Cholera

For a lay person:

Cholera is a bacterial infection of the gut spread through contaminated water and food, mainly where sanitation is poor. It can cause sudden, massive watery diarrhoea and vomiting that leads to severe dehydration and death within hours if not treated.

For a trained medical person:

Caused by toxigenic Vibrio cholerae O1 or O139, whose cholera toxin drives secretory diarrhoea with profound fluid and electrolyte loss. Diagnosis is by stool culture, PCR or rapid antigen test, though treatment should not wait for results. The mainstay is rapid rehydration with oral rehydration solution or intravenous fluids, with antibiotics such as doxycycline for moderate to severe cases, zinc for children, and oral vaccines and water sanitation for prevention.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Mild Case; Severe Case; Heat Type; Dryness Type. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: Cholera is a medical emergency and a notifiable disease: get urgent medical care and start oral rehydration solution immediately; cases must be reported to public health. Chinese medicine is adjunctive at most and must never delay rehydration.