Cholera :Symptom, Diagnosis, prevention and treatment

Social & preventive pharmacy. B pharm 8th Semester

1. HI TECH COLLEGE OF PHARMACY CHANDRAPUR NAME – Mukesh V K apse CLASS – B Pharm 4 th Year 8 th Sem ROLL NO – 32 SUBJECT – Social & Preventive Pharmacy TOPIC –Cholera (prevention and control)

2. Contents Introduction Transmission Sign & Symptoms Diagnosis & Evaluation of cholera Treatment of cholera Prevention and control of cholera References

3. Introduction Cholera is an acute diarrheal illness caused by infection of the intestine with the bacteria named as Vibrio cholerae . Cholera is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated. It is spread by ingestion of contaminated food or Water . The infection is often mild or without symptoms, but sometimes it can be severe and life threatening . Cholera is comma-shaped, gram-negative aerobic or facultative anaerobic bacillus bacteria . It is highly motile by means of polar flagellum. Incubation period of cholera is from few hours up to 5 days.

4. Sign & Symptoms Intravascular volume depletion, Almost no urine production. Cardiac and renal failure, Tachycardia rapid pulse, Hypoglycemia. Sunken eyes, cheeks and fontanelle in infants. Metabolic Acidosis, Hypokalemia -Cardiac Arrest. Weakness, Decreased skin turgor , wrinkled hands. Stomach pains, Muscle cramps. Mild fever, Dry mucous membranes.

5. Diagnosis & Evaluation of cholera Diagrosis Property Stool Specimen Gram staining & Dark field microscopy. Different methods such as Rectal swab method, Cather method and Blotting Paper method etc. Rapid Diagnostic Test for Cholera (RDT) Crystal@ VC dipstick rapid test can be used when an outbreak of cholera. Serological Tests Serological Tests Slide Agglutination Test. By using 0.85 % sterile saline and polyvalent anti- cholera solution

6. TREATMENT OF CHOLERA Cholera patients should be evaluated and treated quickly because the disease can cause death within hours but with proper treatment, even severely ill patients can be saved. Some of the first line treatment for cholera is outlined here : 1 . Rehydration : Cholera requires immediate treatment of Rehydration to replace proper amount of fluids and electrolytes using a simple rehydration solution (ORS). Lactated Ringer solution (mixture of sodium chloride, sodium lactate, potassium chloride, and alcium chloride in water) is also preferred in some cases . 2. Intravenous fluids : Severely dehydrated people might need intravenous fluids. Ringer's lactate is mostly used intravenous solution, normal saline may also use with ORS . 3. Antibiotics : Antibiotic treatment is not a necessary part of cholera treatment but some antibiotics can reduce cholera-related diarrhea and shorten the effectiveness of symptoms . 4 Zinc supplements : Administration of zinc along with ORS can reduce the duration and severity of diarrheal episodes.

7. Prevention and control of cholera 1) Safe food Cook food thoroughly Fruits and vegetables should be cooked and peeled Raw. 2) Safe Drinking Water O btain drinking water from a safe, uncontaminated source Water releasing agents such as tablets or powders. It is very effective method and can provide safe water Dispose of all stools and fecally - contaminated materials in a latrine or buy them if latrins are not availabl e.

8. 3) Public health measures Provide/ Maintain safe and adequate community facilities for disposal of contaminating. Provide information about how people can purify water at home Washing hands with soaps and water or ash or lime before cooking, before eating and after using the latrine kill the germs and prevents the spread of cholera.

9. 4) Vaccination (ORAL VACCINE) Three WHO pre-qualified oral cholera vaccines (OCV ): Dukora ®, Shanchol and Euvichol ®. All three vaccines require two doses for full protection. Dukorais ® administered with a buffer solution that, for adults. Shanchol ® and Euvichol ® are essentially the same vaccine produced by two different manufacturers. 5) CHEMOPROPHYLAXIS Chemoprophylaxis (Chemoprevention) is administered of specific medicine for the purpose of preventing disease or infection in broad range. This may be useful when a cholera outbreak occurs in a closed population, such as prisons, mental health institutions, child care homes , boarding schools, refugee camps etc. Tetracycline is the drug of choice for this purpose.

10. Reference Kirti Malviya, Dr. Satyajit Sahoo, Dharti Dasadiya, Vidhi Acharya. ESSENCIALS OF SOCIAL AND PREVENTIVE PHARMACY, Pee Vee publication,Page 56-58

11. Thank You