Assesment Of Knowledge, Attitude And Practice Towards Cholera Prevention And Control
[A CASE STUDY OF ILORIN METROPOLIS KWARA STATE, NIGERIA]

•    Surface or well water. Cholera bacteria can lie dormant in water for long periods, and contaminated public wells are frequent sources of large-scale cholera outbreaks. People living in crowded conditions without adequate sanitation are especially at risk of cholera.
•    Seafood. Eating raw or undercooked seafood, especially shellfish that originates from certain locations can expose you to cholera bacteria. Most recent cases of cholera occurring in the United States have been traced to seafood from the Gulf of Mexico.
•    Raw fruits and vegetables. Raw, unpeeled fruits and vegetables are a frequent source of cholera infection in areas where cholera is endemic. In developing nations, uncomposted manure fertilizers or irrigation water containing raw sewage can contaminate produce in the field.
•    Grains. In regions where cholera is widespread, grains such as rice and millet that are contaminated after cooking and allowed to remain at room temperature for several hours become a medium for the growth of cholera bacteria.

2.3 MODE OF TRASMISSION
For a cholera outbreak to occur, two conditions have to be met: there must be significant breaches in the water, sanitation, and hygiene infrastructure used by groups of people, permitting large-scale exposure to food or water contaminated with Vibrio cholera organisms; and cholera must be present in the population. Cholera has been proven to be transmitted through fecal-oral route via contaminated food, carriers of the infection and inadequate sanitary conditions of the environment. The principal mode of transmission however remains ingestion of contaminated water or food.
2.4 SIGNS AND SYMPTOMS
Most people exposed to the cholera bacterium (Vibrio cholerae) don't become ill and never know they've been infected. Yet because they shed cholera bacteria in their stool for 7 to 14 days, they can still infect others through contaminated water. Most symptomatic cases of cholera cause mild or moderate diarrhea that's often hard to distinguish from diarrhea caused by other problems.
Only about 1 in 10 infected people develop more-serious signs and symptoms of cholera, usually within a few days of infection.
Symptoms of cholera infection may include:
•    Diarrhea. Cholera-related diarrhea comes on suddenly and may quickly cause dangerous fluid loss — as much as a quart (about 1 liter) an hour. Diarrhea due to cholera often has a pale, milky appearance that resembles water in which rice has been rinsed (rice-water stool).
•    Nausea and vomiting. Occurring especially in the early stages of cholera, vomiting may persist for hours at a time.
•    Dehydration. Dehydration can develop within hours after the onset of cholera symptoms. Depending on how many body fluids have been lost, dehydration can range from mild to severe. A loss of 10 percent or more of total body weight indicates severe dehydration.
Signs and symptoms of cholera dehydration include irritability, lethargy, sunken eyes, a dry mouth, and extreme thirst, dry and shriveled skin that's slow to bounce back when pinched into a fold, little or no urine output, low blood pressure, and an irregular heartbeat (arrhythmia).
Dehydration may lead to a rapid loss of minerals in your blood (electrolytes) that maintain the balance of fluids in your body. This is called an electrolyte imbalance.
Electrolyte imbalance: An electrolyte imbalance can lead to serious signs and symptoms such as:
•    Muscle cramps. These result from the rapid loss of salts such as sodium, chloride and potassium.
•    Shock. This is one of the most serious complications of dehydration. It occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body. If untreated, severe hypovolemic shock can cause death in a matter of minutes.
2.4.1 SIGNS AND SYMPTOMS OF CHOLERA IN CHILDREN
In general, children with cholera have the same signs and symptoms adults do, but they are particularly susceptible to low blood sugar (hypoglycemia) due to fluid loss, which may cause:
•    An altered state of consciousness
•    Seizures
•    Coma