cholera community medicine
TRANSCRIPT
CHOLERA
Cholera is an acute diarrheal illness caused by Vibrio cholera 01 OR O139
V.CHOLERA O1 Classical and El tor biotype
CHOLERA
EPIDEMIOLOGY
Category 1 Category 2 Category 3 Category 4
1
2 2
3
5
24%INCREASE IN BURDEN OF CHOLERA FROM 2000-
2004 TO 2004-2008
2000 -2004 2004-2008
BURDEN OF INFECTIOUS DESEASES IN PAKISTAN
ACUTE RESPI-RATORY INFEC-
TIONS51%
MALARIA16%
VIRAL HEPATITIS8%
DIARRHEA AND DYSENTRY
23%
OTHERS2%
ACUTE RESPIRATORY IN-FECTIONSMALARIAVIRAL HEPATITISDIARRHEA AND DYSENTRYOTHERS
CHOLERAEPIDEMIC ENDEMIC
AGENT
ABILITY TO SURVIVE IN A
GIVEN ENVIRONMEN
T
VIRULENCE
ENVIRONMENT
SUSCEPTIBILITIES
OPPORTUNITIES
CASES CARRIERSI. PRECLINICAL OR INCUBATORY CARRIERII. CONVALLSCENT CARRIERIII. HEALTHY CARRIER IV. CHRONIC CARRIER
CASES AND CARRIERS
a) AGENTb) RESISTANCEc) TOXIN PRODUCTIONd) RESERVOIR OF INFECTIONe) INFECTIVE MATERIALf) INFECTIVE DOSE(ID)g) PERIOD OF COMMUNICABILITY
EPIDEMIOLOGICAL DETERMINANTSAGENT FACTORS
a) AGE AND SEXb) GASTRIC ACIDITYc) ECONOMIC STATUSd) IMMUNITYe) LACK OF HEALTH EDUCATION f) POOR PERSONAL HYGIENE
HOST FACTORS
ENVIRONMENTAL FACTORS
Drinking contaminated water.
eating raw or undercooked shellfish
a) Fecaly contaminated waterb) Fecaly contaminated foods and drinksc) Direct contact
MODE OF TRANSMISSION
Man Man
Incubation period
•From few hours to 5 days
MECHANISM OF ACTION OF CHOLERA TOXIN
Stage of evacuation
• Onset is abrupt
• Profuse diarrhea 40 stools in a day
Stage of collapse
• Sunken eyes
• Hallow cheeks
• Subnormal temparature
Most people remain asymptomatic. The symptoms of cholera include :
SIGNS & SYMPTOMS
profuse, watery
diarrhea
stomach pains leg cramps
Mild fever Vomiting
Sunken eyes and cheeks
Dry mucous membranes
Decreased urinary output
severe dehydration Shock
Renal failure Death
COMPLICATIONS
STOOLS FOR D/R &C/S
1-3LITRE OF WATER&1-3g OF SUSPECED WATER AND FOOD IS COLLECTED FOR CHEMICAL ANALYSIS
DIRECT HEMAGLUTINATION TES
LABORATORY INVESTIGATIONS
CONTROL OF CHOLERA
VERIFICATION OF THE DIAGNOSIS NOTIFICATION EARLY CASE FINDING ESTABLISHMENT OF TREATMENT CENTERS ORAL REHYDRATION THERAPY SANITAION MEASURES CHEMOPROPHYLAXIS VACCINATION HEALTH EDUCATION
Oral rehydration salts• Up to 80% of cases can be treated
through this.
Intravenous fluids (Ringer lactate)• For severe cases.
Antimicrobial Therapy• can diminish duration of diarrhea,
reduce volume of rehydration fluids needed, and shorten duration of V. cholerae excretion.
TREATMENT
ORS BICARBONATEINGREDIENTS QUANTITYNa bicarbonate 2.5gmNaCl 3.5gmPotassium chloride 1.5gmglucose 20gm
INGREDIENTS QUANTITYNa Citrate dehydrate 2.9gmNaCl 3.5gmPotassium chloride 1.5gmglucose 20g
ORS CITRATE
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