Dehydration, major killer of cholera patients, says NCDC boss

For weeks now, Nigeria has been under the chokehold of an aggressive strain of cholera, with various health authorities grappling to bring the disease, which has claimed the lives of 53, under control.

As more infections are being reported and those already hospitalised battling for their lives, the Nigeria Centre for Disease Control and Prevention says dehydration is the major killer of patients diagnosed with acute diarrhoeal infection.

The Director-General of NCDC, Dr Jide Idris, disclosed this during an exclusive interview with PUNCH Healthwise, warning that severe cases of vomiting and stooling, which are the symptoms of cholera, should not be treated at home.

He recommended that the best course of action for those experiencing severe vomiting and diarrhoea to take is to seek urgent medical attention, rather than drinking salt and sugar solutions, commonly referred to as Oral Rehydration Solutions, at home.

Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholera.

Symptoms of cholera include acute, painless watery diarrhea of sudden onset, with or without vomiting. It may be associated with nausea, profuse vomiting, and fever.

Nigeria is experiencing a significant cholera outbreak, with the NCDC reporting over 1,528 suspected cases in 31 states.

The outbreak has notably affected Lagos, Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, and Nasarawa states.

Lagos, within the last couple of days, has been ravaged by a cholera outbreak that has claimed no fewer than 29 lives from almost 579 suspected cases.

The NCDC boss told our correspondent that what kills cholera patients is dehydration and not the organism itself.

Idris explained that the bacteria that causes cholera infection known as vibrio cholerae produces toxins in the small intestines, which causes the body to secrete enormous amounts of water, leading to diarrhoea and a rapid loss of fluids and salts (electrolytes).

The NCDC DG warned that severe cases of cholera could lead to death within hours due to dehydration from massive fluid loss.

Idris said, “The best thing is for them to seek medical attention immediately. As far as I am concerned, what kills them is dehydration. It gets to a particular level and they have to be rehydrated and treated in the hospital.”

If the person is seriously sick and gets severely dehydrated, the person has to be treated in a hospital.

“Also, if the person is vomiting, you can’t be drinking salt-sugar solution every time because, by the time you take it, you throw it out. So, you must be treated in the hospital where they will set a drip for you and pass in the fluid.”

The physician maintained that severe cases of cholera can’t be treated at home, advising people experiencing severe diarrhoea and vomiting to seek immediate medical attention and avoid self-medication.

“Normally, in a situation where you don’t trust where you are when diarrhoea gets too much and you are passing stool so many times, it is better to go to the hospital where you will be properly treated.

“However, a lot of people have cholera and they may not stool that much. So such people can be given this salt-sugar solution just to replace whatever they are losing because diarrhoea can be very profuse.

“It can become explosive in which case, when it starts, dehydration can set in and that is what kills. That is why we say, go to the hospital. “

The NCDC DG stated that it is the loss of body fluids and electrolytes that usually leads to the death of cholera patients.

He further noted, “What kills is the hydration. The organism doesn’t kill and what it does is that it produces a toxin in the abdomen. It is that toxin that reacts with the intestinal layer that makes you lose a lot of water.

“It is that frequency and the amount of fluid you lose that is causing dehydration and that is what kills and not the organism itself and that is why cholera kills. It is the loss of body fluid and electrolyte that kills and that is why once you start losing fluids, it has to be replaced.”

Giving further insight into the dangers of dehydration, Idris said severe dehydration could also cause weakness or confusion.

“We have different levels of dehydration. It could be mild, moderate or severe. If it is severe, it can kill quickly. Once it is severe, the person must be rehydrated because the body is dry and needs water and electrolytes for the organs to function properly.

“That is why you have to replace water, fluids, and electrolytes. These fluids are needed for the body to function and to avoid going into shock”, he said.

Speaking on prevention, the NCDC boss pointed out that as simple as hand washing with soap and water is, it will break the transmission circle of cholera if Nigerians adhere to it as part of precautionary measures.

He also advised people to avoid eating raw fruits and vegetables, food from street vendors, and raw or undercooked seafood.