Debbie Sing, age 13, of Visalia, California, for her question:

What is so dreadful about cholera?

Let's face it, people are prone to dramatic exaggerations. The heroic types insist that a bad bout of flu is merely a case of the sniffles. The sorrowful types claim that a simple head cold is a case of flu. This human tendency to confuse the facts led some of us to suspect that cholera is not so dreadful    when in reality it is one of mankind's cruelest scourges. A doctor knows the difference between a cold and the flu    and also the fearsome difference between true cholera and several similar diseases we mistakenly call cholera.

Pig cholera and chicken cholera strike the barnyard population with dysentery diseases. Children and sometimes older people are attacked with another dysentery causing germ which has also been called cholera. While they last, these cholera like diseases cause dreadful intestinal upheavals. But medical science insists that cholera is the wrong name for them. The true cholera is caused by a very different germ, causing a far more dreadful dysentery and devastation. It spreads like wildfire, and when the population is unprotected, close to 60 per cent of the people die in agony.

This true cholera was identified in the 1880's, and the germ that causes it is a tiny, curved bacterium called Vibrio cholerae. Several. other bacteria cause less dreadful diseases in humans and animals, but the true cholera plagues that have scourged mankind for thousands of years were caused by Vibrio cholerae    a rather fragile bacillus that multiplies at a stupendous rate and is highly contageous.

A true cholera epidemic strikes down whole populations in days. The bacillus enters by the mouth with food or water, or from contact with an infected person    his skin, wastes or personal belongings. The bacillus settles in the intestines, producing deadly toxins as it uses oxygen to multiply. After an incubation period of one to five days, the violent symptoms strike. With vomiting and diarrhea the body tries to purge itself of the milky, toxic fluid. The normal quota of body fluids is depleted and the patient suffers weakness and painful cramps of dehydration. The flesh shrinks, the skin grows lax and becomes cold and clammy; the eyes become sunken, and the cheeks hollow. In severe cases, when there is no medical aid, the victims perish from dehydration after several days. Those that survive may suffer permanent damage to the heart and kidneys.    

The story of this pandemic, world wide plague is almost as dreadful as its symptoms    or it was until medical science discovered its sources and treatment. The dreadful bacillus originates in two areas; one in China and one by the Ganges of India. From these pest pockets, the plague of cholera has been carried around the world many times. A most horrifying fact is that Vibrio cholera survives on human wastes, where sewage is allowed to mingle with food and water supplies. Medical experts suspect that if people in the plague centers adopt better methods of sanitation, cholera will be stamped out forever. But until this happens, outbreaks spread by human contact can be expected anywhere at any time.

The cholera bacillus cannot survive long without human hosts, and strict sanitation is the key to its control. Vaccines give limited protection and when the plague strikes, the region is usually quarantined. Victims are given transfusions to replace lost fluids and sometimes whiffs of chloroform to dull the pain. With treatment, 90 per cent of those infected have a chance of surviving.