Cholera is an infection that can cause severe diarrhoea
It is caused by the bacteria vibrio cholerae of the serogroups O1 or O139 and humans are the only relevant reservoir.
SOURCES OF THE INFECTION:
1.Drinking contaminated water or eating food made with it.
2. Eating raw or undercooked seafood,such as shell fish.
3. Eating raw fruits and vegetables.
NOTE: Cholera is not usually transmitted from person to
person through casual contact.
The primary symptoms are profuse diarrhea
and vomiting of clear fluid. The symptom usually start
suddenly, half a day to five days after ingestion of the
bacteria. The diarrhea is called Rice water and may
have a fishy odor.
Fever is rare and should raise suspicion for secondary infection.
Patient can be lethergic and might have sunken eyes,dry mouth,
cold clammy skin or wrinkled hands and feet.
Kussmaul breathing, a deep and
labored breathing pattern can occur because of acidosis from stool bicarbonate
losses and lactic acidosis associated with poor perfusion
blood pressure drops due to dehydration, peripheral pulse is rapid and thready
and urinre output decreases with time, muscle cramping and weakness ,altered
consciousness, seizures or coma due to electrolyte imbalance especially in
1.Stool culture and
2.Stool and swab collected
in acute stage before antibiotics
are most useful specimen.
3. Polymerase chain reaction
4. Rapid dipstick test
5.Serum electrolytes, blood urea
nitrogen & creatinine should be measured.
1.Fluid replacement : for hypovolemic
&severely dehydrated pts. IV replacement
with isotonic fluids should be used.
2. To replace potassium losses, potassium
chloride canbe added to IV solution or
oral potassium bicarbonate.
Once intravascular volume is restored, the
adequacy of hydration should be confirmed
by frequent clinical evaluation (pulse rate,
skin tugor, urine output).Plasma volume expanders
& vasopressors should nit be used.
Oral glucose electrolyte solution is effective in re-
placing stool losses and may be used after initial
IV rehydration and may be the only means of rehyd-
ation in epidemic areas.
Solid food should be given only after vomiting stops
and appetite returns.
Early treatment with oral microbial eradicates vibrios,
reduces stool vol. by 50% and stop diarrhea within
Doxycycline is recommended as first line tx for
adults abd children. If resistance, azithromycin &
ciprofloxacin are alternaive optons.
For control of cholera, human excrement must be correctly disposed
and water supplies purified.. In endemic regions, drinking water should be boiled or chlo-
rinated and vegetables and shellfish cooked thoroughly.
Antibiotics prophylaxis for househould contacts of pt with cholera is not recommended.
lIVE ATTENUATED SINGLE DOSE MONOVALENTVACCINE LYOPHILIZED V. CHOLERAE
CVD 103Hgr IS AVAILABLE
THREE KILLED WHOLE CELL ORAL VACCINES ARE AVAILABLE .