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Cholera AR

Cholera is an acute diarrheal disease caused by the bacteria Vibrio cholerae. It is transmitted through contaminated food or water and causes sudden onset of severe watery diarrhea and vomiting which leads to rapid dehydration. Diagnosis involves microscopy or culture of stool samples. Treatment focuses on oral rehydration with fluids and electrolytes and antibiotics to shorten shedding of the bacteria. Prevention relies on proper sanitation, safe water supplies, hygiene, and vaccination.

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835 views6 pages

Cholera AR

Cholera is an acute diarrheal disease caused by the bacteria Vibrio cholerae. It is transmitted through contaminated food or water and causes sudden onset of severe watery diarrhea and vomiting which leads to rapid dehydration. Diagnosis involves microscopy or culture of stool samples. Treatment focuses on oral rehydration with fluids and electrolytes and antibiotics to shorten shedding of the bacteria. Prevention relies on proper sanitation, safe water supplies, hygiene, and vaccination.

Uploaded by

Immanuel
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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Cholera

Dr Shanker Bahadur Shrestha


Cholera
Cholera is acute watery diarrhoea caused by vibrio cholerae.
Bacterial serotype 01,
0139, and
bio type El Tor

El Tor – more resistant than classic vibrio caused several pandemic.

0139 – new strain, more toxigenic, established in Asia and Africa.


Source of infection:
- stools
- vomitus of symptomatic patients
- subclinical cases/carriers
Transmission: through
- drinking water and eating food, shelfish contaminated with vibrio
V. cholera can survive up to 2 wks in fresh water
and up to 8 wks in salt water.
Cholera

Clinical features:
- Sudden onset of severe watery diarrhoea.
- typical “rice water” diarrhoea with no pain or colic
- vomiting
- rapid loss of fluid leads to severe dehydration
- acidosis
- hypokalaemia
- hypotension
- shock, oliguria
- musles cramps
- occasionally “cholera sicca” resulting loss of fluid into the
dilated bowel, patient may die without G.I. symptoms appear
Cholera

Laboratory diagnosis:
a) Stool dark field microscopy: shows
“shooting star” motility of v. cholera
b) Rectal swab or stool cultures
Treatment:
1. Fluid and electrolyte balance:
In mild cases give ORS solution plenty as per fluid lost in stool
(ORS solution contains sodium chloride 3.5 gm,
sodium bicarbonate 2.5 gm, potassium chloride 1.5 gm, and
glucose 20 gm, dissolved in one litre of drinking water).

In serious cases or those unable to take orally give it by i.v.

Inj Ringer-Lactate: initially 50-100 ml / minute until circulatory


blood volume and blood pressure becomes normal.
i.v. fluid should be decreased accordingly and should keep up with
the amount of stool passing out.
Cholera

Treament continue…
when the patient’s vomiting stops and urine passes, i.v. fluid omitted
and ORS given orally, up to 500 ml hourly.

The fluid requirement is calculated every 8 hours from the urine


volume, stool and vomit output and plus, estimated insensible loss.

2. Antibiotics: to shorten the period of vibrio excretion and reduces


the fluid loss.
a) Tetracycline: 250 mg 6 hourly X 3 days.
or
b) Doxycycline: 300 mg single dose
or
c) Ciprofloxacin: 1 gm single dose.
Cholera

Prevention:
- Personal hygiene
- Safe drinking water supply or use boiled water
- prevention of contamination by flies and/or carriers
- Cholera vaccination although limited efficacy.
- in epidemic, public health education, mass media,
- control of water resources
- control of population movement
- mass single dose vaccination
- mass treatment with Tetracycline
- disinfection of discharge and soiled clothing
- proper hand washing with soap and water by care takers, and
before food preparation, before eating and after defecation

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