Cholera.pptx

Cholera is an acute diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae.

1. CHOLERA Ms. Sonam Sharma Asst. Professor

2. Introduction Cholera is an acute diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae . The disease is typically transmitted through the ingestion of contaminated water or food. Cholera remains a global threat to public health and an indicator of inequity and lack of social development .

3. Causes Cholera is primarily caused by the bacterium Vibrio cholerae . Several factors contribute to the transmission and spread of this bacterium, leading to outbreaks of the disease. Below is an overview of the key causes and contributing factors.

4. Transmission Routes Contaminated Water : The primary mode of transmission is through drinking water contaminated with Vibrio cholerae . Contaminated water sources are a major cause, especially in areas lacking proper sanitation and clean water supplies. Contaminated Food : Consumption of food, especially raw or undercooked seafood, that has been contaminated with cholera bacteria can also cause infection. Food can become contaminated through water used for washing, cooking, or irrigation .

5. Continue Fecal-Oral Route : The bacterium is excreted in the feces of infected individuals. Poor hygiene practices and inadequate sanitation facilities can lead to the contamination of water and food, facilitating the fecal-oral transmission of the disease .

6. Pathophysiology

7. Clinical Manifestations The symptoms of cholera can range from mild to severe and include: Diarrhea : Profuse, watery diarrhea often described as "rice-water stools". Dehydration : Rapid loss of body fluids leading to dehydration and shock if untreated. Vomiting : Occurs in many patients, contributing to fluid loss. Muscle Cramps : Due to electrolyte imbalance. Other Symptoms : Severe cases can lead to kidney failure, shock, and even death if not treated promptly .

8. Diagnosis Clinical Presentation : Symptoms of severe dehydration and profuse watery diarrhea . Stool Culture : Isolation of Vibrio cholerae from stool samples. Rapid Diagnostic Tests : Can provide quick results, particularly useful in outbreak settings .

9. Process for diagnosis Patient presents with symptoms of watery diarrhea and dehydration. ↓ Clinical assessment for signs of cholera. ↓ Collection of stool sample. ↓ Rapid Diagnostic Test (RDT) for preliminary screening. ↓

10. | ↓ If RDT positive: If RDT negative: Confirm with stool Consider other culture and PCR. causes of diarrhea . ↓ Stool culture on TCBS agar to isolate *Vibrio cholerae *. ↓ Biochemical tests and serotyping for confirmation. ↓ PCR for additional confirmation and detection of toxin genes (if necessary).

11. Treatment

12. Rehydration Therapy The cornerstone of cholera treatment. Oral rehydration salts (ORS) solution is used for mild to moderate dehydration. Intravenous (IV) fluids are necessary for severe dehydration. Oral Rehydration Therapy (ORT) : Oral Rehydration Salts (ORS) : ORS is a simple, cost-effective solution containing a precise mixture of salts and glucose. It is used to treat mild to moderate dehydration. Administration : The ORS solution is given to patients to drink in small, frequent sips. For mild dehydration, WHO recommends 75 ml/kg of ORS solution over the first 4 hours, and then as much as the patient needs to replace ongoing fluid losses .

13. Intravenous (IV) Rehydration : Indications : IV fluids are necessary for patients with severe dehydration or those who cannot take ORS orally due to vomiting or unconsciousness. Fluids Used : Ringer's lactate solution is preferred due to its balanced electrolyte composition. Normal saline can also be used if Ringer's lactate is unavailable. Administration : Rapid IV rehydration is critical in severe cases. The initial bolus of 30 ml/kg should be given within the first 30 minutes, followed by 70 ml/kg over the next 2.5 hours. Continuous monitoring and adjustment based on the patient's response are essential .

14. Antibiotics Can reduce the duration of diarrhea and bacterial shedding. Commonly Used Antibiotics : Doxycycline : A single dose of 300 mg for adults or 2-4 mg/kg for children. Azithromycin : A single dose of 1 g for adults or 20 mg/kg for children. Ciprofloxacin : 1 g as a single dose for adults or 20 mg/kg for children .

15. Zinc Supplementation Zinc is recommended for children to reduce the duration and severity of diarrhea in cholera and other diarrheal diseases. Dosage : 10-20 mg of zinc per day for 10-14 days, depending on the child's age. Benefits : Zinc helps in improving intestinal barrier function and immune response, thereby reducing the severity and duration of diarrhea .

16. Supportive Care Monitoring : Continuous monitoring of vital signs, fluid intake and output, and electrolyte levels is crucial in managing cholera patients. Nutritional Support : Encouraging patients, especially children, to continue eating a balanced diet helps in faster recovery. Breastfeeding should be continued for infants .

17. Prevention Safe Water and Sanitation : Ensuring access to clean drinking water and proper sanitation facilities is crucial. Hygiene Practices : Handwashing with soap, safe food preparation, and storage. Surveillance : Monitoring and early detection of outbreaks to implement control measures quickly . Vaccination : Oral cholera vaccines (OCVs) are available and recommended for at-risk populations .

18. Vaccination Dukoral Adults and Children (6 years and older) : Dosage : Two doses taken orally, 1-6 weeks apart. Booster : A booster dose is recommended every two years if there is ongoing risk of cholera exposure. Children (2-5 years old) : Dosage : Three doses taken orally, 1-6 weeks apart. Booster : A booster dose is recommended every six months if there is ongoing risk of cholera exposure .

19. Continue Shanchol and Euvichol -Plus Adults and Children (1 year and older) : Dosage : Two doses taken orally, two weeks apart. Booster : A booster dose is recommended every three years if there is ongoing risk of cholera exposure .

20. Continue Vaxchora Adults (18-64 years old) : Dosage : Single oral dose. Booster : Currently, no routine booster is recommended, but further guidance may be issued based on ongoing research .