2023-07-10 15:18:58
by Ruggiero Corcella
Claudio Mastroianni, president of Simit: «Don’t be alarmed, we must first verify which serotype the vibrio isolated in Sardinia belongs to». Symptoms, causes, treatments
The one reported in Sardinia is not the last case of cholera notified by the health authorities in Italy: the previous one dates back to 2019, according to what was reported in the «Cholera Annual Epidemiological Report for 2021» dello European Centre for Disease Prevention and Control (Ecdc).
The checks of the Higher Institute of Health
«First of all, let’s not create false alarms – warns Professor Claudio Mastroianni, president of the Italian Society of Infectious and Tropical Diseases (Simit) -. First of all, it is necessary to verify which is the serotype of the cholera vibrio. Only Vibrio cholerae 01 and Vibrio cholerae 0139 can cause epidemics. The others, on the other hand, can also only give gastroenteritis ». The sample taken from the 71-year-old pensioner from Arbus is now being examined by experts from the Istituto Superiore di Sanità (ISS), who will have to verify which strain it belongs to
The transmission
Cholera is a fecal-oral transmitted disease: it can be contracted following the ingestion of water or food contaminated with faecal material from infected individuals (sick or healthy carriers or convalescents). As regards Vibrio cholerae 01 and 0139, the main reserve is represented by man and the waters, especially the brackish ones present in the estuaries, often rich in algae and plankton. “Even undercooked foods such as seafood or other vehicles contaminated with water can act as transmitters – adds Professor Mastroianni -, but cholera develops above all in countries where hygienic-sanitary conditions are poor and the sewage and water systems ‘unreliable drinking water’.
Symptoms and diagnosis
The incubation period of the disease usually varies between 24 and 72 hours (2-3 days), but in exceptional cases it can vary between 2 hours and 5 days, depending on the number of bacteria ingested. In 75% of cases, infected people do not show any symptoms. Conversely, among those who experience them, only a small proportion develop a severe form of the disease. When present, the prevalent symptom is diarrhea, which is watery and brown at first, then clear and runny. In some people, continued fluid loss can lead to dehydration and shock, which in severe cases can be rapidly fatal. Fever is not a prevalent symptom of the disease, but vomiting and leg cramps may occur.
What to do in the event of an epidemic
What are the actions to be implemented in the event of an epidemic? “The first is to trace the source of the infection, through a careful epidemiological analysis – explains the infectious disease specialist -. So it is necessary to ask the people who have contracted it what they have eaten, examine the place where it lives and look for the vibrio itself in the waters”. Then there are a number of steps to take. «As regards infected people, careful personal hygiene and the places where they live. Furthermore, at a general level, water purification and sewage system interventions, as well as health promotion activities that limit the spread of the epidemic. The heat could favor it, but fortunately it is a fairly manageable disease ».
The cure
Cholera is a simple disease to treat if you intervene quickly by replenishing lost body fluids and electrolytes through oral or intravenous solutions. Oral rehydration is successful in 90% of cases. With adequate rehydration, only 1% of patients die, and the disease usually resolves on its own after fluid replenishment. Antibiotics, usually tetracyclines or ciprofloxacin, can shorten the course of the disease and reduce the intensity of symptoms and are mainly used for the more severe forms or in patients most at risk, such as the elderly.
the situation in the rest of the world
As we said, that of Arbus is not the last officially known case in Italy or even in Europe. In 2019, the ECDC reported 25, but 16 were for the UK alone, 5 for France and one each for Denmark, Poland. Germany and Italy. In 2021, all EU/EEA countries reported cholera notifications. In 2021, Norway alone reported two confirmed cases of cholera, both linked to travel to Pakistan. Those affected have been hospitalized, but no deaths have been reported. The situation in the rest of the world is different where cholera has never ceased to frighten. Especially in Africa. But now the situation is becoming dramatic in several other areas, so much so that last May the experts of the United Nations Global Task Force for Cholera Control (GTFCC) launched an appeal for international mobilisation.
The pandemic
In the nineteenth century cholera spread several times from its original area around the delta of the Ganges to the rest of the world, giving rise to six pandemics (by pandemic we mean an epidemic manifestation of a disease on a very large scale, even planetary) which killed millions of people around the world. Researchers have estimated that each year there are 1.3 to 4 million cases of cholera and 21,000 to 143,000 deaths worldwide.
due to cholera. The seventh pandemic is still ongoing: it started in 1961 in South Asia, then reached Africa in 1971 and America in 1991. Today the disease is considered endemic in many countries and the bacterium that causes it has not yet been eliminated from the environment.
July 10, 2023 (change July 10, 2023 | 3:18 pm)
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