cholera p and p

8/3/2019 CHOLERA P AND P

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CHOLERA OUTBREAK

PREVENTION AND PREPAAREDNESS

Presented By-Dr.S.K.Gupta


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CONTENTS OVER VIEW

1.INTRODUCTION

2.CHOLERA AS EPIDEMIC

3.FACTORS CONTRIBUTING TO SPREAD4. PREPAREDNESS AND CONTROL

5.CHALLENGES

6.KEY MESSAGES

7.RECOMMENDATIONS8.CONCLUSION


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INTRODUCTION-

Cholera is a acute diarrheal disease persisting in smallintestine.

Causative Organism Vibrio Cholerae

Serogroup-O 1 and O139

Clinical Symptoms-

1.Rapid onset of Profuse rice watery stool

2.Vomiting3.Diarrhoea leads severe dehydration

4.Phisical weakness

5.Low pulse and BP

6.Sunken eyes, wrinkled hands and feet


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HISTORY OF CHOLERAGlobal Prospective-

First Cholera was identified

in 1817 in Russia thenWestern Europe,

North America and Indonesia.

In India-

First case of Cholerawas reported in

West Bengal in 1817

to 1824.


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HISTORICAL FACT OF CHOLERAy

Cholera become a most widespreadand deadly diseases of19th Century.

y About 10 million people was killed

in Russia and North America

at initial outbreak.

y Cholera became first

Notifiable disease in USA.

y John Snow in 1854 was the first

who identify the importance of

Contaminated water in its cause.


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INDIAN SCENARIOAccording to WHO Analysis-Bulletin of the World Health Organization 2010;88:185-191. doi: 10.2471/BLT.09.073460

Total 838315 cases had been notified for a period of 2004 to 2008.

Total 676651 cases were reported from 2000 to 2004.

Estimated actual burden of cholera is 3 to 5 million cases in India

About 100000 to 130000 death per year.


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CHOLERA CASES AND DEATH REPORTED

BY INDIA TO WHO,1997-2006.

Reporting year No. of cases No. of deaths CFR

1997 2768 16 0.57

1998 7151 10 0.14

1999 3839 6 0.16

2000 3807 18 o.47

2001 4081 6 0.15

2002 3455 10 0.29

2003 2893 2 0.072004 4695 7 0.15

2005 3155 6 0.19

2006 1939 3 0.15

Total 37783 84 ---


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Global Dominance

Africa's percentage of Global cholera

0%

20%

40%

60%

80%

100%

120%

1996 1998 2000 2002 2004 2006


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FACTORS CONTRIBUTING TO SPREAD

Mode of Transmission- Mainly faecal-oral route.

1.Through Contaminated water

2.Unwashed fruit and Vegetables

3.Lack of Hand washing

4.Uncooked food


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OTHERS-1.Migration of possibly infected people from affected

countries and areas.

2.Easy travel within the country makes it possible forthe efficient movement of possibly infected people


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CHOLERA AS EPIDEMICWhen does Cholera Become Epidemic?

After heavy period of rainfall

When water temperature is rise

When normal incidences increases

When proper hygienic practices not followed


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How long does it take?

1.Incubation period- 2hours to 5 days

2.Infection 7 to 14 days but most of people do not

become ill or show any symptoms

3.Only about 10-20% of infected people show moderate

and severe symptoms

4.Blood group O having highest risk-

According toWHO.


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Howisit Prevented?1.Blocking routes of transmission water disinfection

(source and /or household), hand washing, sanitation,

good food hygiene and well-cooked


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y2.Cholera vibrio doesnt like acid

environment (block with acidic watere.g.. With citrus juice, healthy stomachacid levels, acid food)


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What ProportionWill Die?1.Most people who die, do so within the first day of symptoms

appearing

2.Without any treatment about 50%

of people survive

3.With adequate re-hydration less than 2% will die

4,With good surveillance, rapid establishment ofre-hydration, and anti-biotic for worst cases, almost alldeaths can be avoided


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PREPAREDNESS AND CONTROLCHOLERA EMERGENCY PREPAREDNESS AND CONTROL

1.CO-ORDINATION

2.STOCK AND LOGISTICS

3.COMMUNICATION

4.NATIONAL CAPACITIES

5.RESOURCES MOBILIZATION


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CHALLENGES

General--Preparedness for all potential scenarios.

-Assimilation of knowledge amongst

medical personnel.

- Maintenance of capabilities over time.

-Assuring staff protection while saving livesof contaminated casualties

-Stockpiles of vital equipment.


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CHALLENGES-

WATER AND SANITATIONS

1.Contaminated Water Sources include:

-River water, streams, bore holes,

wells etc. with faecal Contamination

through sewerage plant.

-Contaminated water containersdue to improper handling and

water storage.


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2.Formal Water Supply problems

-Problems of chlorination.

-Interrupted water supplies.

-Sub-optimal maintenance of the system.

-Over-stretched water system.

-Poor water handling in households.

-Raw water supply to communities through taps.

3. Poor sanitation coverage-


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CHALLENGES- HEALTH SYSTEM

1.Regional Cross-border cholera epidemic out of control .

2.Institutions challenged with pre-existing burden of disease.

3.Infrastructure challenges insufficient beds.

4.Insufficient Health Promotion and IEC material.

5.Insufficient medical supplies in some provinces.

6.Inadequate human resources national, provincial and institutions.


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KEY MESSAGES1.Bad water is one source of cholera (disinfect source or

stored water) but others, especially contaminated food(clean and cook well)

2.Lack of hand washing (essential times and methods forhand washing) should also be highlighted

3.Rapid transfer to clinics or use of ORT corners speeds uptreatment and reduces cross infection.

4.Re-hydration as early as possible saves the most lives- waterquality in OR is of little importance

5.Good surveillance systems can identify causes and reduceinfection rates


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RECOMMENDATION-1.Continued co-ordinationwith partners and mobilization

of resources.

2.Strengthen health promotionand IEC support.

3.Strengthen capacity toprovide technical support.


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CONCLUSIONS-1.Fundamental preparedness and control measures are

crucial to manage the epidemics.

2.Co-ordination of local and concern authority isneeded.

3.Control and preventive measures requires resourcemobilization and right decision making.


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cholera p and p

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