CHOLERA

TORRES, MELTRICK
TRESMARIA, JIANA
3APH
DEFINITION
▸ an acute infectious disease caused by Vibrio cholerae.

▸ transmitted between humans through fecal-oral route.

▸ affects the intestinal tract

▸ major epidemic disease

▸ it is spread mostly by unsafe water and unsafe food that has been
contaminated by human stool containing the bacteria.

▸ came from the greek work “kholē” meaning bile

▸ then was a flushing of bile from the body in an attempt to rebalance

Galen’s four humors of the body (blood, bile, black bile, and phlegm)
VIBRIO CHOLERAE / ASIATIC CHOLERAE
▸ are gram-negative, comma-shaped
rods, adapted to life in brackish water

▸ highly motile, with long terminal

flagellum that moves them in water.

▸ grow rapidly at a pH that is neutral to

somewhat basic.

▸ exquisitely susceptible to drying,

sunlight, and acid.

▸ die rapidly at pH of 4.0 or less.

VIBRIO CHOLERAE / ASIATIC CHOLERAE

▸ has different types or

serogroups but only two can
cause cholera

▸ serogroup O1 and serogroup

O139 possess the cholera
toxin.

▸ O139 is only found in Asia

▸ causes gastroenteritis
EPIDEMIOLOGY

▸ September 1992, a new strain of V. cholerae belonging to

O139, appeared in India and spread rapidly across South
Asia

▸ Cholera affected 3-5 million people world wide and

caused 58,000-130,000 deaths in 2010.
CHOLERA IN THE PHILIPPINES

▸ March 1902, a vessel from Hong Kong arrived in Manila

carrying cholera.

▸ Lower classes were the hardest hit because of

overcrowding, poor sanitation, and poor diet.

▸ About 109,461 died.

SYMPTOMS

▸ Diarrhea

▸ Nausea

▸ Vomiting

▸ Dehydration
TEXT

DIARRHEA

▸ profused water diarrhea

▸ cholera stool is an opaque

white liquid that is not
malodorous

▸ often describes as having a

rice water appearance
DIAGNOSIS

▸ Culture Method

▸ Dipstick
CULTURE METHOD
▸ most recommended test for diagnosis
of cholera.

▸ stool samples are taken from a patient

using a sterile cotton swab and placed
on a plate containing thiosulphate
citrate bile salts (TCBS) agar.

▸ Upon incubation, V. cholerae appear

as yellow clumps.

▸ Incubation period is from few hours to

five days.
DIPSTICK

▸ is used when area is endemic

▸ involves dipstick strip into a

stool sample

▸ cholera is confirmed if two red

lines appear on the dipstick.

▸ takes between 2-15 minutes

for the test to make a
diagnosis
DRUG TREATMENT

▸ Oral Rehydration Solution

▸ Intravenous

▸ Antibiotics
ORAL REHYDRATION SOLUTION

▸ a carefully defined mixture of carbohydrates and

electrolytes

▸ rapid replacement of lost fluids and electrolytes

INTRAVENOUS
‣ Lactated Ringer solution is preferred over isotonic
sodium chloride solution because saline does not correct
metabolic acidosis
ANTIBIOTICS
▸ World Health Organization recommends the use of antibiotics to
people with severe dehydration.

▸ Tetracycline and trimethoprim-sulfamethoxazole is the known to

shorten the course and diminish the severity of the illness.

▸ useful adjunct to fluid therapy as it decreases fluid loss and

hastens recovery

▸ must maintain hydration

▸ V. cholerae showed resistance to Doxycycline and

Fluoroquinolones.
IMMUNIZATION

▸ Dukoral

▸ Shanchol

▸ Euvichol

▸ Vaxchora
DUKORAL

▸ taken orally with bicarbonate buffer

▸ provides approximately 65% protection against cholera for

2 years

Vaxchora
‣ recommended vaccine by the FDA
‣ oral attenuated live vaccine
‣ effective as a single dose
SHANCHOL AND EUVICHOL

▸ same vaccine produced by 2 different manufacturers.

▸ do not require a buffer solution for administration

▸ easier to administer to large number of people in

emergency context

▸ minimum of 2 weeks delat between each dose of these 2

vaccines.
PREVENTION

▸ Sterilization

▸ Sewage management

▸ Water Purification

▸ Proper Sanitation

▸ Handwashing
GOVERNMENT PROGRAMS IN THE PHILIPPINES
‣ Food and Waterborne Diseases Prevention and Control
Program 

-approaches to control and prevention is centered on
public health awareness regarding food safety as well as
strengthening treatment guidelines
PARTNER ORGANIZATION / AGENCIES
▸ University of the Philippines-National Institutes of Health (UP-NIH)

▸ Department of Agriculture - National Meat Inspection Services

(DA-NMIS)

▸ Asia Centric Disease Bureau

▸ World Health Organization - Western Pacific Regional Office

(WHO-WPRO)

▸ World Health Organization - Southeast Asia Regional Office

(WHO-SEARO)
THANK YOU
FOR LISTENING