Cholera outbreak in Mayotte (France): A retrospective description of 16 patients treated for hypovolemia in the ICU

Abstract

Objectives

To describe the presentation and therapeutic management of severe cholera in Mayotte (France).

Patients and methods

We carried out retrospective data collection. All patients treated in the intensive care unit (ICU) with a confirmed diagnosis of cholera by PCR were studied. Only patients treated for hypovolemia were included.

Results

Out of the 215 confirmed cases of cholera in Mayotte on July 12, 2024, 25 required treatment in the ICU (11.6 %). Among these cases, 16 were treated for hypovolemia (7.4 %), while five patients died of cholera before they could be admitted to hospital (lethality rate 2.3 %). No patient died in hospital.

Median patient age was 17 years (4–30) with a sex ratio of 1. Severe diarrhea was the rule with a median of one diarrheal stool every two hours. Clinical severity was characterized by sunken eyes and Glasgow Coma Scale (GCS) < 14 (n = 16/16,100 %). Biological severity was determined by profound metabolic acidosis with venous pH < 7.20 (n = 16/16, 100 %). Intravenous fluid therapy was aggressive with a median of 280 mL/kg (230–300) Ringer’s lactate solution during the first 48 h.

Conclusions

Cholera can be a life-threatening infection, with deaths occurring due to severe diarrhea and hypovolemia. From the onset of symptoms, which are sometimes fulminant, patients must be admitted to a care center as soon as possible. We will continue to collect data to create scores that will enable us to better recognize the most severe forms of the disease.