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Cholera and amoebiasis: Preventable infections with lethal diarrhoea symptoms.

Six people dead, 182 admitted, and counting. What exactly is plaguing Meru county? There are contradictory reports.

County officials say it is amoebiasis, critics and some medics say it is cholera. So what is the difference?

According to MedicaLook, amoebiasis is caused by the protozoan parasite Entamoeba histolytica, and it results in an intestinal ailment known as amoebic dysentery.

It is a worldwide illness that affects both first-world nations and developing countries.

In areas with warmer climates, poor sanitary environments and crowded living spaces, it affects almost 50 per cent of the population.


Amoebiasis is one of the top three causes of death due to a parasitic infection, the first two being malaria and schistosomiasis.

The ailment is usually diagnosed in young and middle-aged adults who have consumed food or drinking water contaminated with faecal matter, where the parasite usually thrives.

Amoebiasis can also be transmitted through unhygienic habits, direct or indirect contact with the stool of infected individuals, dirty body parts or personal belongings, as well as through anal-to-oral contact.

In typical amoebiasis cases, which comprise 90 per cent of contaminated individuals, symptoms generally appear within 7-30 days after contamination.

Very rarely, symptoms may appear before seven days, or even after 30 days of acquiring the protozoan parasite.

A person with amoebiasis will experience severe amoebic dysentery, which is indicated by abdominal cramping, diarrhoea, stool that is accompanied by blood or mucus, nausea and vomiting, loss of weight, and an intermittent fever. Patients may also experience symptoms that are vague and not specific to the ailment itself.


The first goal of treatment for amoebiasis is to relieve the symptoms of amoebic dysentery, as well as to prevent further loss in fluids and electrolytes through intake of anti-diarrhoeal medication.

For patients who do not exhibit any symptoms, doctors will usually administer luminal agents such as Diloxanide Furoate or Liodoquinol.

To get rid of the parasites infesting the intestines, doctors normally prescribe anti-parasitic treatments like Paromomycin or Metronizal to destroy any traces of amoeba in intestinal tissue and other surrounding organs.

A five-day round of antibiotics may also be necessary, particularly if a patient exhibits liver abscess or a spread of the parasitic infestation beyond the intestines.

For sizeable liver abscesses, an ultrasound scan may be used to accurately pinpoint the location of these abscesses to undertake the necessary surgical liver drainage.

Patients suffering from amoebiasis should refrain from excessive solid food intake during the duration of their illness to avoid intestinal cramping. Alcoholic drinks should also be avoided, as they may cause complications for a person suffering from this ailment.


According to WebMD, cholera is an infectious disease that causes severe watery diarrhoea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae.

Medical News Today notes that despite being easy to treat, cholera is estimated to affect between 3 and 5 million people each year, and it causes over 100,000 deaths worldwide.

Due to severe dehydration, fatality rates are high when untreated, especially among children and infants. Death can occur in otherwise healthy adults within hours. Those who recover usually have long-term immunity against re-infection.

The treatment consists of large volumes of water mixed with a blend of sugar and salts.

Prepackaged mixtures are commercially available, but widespread distribution in developing countries is limited by cost, so homemade ORS recipes are often used, with common household ingredients.

Severe cases of cholera require intravenous fluid replacement. An adult weighing 70kg will need at least 7 litres of intravenous fluids.

Antibiotics can shorten the duration of the illness, but the WHO does not recommend the mass use of antibiotics for cholera, because of the growing risk of bacterial resistance.

Anti-diarrhoeal medicines are not used because they prevent the bacteria from being flushed out of the body.

With proper care and treatment, the fatality rate should be around 1 per cent.
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Publication:The Star (Nairobi, Kenya)
Geographic Code:0DEVE
Date:Jan 19, 2018
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