (Ujah et al. 2015). The myths though brought a change by implementing various measures for tackling the disease, thus, managing efforts to for determining the number of individuals in the area. There was the transformation of perceptions which has been followed by changes and improvements in sanitation measures, hygiene measures, development of infrastructures, and prescribing appropriate drugs including ORS, which is used as an oral rehydration therapy too (Deen, Mengel, and Clemens 2020). Also supported by providing clean water supply along with vaccination largely helped in strengthening the healthcare system, thus, creating awareness among people and improving effectiveness of public health while maintaining a healthy environment as well (Legros 2018).
Phelps et al. (2018) argue that witchcraft had a heavy influence on the beliefs of the individuals of the Democratic Republic of Congo on affectation by cholera. These people approached the witch doctors for getting a cure for cholera. Sometimes the cure was not that effective, as the people saw several of them dying from cholera. Christian beliefs and faiths influenced the practice of healing the people affected by cholera. According to these beliefs, God was responsible for making people suffer from cholera (Shaikh et al. 2020). These experiences encountered by the people of the Democratic Republic of Congo enhanced their awareness about the source, aetiology, control, and containment of cholera. According to the revelations of one of the reports, 93% visit doctors for getting a cure for cholera (Afro.who.int 2021).
With the improvement of measures of sanitization and maintenance of hygiene measures, cholera seemed to be one of the considerable factors of concern. An increase in the outbreak of cholera necessitated the need for a sanitary reform movement, aiming at altering the standards and quality of public health in Europe and North America during the time of 19th century. Taking a lesson from Europe and North America, some of the Asian countries also initiated sanitary reform movements for upgrading the standards of public health conditions (Legros 2018). Inadequate sanitization, infrastructure, and public health facilities gave rise to seventh cholera, affecting people in the countries of Africa, Asia, Latin America, and others. In Africa, cholera recurring nature of cholera as an epidemic necessitates the need for constructive change in the public health model, which could increase the standards of living of the people (Cdc.gov 2022). For this, the environmental models are also to be revised in the form of proactiveness towards cleaning the accumulated debris, and water, so that the environment is clean and healthy.
Treatment of Cholera
Initiatives have been undertaken for upgrading the infrastructural stability, still, some countries like Nigeria lack basic infrastructure like taps producing clean and healthy drinking water, proper hygiene which is the cause of high cholera infections (Ambrus, Field, and Gonzalez 2020). According to the reports, programs recognizing the importance of supplying safe drinking water, access to improved sanitization, education on the ways to deal with cholera, and healthcare, have been initiated. But there is a huge gap in the proactiveness towards achieving the change in health conditions, as there is no improvement in the number of people affected by cholera (Azman et al. 2019).
Access to the improved water sources and its management reflects an improper approach, as stagnation has been detected in the records of 1990 to 2006, as published by World Health Organization (WHO) and United Nations International Children’s Emergency Fund (UNICEF). This poor management practice indicates unequal access towards availing the water resources, which was 47% in 1990-2006 (Bompangue et al. 2020). The management practices for exerting control over the cure of cholera were revised. Typical evidence of this lies in the increase of access to water resources, but there was a still long way to achieve for coming up the mark. The rationale behind this was the defective infrastructure of the broken pump and lack of fuels for pumping (World Health Organization 2018). This reflected a huge wastage of water, which is striking to note in terms of a mere 35% of the population having access to improved sanitization. In this context, uncertainty lies in the influence of myths and social investments on governmental interventions (Tsereteli 2021).
The government perceived that drinking contaminated waters purchased from the local unauthorized vendors, lack of safe and healthy water discharged from tap, lack of knowledge about washing and rinsing hands are various factors that contribute to the symptoms of cholera. According to the reports published by WHO in 2008, 42% of the total population group do not have proper access to the improved supply of water and 68% lacked access to proper sanitization (Ganesan, Gupta, and Legros 2020). The statistics are alarming, evoking the densely populated areas, where overcrowding was detected, pouncing on the contaminated water in the rainy seasons, and the result is cholera. However, cultural myths and beliefs are placed on a higher pedestal than governmental initiatives of improving the infrastructure of sanitization, water supply, hygiene, education, and others (Balasubramanian et al. 2021). It is due to these cultural myths and beliefs, that several people have encountered the tragic fate of death from being affected by cholera. Rumors and myths are ignited more as compared to the launch of new treatments, which reduces the efficiency in the operations of upgrading the health conditions (Ajayi and Smith 2019).
One of the most prominent treatments available at present is antibiotic treatment, which includes oral or intravenous hydration, which is considered as one of the major procedure to treat individuals with cholera. Along with this, there is need to manage proper hydration procedures, which represent oral medical treatment for keeping people hydrated, the treatment of individuals suffering from this disease must be done with the use of antibiotics, prescribed by the doctors and medical professionals, though it is recommended especially for severely ill patients (Kayembe et al. 2022). The procedure of treatment has been recommended for the patients, who suffer from severe dehydration and have continued to pass a large volume of stools, which tend to deteriorate their health furthermore (Williams and Berkley 2018). Oral and intravenous hydration is one of the major and primary treatments for cholera. Not only does it restore the balance in fluids in the body, but also improves the overall health of the individual, making the person feel energized and active more than before. The antibiotics are mainly prescribed by doctors for the patients, who could have the oral hydration procedures, prescribed for them. The suggested antibiotic must be informed, according to the patterns of susceptibility of medicine, based on whether the individual can tolerate the medicine or not. To be precise, the antibiotic named doxycycline has been recommended as the primary or first-line treatment for adults suffering from cholera, including both pregnant women and children (Hsueh and Waters 2019). In case, there is resistance to the doxycycline antibiotic, azithromycin and ciprofloxacin have been considered as alternative options for treating individuals with cholera.
Prevention of Cholera
The antibiotics are to be provided, once the patients have managed to tolerate the oral medication. Panja (2019) opines that the susceptibility of the antibiotic must be monitored through proper testing of samples that have been isolated from different geographic areas. Though the specific guidelines do not recommend antibiotics, as part of the prevention of cholera, it has emphasized the antibiotics’ usage, thoroughly supported by aggressive oral hydration measures too (Holmgren 2021). As a treatment procedure, the health care workers are also needed to be educated and provided with training, for acquiring the desired skills and knowledge (Trevisin et al. 2022). This promotes assurance of adequate supplies as well as monitors the practices that are important for effective dispensation of antibiotics.
Most importantly, Trevisin et al. (2022) state that hydration measures are considered an effective treatment for cholera. With the loss of fluids in large amounts, the human body becomes tired and feels exhausted most of the time, and thus, Rehydration therapy has been beneficial since its introduction. This is about providing sufficient quantity of the solution of oral rehydration salts and also intravenous IV fluids, whenever required along with passing electrolytes into the body (Bwire et al. 2020). Oral rehydration solution or ORS must be given to the individuals, who have been dehydrated, while drinks of high sugar content, including soft drinks, juices must be avoided at any cost, as it might worsen diarrhea furthermore (Sousa et al. 2020). The zinc treatment is also sometimes recommended as an alternative solution to cholera, as it decreased the time period and also the severity and nature of the diarrhoea that the children have been suffering from. The individuals recovering zinc supplementation, especially the children were found to experience lesser stool volume, gradually diminishing the infections caused by the cholera epidemic (Shackleton, Memon, and Chen 2019).
Conclusion
The paper demonstrated the major health illness or disease, i.e., cholera, and how healthcare practices managed to improve the condition of patients, suffering from this disease or illness. The various modes of infection were found to be contaminated food and water along with the transfer of feces of a person into water, which makes it infectious. Also, the poor sanitation and hygiene measures along with inadequate water treatment procedures and sewage systems, further alleviated the issues in rural areas, thus, causing cholera. The symptoms included diarrhea, vomiting, and dehydration which affected the human body furthermore. There were various myths surrounding it as a curse of God, and supernatural forces along with cultural and social beliefs, which ultimately drew criticism, and it was considered as a health issue, which required proper mapping of cholera and measures of intervention. Oral hydration, use of antibiotics, rehydration therapy, and use of zinc supplements had been considered as necessary treatment approaches and procedures, for mitigating the issues associated with the health illness or disease, i.e., cholera.
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