WHY CHOLERA IS IMPORTANT ?????

YEAR CASES

DEATHS

1950 1965 1975 1985 1995 2005 2009 2010 2011

176,307 43,285 21,955 5,808 3,315 3,156 3,482 5,004 2,341

86,997 12,947 2,302 155 5 6 12 9 10

Study about cholera

Applying the study to control cholera

AGENT HOST MODE OF TRANSMISSION PATHOGENSIS CLINICAL FEATURES CARRIER LABORATORY DIAGNOSIS

CONTROL OF CHOLERA

Vibrio cholera Belonging to Vibrio bacteria

•They live in water•Vibrio cholera is killed by: Heating for 30 min at 56*C By drying in sunlight Bleaching powder

•El tor is more resistant than classical•They produce a toxin called ENTEROTOXIN

AGENT HOST MODE OF TRANSMISSION PATHOGENESIS CLINICAL FEATURES CARRIER LABORATORY DIAGNOSIS

CONTROL OF CHOLERA

HOST CHOLERA AFFECTS ANY AGE

AFFECTS BOTH SEX

ECONOMICALLY POOR AND LACK OF EDUCATION

AGENT HOST MODE OF TRANSMISSION PATHOGENESIS CLINICAL FEATURES CARRIER LABORATORY DIAGNOSIS

CONTROL OF CHOLERA

Faecally contaminated water

Contaminated food and water

Overcrowding

AGENT HOST MODE OF TRANSMISSION PATHOGENESIS CLINICAL FEATURES CARRIER LABORATORY DIAGNOSIS

CONTROL OF CHOLERA

Entry is through oral route Get adhered to small intestine Incubation period is 2- days Causes many symptoms Get excreted to faeces and

vomiting

• AGENT• HOST • MODE OF TRANSMISSION• PATHOGENESIS• CLINICAL FEATURES• CARRIER• LABORATORY DIAGNOSIS

CONTROL OF CHOLERA

SuspectedIn an area where the disease is not known to be present: severe dehydration or death from acute watery diarrhoea in a patient aged 5 years or more; In an area where there is cholera endemic: acute watery diarrhoea, with or without vomiting in a patient aged 5 years or moreEpidemic ongoing: acute watery diarrhoea with or without vomittingConfirmed A suspected case that is laboratory-confirmed.( Isolation of Vibrio cholerae O1 or O139 from stools in any patient with diarrhoea is the laboratory criteria for diagnosis)

• Stage of evacuation• Stage of collapse • Stage of recovery

• Sunken eyes• Hollow cheeks • Scaphoid abdomen• Washerman hand and

feet• Loss of elasticity of

skin• Sub-normal temperature• Absent pulse• Low BP• Shallow and quick respiration• Oliguria

AGENT HOST MODE OF TRANSMISSION PATHOGENESIS CLINICAL FEATURES CARRIER LABORATORY DIAGNOSIS

CONTROL OF CHOLERA

1)PRE-CLINICAL/INCUBATORY CARRIER- INCUBATION PERIOD 1-5 DAYS

2)CONVALESCENT CARRIER-ARE PATIENTS WHO RECOVERED BUT STILL CONTINUE TO EXCRETE VIBRIOS

3)

AGENT HOST MODE OF TRANSMISSION PATHOGENESIS CLINICAL FEATURES CARRIER LABORATORY DIAGNOSIS

CONTROL OF CHOLERA

LABORATORY DIAGNOSIS OF CHOLERA

oLoss of at least 10% of body weightoHypovolemic shockoLow blood pressureoRapid, weak, or undetectable peripheral pulseoSkin has lost normal turgor (“tenting”)oMouth is very dryoThinking is dulled