霍乱 Cholera

Cholera  霍乱

During the 19th century, cholera spread across the world from its original reservoir in theGanges delta in India. Six subsequent pandemics killed millions of people across allcontinents. The current (seventh) pandemic started in South Asia in 1961, reached Africa in1971 and the Americas in 1991. Cholera is now endemic in many countries. In the sevenworldwide pandemics, around a hundred and forty million people are infected. Researchershave estimated that each year there are 1.3 to 4.0 million cases of cholera, and 21 000 to143 000 deaths worldwide due to cholera.

在19世纪，霍乱在世界各地的蔓延源自印度恒河三角洲的最初宿主。随后的六次大流行使各大洲数以百万计的人失去了生命。目前的第七次大流行于1961年始于南亚，1971年波及非洲，1991年扩大到美洲。霍乱目前是许多国家的地方流行病。在这七次世界性大流行中，约1.4亿人罹难。如今在世界范围内，霍乱每年导致大约130万至400万例病例，其中有2.1万至14.3万例死亡。

症状

Symptoms

#1

Cholera is an extremely virulent disease that can cause severe acute watery diarrhoea. Ittakes between 12 hours and 5 days for a person to show symptoms after ingestingcontaminated food or water. Cholera affects both children and adults and can kill withinhours if untreated.

霍乱是一种致命性极强的疾病，可引起严重急性水样腹泻。一个人在摄入受到污染的食物或水之后12小时至5天内出现症状。霍乱对儿童和成人都有影响，如果不治疗，几小时内就会死亡。

Diarrhoea: Cholera-related diarrhoea comes on suddenly and can quickly cause dangerousfluid loss — as much as a quart (about 1 litre) an hour. Diarrhoea due to cholera often has apale, milky appearance that resembles water in which rice has been rinsed.

腹泻：霍乱所引起的严重急性腹泻会导致迅速的体液流失，至多可达每小时一夸脱（约一公升）。霍乱所引起的腹泻通常是乳白色的，与淘米水十分相似。

Nausea and vomiting: Vomiting occurs especially in the early stages of cholera and can lastfor hours.

恶心与呕吐：在前期感染中，呕吐时常会出现，有时可持续数小时。

Dehydration:

Dehydration can develop within hours after cholera symptoms start and rangefrom mild to severe. A loss of 10% or more of body weight indicates severe dehydration.

脱水：在霍乱症状出现后的几小时内，轻度至重度脱水便会出现。当体液流失至体重的10%或更多时就表示了患者出现了重度脱水。

Signs and symptoms of cholera dehydration include irritability, fatigue, sunken eyes, a drymouth, extreme thirst, dry and shriveled skin that's slow to bounce back when pinched into afold, little or no urinating, low blood pressure, and an irregular heartbeat.

霍乱所引发的脱水还可能带来一些其他症状，例如易怒、疲劳、凹陷的眼睛、口干舌燥、极度干渴、干瘪以及反弹极慢的皮肤、少尿或无尿、低血压与不规律的心律等。

Dehydration can lead to a rapid loss of minerals in your blood that maintain the balance offluids in your body. This is called an electrolyte imbalance.

脱水也会导致血液中用来平衡体液的矿物质的快速流失。这也被称作电解质不平衡。

#2

Treatment

治疗

Cholera is an easily treatable disease. The majority of people can be treated successfullythrough prompt administration of oral rehydration solution (ORS). The WHO/UNICEF ORSstandard sachet is dissolved in 1 litre (L) of clean water. Adult patients may require up to 6 Lof ORS to treat moderate dehydration on the first day.

霍乱是一种易于治疗的疾病。多数病人可通过及时使用口服补液得到成功治疗。世卫组织/联合国儿童基金会规定口服补液盐标准袋需要溶于1升清洁饮用水中。在第一天可能需要多达6升的口服补液来治疗中度脱水的成年病人。

Severely dehydrated patients are at risk of shock and require the rapid administration ofintravenous fluids. These patients are also given appropriate antibiotics to diminish theduration of diarrhoea, reduce the volume of rehydration fluids needed, and shorten theamount and duration of V. cholerae excretion in their stool.

严重脱水患者有休克危险，需要快速得到静脉输液。还需要对这类病人使用适当的抗生素，以缩短腹泻时间，减少需要的补液量，并降低霍乱弧菌在粪便中的排泄量和排泄时间。

Mass administration of antibiotics is not recommended, as it has no proven effect on thespread of cholera may contribute to antimicrobial resistance.

不建议大规模使用抗生素，因为这对控制霍乱的蔓延并无实际效果，而且可能会助长抗微生 物药物耐药性。

Rapid access to treatment is essential during a cholera outbreak. Oral rehydration should beavailable in communities, in addition to larger treatment centres that can provide intravenousfluids and 24 hour care. With early and proper treatment, the case fatality rate should remainbelow 1%.

在霍乱疫情期间，得到快速治疗十分重要。除可提供静脉输液和24小时医护的大型医疗中心外，社区应当具备口服补液服务。通过早期适当治疗，应将病死率保持在1%以下。

Zinc is an important adjunctive therapy for children under 5, which also reduces the durationof diarrhoea and may prevent future episodes of other causes of acute watery diarrhoea.

对五岁以下儿童，锌是一种重要的补充治疗，可以减少腹泻持续时间，并可能预防未来其它原因导致的急性水样腹泻。

// Reference 参考文献

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Mayo Clinic Staff. (2022, December 9). Cholera. Mayo Clinic. Retrieved January 1,2023, from  https://www.mayoclinic.org/disea ... causes/syc-20355287

WHO. (2022, March 30). Cholera. World Health Organization. Retrieved January 1,2023, from https://www.who.int/news-room/fact-sheets/detail/cholera

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