Monday, March 5, 2012

Preparedness: Treating Cholera

In this part of my preparedness series, I will talk about different common and uncommon diseases, illnesses and other health inflictions that wouldn't be easily treated during a long term crisis. This is not a replacement for medical advice, it is just my notes on how to cope with the situation using herbs if no medical help was available due to a long term crisis or other disaster scenario. It is intended for educational purposes only. All cases of cholera should be assessed and treated by a medical provider.

What is it?

Cholera is a bacterial infection of the small intestine caused by the bacterium Vibrio cholerae. It occurs primarily by drinking contaminated water or eating contaminated food. Contamination can come from an infected person, regardless is they are showing symptoms or not. Seafood is often the cause of cholera outbreaks in the developed world.
It causes diarrhea and vomiting which if left untreated can cause death, usually through dehydration.
Why should it be feared?
The severity of the diarrhea and vomiting can quickly lead to dehydration which can lead to death. About 3 - 5 million people are affected per year. There are about 100,000 - 130,000 deaths per year related to cholera infection worldwide. 
When treated, mortality rate is less than 1%. If left untreated, it can be as high as 60%. Some strains such as those seen in Haiti and India in the mid-2000’s caused death within 2 hours for the first sign of symptoms. 
75% of those infected will not show symptoms while the bacteria present in their stools can live 7 - 14 days after infection, potentially infecting others. 80% of those who develop symptoms will only have mild or moderate symptoms. The remaining 20% will develop acute watery diarrhea and severe dehydration which can lead to death if untreated.
What should be done?
During normal times, unsafe drinking water should be treated before using or avoided altogether. If there is a cholera outbreak, antibiotics and oral rehydration solutions are given. Intravenous fluids may be used to rehydrate a patient more quickly. Antibiotics are not necessary though they can shorten the duration of the illness and are typically given for 1 -3 days. Doxycycline is the first choice though there is now a resistance to it. Other antibiotics used include erythromycin, tetracycline, chloramphenicol, and furazolidone. 
Keep the patient hydrated by offering electrolyte and rehydration drinks often. Allow them to continue to eat frequent small meals to encourage healing. 
Make sure all water is properly strained and safe for drinking and cooking.
Make sure feces is properly disposed of. If using a humanure system, make sure the composing is working properly so the feces will be properly heated destroying the bacteria. The best option would be to burn the feces.
What are the stages?
Incubation Period: 2 hours - 5 days
Initial Symptoms: 1 day
After a short incubation period, symptoms include:
A sudden onset of large amounts of watery diarrhea
Muscle cramps
Stool will be grey, slightly cloudy with specks of mucus and have a slight odor
Additional Symptoms: 1 or more days
As the person becomes dehydrated, he will start to experience:
Increased heart rate
Reduced urine production
What are my options?
Cholera is easily treated without the use of conventional antibiotics. The most important thing is to keep the patient from becoming dehydrated.
Step 1: Encourage fluids
Give the patient lots of fluids. If you have access to intravenous fluids, definitely use them if needed. If the patient is too weak to drink, enemas of the rehydration fluids can be given. 
Have the patient sip their rehydration fluids every 5 minutes around the clock until he begins to urinate normally. A large adult needs 3 quarts a day. Give a child about 1 quart a day or 8 oz for each watery stool. Even if the person is vomiting, continue the small sips. 
Alternate between the rehydration drink recipes in the recipe section if the patient is not eating. You can add 1/2 cup of fruit juice, coconut water or mashed ripe banana to either drink to boost the potassium content.
Step 2: Diet
Allow the patient to continue to eat as they feel up to eating. Keep the diet light and easy to digest so the body can concentrate on fighting the infection. Foods to feed the patient include:
Bone broth, vegetable broth
Oatmeal or barley water
Congee (12 parts water to 1 part rice)
Natural juices both vegetable and fruit
Ripe fruits, especially pears and apples to help cleanse the bowels and bananas
Step 3: Herbal Treatment
The following are various herbal treatments that are recommended to be used for treating cholera. Use what you have available in your region.

Yarrow (Achillea millefolium)
Yarrow kills both gram positive and gram negative bacteria. Take 1 dropperful 3 times a day for 7 days.
Cayenne (Capsicum annuum)
Cayenne is antibacterial. As a tincture, take 20 - 30 drops in a cup of water 2 times a day for 5 days.
Garlic (Allium sativum)
A powerful antibiotic, garlic should be eaten with every meal. Cloves can be eaten raw, cooked or pickled. Eat several cloves each day. For those who can’t eat, make garlic tea by chopping up a clove of garlic and bringing 8 oz. water to a boil. Let steep for 10 minutes, strain and add honey to taste. This water may be used in the rehydration fluid recipes.

Ginger (Zingiber officinale)
Tinctured Ginger is effective against cholera bacteria. 1 dropperful 3 times daily for 7 days. If available, fresh ginger can be boiled for 10 minutes then allowed to steep for 1 hour. Strain the liquid and add to the rehydration fluids recipes.

Marshmallow root (Althea officinalis
Cold infusions of marshmallow root can be drank to soothe the intestinal walls and irritations. Can also be given as an enema. As a mucilaginous herb, Marshmallow will help to absorb toxins and carry them out through the stools. 
Berberine Rich Herbs
Berberine inhibits bacterial diarrhea caused by Vibrio cholera. Herbs such as Goldenseal (Hydrastis canadensis), Oregon Grape Root (Berberis aquifolium), Goldenthread (Coptis chinensis) and Barberry (Berberis vulgaris) should be taken daily for 3 - 5 days. Dosage should be 1 - 2 droppersful 2 times daily. 
Clove (Syzygium aromaticum)
Place 1/4 ounce whole cloves in 3 quarts water and boil until only 1 1/2 quarts of water remain. Have the patient drink 1 cup throughout the day.
Onion (Allium cepa)
Chop 1 ounce of onion and place in a mortar and pestle with 7 black peppercorns. Thoroughly pound and feed to the patient.
Back To Eden by Jethro Kloss pgs. 345, 429 - 432

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