Description, Causes and Risk Factors:
There is scarcely any disease that causes a greater amount of mortality in childhood than that known by the name of cholera infantum. The malady is not limited to children only, but attacks also a great number of adults and old people, being less mortiferous in the latter than in the former.
Cholera infantum is an acute infectious disease of infancy, characterized by diarrhea, and in severe cases by vomiting, rapid emaciation and extreme prostration.
This disease is largely confined to the summer months in temperate zones, and has its acme of occurrence and mortality in the period of greatest heat. Children in the crowded portions of cities are more subject to cholera infantum than those in the suburbs and in the country.
The factors producing digestive disorders are directly causative. Artificially fed children are more frequently attacked than those breast fed. A contaminated milk supply is commonly responsible for the disease.
The eating of unripe or decomposing fruit, and of articles unsuited to infantile digestive powers, may also precipitate an attack. As suggested above, a period of hot weather will positively influence its occurrence.
The bacterial agents causing the disorder are numerous. In many cases Shiga bacillus — Bacillus dysenteriae (dysentery bacillus) — is found. In other cases the Streptococcus occurs, also the Staphylococcus, the Bacillus pyocyaneus, and a spirillum, though not the spirillum cholerae-asiaticae.
The diarrhea is at first mucopurulent, soon becoming watery, and amounts to purging. The stools are voided with force, and vary in number from ten to fifty in twenty-four hours, and are alkaline in reaction. Vomiting occurs, and may soon become nearly incessant.
The pulse is rapid and weak; the temperature taken in the rectum may be found to be very high while the peripheral temperature may be low. The tongue becomes red and dry; there is intense thirst. The urine is scanty or it may be suppressed. The skin has a mottled appearance from poor capillary circulation; the extremities are usually cold. The child is restless at first, but later becomes listless; the features are drawn and shrunken and the face has often the appearance of extreme age. The eyelids are but partly closed, the mouth is open, and the fontanels are depressed. Not only is prostration present from the beginning, but signs of profound toxemia are marked.
Toward the end of fatal cases the breathing is irregular and the head retracted; the temperature is sub-normal, or there may be hyperpyrexia. Death may occur in twenty-four hours. In cases that recover the disease may pass into an ileocolitis, or gradual improvement may begin in a few days.
From the standpoint of etiology and pathology it is impossible to distinguish this disease from ileocolitis. But its occurrence in the heated season, often in epidemic form, and the uncontrollable diarrhea and vomiting, the serous stools and the symptoms of collapse make cholera infantum a clinical entity easily distinguished and recognized. Micrographic studies may reveal the presence of a bacillus of very small dimensions.
If the child is sucking, considerable attention must be paid to the health of the mother, and if her milk should appear to disagree with the health of the child, it must be changed for fresh cow's milk, with arrow root, sago, or ground rice. Sometimes, when there is much acid in the child's stomach, the milk becomes curdled and thrown up. In this case a little Magnesia (according to the age of the child), given two or three times a day, combined with a little Peppermint or Carraway water, will frequently stop the sickness. If the bowels should be much relaxed, a teaspoonful of antacid preparation chalk mixture, or of the Astringent Mixture, No. 7, may be substituted for the Magnesia, and given three or four times a day. When the Diarrhea subsides, a little Magnesia may be added to the Chalk Mixture, so as not to confine the bowels. A little chicken or mutton broth may be given occasionally; say once or twice a day. Fruit or vegetables (especially pickles) should be prohibited. Calf's-foot jelly is a mild and nourishing food, so also is isinglass jelly.
Thin flannel should be worn next the skin; and the feet and legs should be kept warm. A warm bath, up to the armpits, once or twice a day, will be of benefit.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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