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    Choleracommunicable disease

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    What is cholera? Cholera is an acute infectious disease caused by a

    bacterium, Vibrio cholerae (V. cholerae) Most people who get the disease ingest the organisms

    through food or water sources contaminated with V.cholerae.

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    What is cholera?

    which results in a painless, watery diarrhea inhumans.

    Some affected individuals have copious amounts ofdiarrhea and develop dehydration so severe it can

    lead to death.

    Although symptoms may be mild, approximately5%-10% of previously healthy people will develop acopious diarrhea within about one to five days after

    ingesting the bacteria. Severe disease requires prompt medical care.

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    Signs and Symptoms watery diarrhea that often contains flecks of whitish

    material (mucus and some epithelial cells) that areabout the size of pieces of rice. smells "fishy." Thevolume of diarrhea can be enormous;

    vomiting

    rapid heart rate

    loss of skin elasticity

    dry mucous membranes

    low blood pressure

    Thirst

    muscle cramps

    restlessness or irritability (especially in children)

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    Mode of Transmission

    By drinking water or eating foodcontaminated with the cholera bacterium,Vibrio cholerae.

    the source of the contamination is usuallythe feces of an infected person. Thedisease can spread rapidly in areas withinadequate treatment of sewage and

    drinking water. Cholera has been found in only two other animal

    populations: shellfish and plankton.

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    Mode of Transmission

    The cholera bacterium may also live inthe environment in brackish rivers andcoastal waters.

    Shellfish eaten raw have been asource of cholera, and a few personsin the United States have contractedcholera after eating raw orundercooked shellfish from the Gulf ofMexico.

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    Communicability

    The disease is not likely to spreaddirectly from one person to another;therefore, casual contact with an

    infected person is not a risk forbecoming ill.

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    Cholera outbreaks

    England had several in the 18th century, mostnotable being in 1854, when Dr. John Snow did aclassic study in London that showed a mainsource of the disease (resulting in about 500deaths in 10 days) came from at least one of the

    major water sources for London residents termedthe "Broad Street pump." The pump handle wasremoved, and the cholera deaths slowed andstopped. The pump is still present as a landmarkin London. Although Dr. Snow did not discover

    the cause of cholera, he did show how thedisease could be spread and how to stop a localoutbreak. This was the beginning of modernepidemiologic studies.

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    Cholera outbreaks

    V. cholerae was first isolated as thecause of cholera by Filippo Pacini in1854, but his discovery was not widely

    known until Robert Koch (who alsodiscovered the cause of tuberculosis),working independently 30 years later,

    publicized the knowledge and themeans of fighting the disease.

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    Patoglomonic Sign

    rice-watery stool

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    Treatment

    The main treatment for cholera is fluidand electrolyte replacement, both oraland IV. Antibiotics usually are used in

    severe infections where dehydrationhas occurred.

    Hydration (usually by IV for the very ill)

    of the patient is the key to surviving thedisease

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    Patient condition Treatment

    No dehydrationOral rehydration salts(ORS)

    Some dehydrationOral rehydration salts(amount in first four hours)

    Severe dehydration

    IV drips of Ringer Lactateor, if not available, normalsaline and oral rehydrationsalts as outlined above

    http://www.medicinenet.com/script/main/art.asp?articlekey=72561http://www.medicinenet.com/script/main/art.asp?articlekey=72561http://www.medicinenet.com/script/main/art.asp?articlekey=72561http://www.medicinenet.com/script/main/art.asp?articlekey=72561
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    Management

    Cholera can be prevented withappropriate measures such as

    safe drinking water and non contaminatedfoods;

    some protection can be obtained from oralvaccines while avoiding areas wherecholera commonly occurs or has had a

    recent outbreak. Proper handwashing

    Proper sanitation

    Foods should be well cooked.