The community of Madrid confirmed this morning that it has just diagnosed the first autochthonous case of cholera since 1979. Diagnosed in the Community of Madrid and caused, it seems, on a farm in Toledo, this case is a rarity not only in our country, but throughout the industrialized world. A world where cholera has been little more than a ghost of the past for decades. What do we know about all this?
What happened? The Government of Castilla-La Mancha has just closed a farm located in the province of Toledo after a minor patient positive for cholera explained that she had drunk water from the building. The case, diagnosed in the Community of Madrid by the Carlos III Institute, triggered all the alarms and, after carrying out the appropriate analyzes and detecting cholera on the farm, has led to its closure.
What is cholera? It is a disease (produced by a bacterium called Vibrio cholerae) that spreads through contaminated water, affects the intestinal tract and causes severe diarrhea and dehydration. The V. cholerae produces a toxin that “causes an increase in the amount of water released by the cells lining the intestines.” This is what causes the disease.
Precisely this has been what has made the Ministry rule out that it is a case of cholera. The minor’s infection is actually due to V. cholerae. However, there is no trace of the toxin. For this reason, they estimate from the ministry, it is more correct to speak of “Vibrio gastroenteritis”.
For centuries, cholera was one of the most feared diseases in modern societies and, in fact, research on this bacterium is at the base of modern epidemiology. Today, however, outbreaks of the disease are highly localized in places with poor water treatment or in environments of overcrowding, war, and starvation. Therefore, the last autochthonous case in Spain occurred in 1979.
It’s dangerous? The infection is generally benign and gives few symptoms. However, if not monitored, it can become serious. About one in 20 infected people may have serious symptoms: severe diarrhea, vomiting, and dehydration. All this can lead to muscle problems and, ultimately, a severe hypovolemic shock that can cause death.
Fortunately, cholera has an accessible, simple and cheap treatment: rehydration with oral fluids. In severe cases, antibiotics can also be used, but it is not usual. Otherwise, unlike other diseases, it is transmitted by contaminated water. Person-to-person transmission is extremely rare under normal conditions. In other words, once the focus is located, it is very difficult for a generalized outbreak to occur. However, it is a reminder that, contrary to what happened in one of the last cholera epidemics in Spain, we must not lower our guard.
Image | miguel angel sanz
