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Cholera - Diagnosis
Last reviewed: 03.07.2025
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Clinical diagnosis of cholera in the presence of epidemiological data and a characteristic clinical picture (the onset of the disease with diarrhea followed by vomiting, the absence of pain and fever, the nature of the vomit) is not difficult, but mild, latent forms of the disease, especially isolated cases, are often overlooked. In these situations, laboratory diagnostics are of decisive importance.
[ Specific and non-specific laboratory diagnostics of cholera
Laboratory diagnostics of cholera is based on the use of bacteriological research. Feces and vomit are used as material, feces are examined for vibrio carriage; from persons who died from cholera, a donated section of the small intestine and gall bladder is taken.
When conducting a bacteriological study, three conditions must be met:
- as soon as possible, culture the patient's material ( the cholera vibrio survives in feces for a short period of time):
- The container in which the material is taken should not be disinfected with chemicals and should not contain traces of them, since the cholera vibrio is very sensitive to them:
- eliminate the possibility of contamination and infection of others.
The material must be delivered to the laboratory within the first 3 hours; if this is not possible, preservative media (alkaline peptone water, etc.) are used. The material is collected in individual vessels washed from disinfectant solutions, on the bottom of which a smaller vessel, disinfected by boiling, or sheets of parchment paper are placed. When shipping, the material is placed in a metal container and transported in special transport with an accompanying person. Each sample is provided with a label indicating the name and surname of the patient, the name of the sample, the place and time of collection, the presumed diagnosis and the name of the person who collected the material. In the laboratory, the material is inoculated on liquid and solid nutrient media to isolate and identify a pure culture. The results of the express analysis are obtained in 2-6 hours (approximate answer), the accelerated analysis - in 8-22 hours (preliminary answer), the complete analysis - in 36 hours (final answer).
Serological diagnostics of cholera is of auxiliary importance and can be used mainly for retrospective diagnostics. For this purpose, microagglutination in phase contrast, RIGA can be used, but it is better to determine the titer of vibriocidal antibodies or antitoxins (antibodies to cholera are determined by ELISA or immunofluorescence method).