Pathology

confirmation Place Time Person

IP MOT susceptibility

Cholera Non endemic = Severe dehydration from acute watery diarrhea = death Endemic = acute watery diarrhea Patient must be > 5 yo May be asymptomatic or mild or severe + acidosis & collapse = death CFR if untreated = 30-50% If treated < 1% Isolation of vibrio cholera from stool WW, highly endemic, neoepidemics & outbreaks Variable, usually summer Low gastric acid, immunocompromised, Bd gp O, mobile population, low SE 5 days Common vehicle, vector, feco oral General

Enterica Major: 1- Fever > 2 days 2- Headache 3- Abdominal discofort Minor: 1- Non productive cough 2- Relative bradycardia Ulceration of payers patches = intestinal He & perforation CFR = 10-20% in untreated If treated < 1%, 15-20% relapse Isolation from stool or urine or +ve blood culture & widal test Substandard sanitation Endemic in Egypt Summer 5-20 yo

Salmonella Acute abdominal pain, nausea, vomiting & diarrhea

Staph Abrupt severe nausea & vomiting, cramps, prostration, diarrhea 1-2 days

Botulism Unexplained diplopia, blurred vision, bulbar weakness & symmetrical paralysis

Stool culture WW Summer Any

Isolation or toxin detection WW Summer Any & rises with older

Lab confirmation or similar cases with same food Sporadic Any Any

8-14 days Same General, more in achlorhydria & HIV First week through conv. 10% for 3 months & 5% chronic Active immunity 1- food measures 2- sanitation 3- identify carriers & control 4- vaccine

12-48 hours Same General but severity changes acc. serotype Few days to several weeks --------1- food measures 2- animal husbandary 3- food handlers examination & education

2-4 hours Common vehicle General No ----------1- protection of food 2- education 3- examination of handlers 4- exclusion of possible staph infected from food Same Ix source

12-48 hours Common vehicle General No --------------1- supervision on canning 2- education 3- not use bulging cans

Period of 10-14 days communicability Immunity All types of immunity Prevention 1- Water supply 2- Safe food handling 3- Disposal of execreta 4- Education 5- Flies 6- vaccine Control (cases) Control (contacts) Report, isolate, treat, disinfect Surveillance, culture, missed cases, chemoprophylaxis

Same Immunization, surveillance, food handling, education, Ix source

Same Culture

Same +botulinum antitoxin & ICU Observe, enema, antitoxin