PUBLIC HEALTH

Valerie T. Dumapi

BSPharma-3B

Cholera

Cholera

It is an acute diarrheal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae.

John Snow Born in 1813-1858, was the son

of a coal-yard laborer in York, England.

“Father of modern epidemiology” Discovered that cholera is spread

by contaminated water.

History

During the 19th century, cholera spread across the world from its original reservoir in the Ganges delta in India. Six subsequent pandemics killed millions of people across all continents. The current (seventh) pandemic started in South Asia in 1961, and reached Africa in 1971 and the Americas in 1991. Cholera is now endemic in many countries.

Vibrio Cholerae

Are gram-negative rods that are facultatively anaerobic.

First discovered by Filippo Pacini in Italy in 1854,

Modes of transmissionoWater borne

The term “waterborne” refers to the fact that water can serve as a transmission vehicle to cause disease. Pathogens comprise bacteria, protozoa, and viruses. All of them have different survival characteristics in different water types. However, that microbiologically contaminated water is a common source for food contamination.

Food borne

It is the transmission by ingestion of contaminated food. Secondary cases can occur through close contact with infected persons with transmission generally occurring via the fecal oral route.

Mechanism of action for cholera toxin: Vibrio cholerae, the causative bacterium, enters the through

contaminated food or drink.

The bacteria attach to the epithelial cells of the small intestine.

V. Cholerae toxin enters the cells and prevent them from down-

regulating secretion of water and electrolytes.

The epithelial cells pump water and electrolytes from the blood into the

intestinal lumen, causing watery diarrhea.

Shock and death occur because of fluid loss in the circulatory system

unless the fluid can be replaced.

The bacteria exit in the body through the feces.

Symptomso Abrupt onset of massive

diarrhea generally

followed by vomitting

without nausea, muscle

cramps and when severe

dehydration and shock.

Prevention

Purification of water

Carefull handwashing

Do not eat undercooked or raw shellfish or fish.

Proper cooking and storing practices, and

personal hygiene of food handlers.

Vaccines

Dukoral

Shankol

Cholera vaccines

Cholera vaccine contains a mixture of inactivated Vibrio cholerae bacteria and a non-toxic component of the toxin that these bacteria produce. It works by stimulating the body's immune response to the cholera bacteria, without actually causing the disease.

Treatment

80% of people can be treated successfully through prompt administration of oral rehydration salt.

Very severely dehydrated patients administration of intravenous solution (Na, K, Glucose).

Through the WHO Global Task Force on Cholera Control, WHO works to:

provide technical advice and support for cholera control and prevention at country level

train health professionals at national, regional and international levels in prevention, preparedness and response of diarrhoeal disease outbreaks

disseminate information and guidelines on cholera and other epidemic-prone enteric diseases to health professionals and the general public.