HTF211

STUDY CASE: CHOLERA

NAME OF GROUP MEMBERS: 1. NUR LIYANA BINTI MAINUDDIN (2019617956)

2. NUR AQILAH IZZATI BINTI SALIMI (2020955373)

3. RANIA BINTI ZULKIFLI (2020369581)

4. AIMI RIDANI BINTI ROZLAN (2020956753)

5. NUR AINNI BINTI BERAHIM (2020955699)

LECTURER: NORLAILA MAT TAHIR

INTRODUCTION

Cholera is an acute, diarrheal illness caused by ingestion of food or water contaminated with the
bacterium VIBRRO CHOLERA. The bacteria typically live in waters that are somewhat salty and
warm, such as estuaries and water along coastal areas. Symptoms may range from none, to mile, to
severe. Approximately one in 10 (10%) infected person will have severe disease characterized by
profuse watery diarrhea, vomiting, and leg cramps. In these people, rapid loss of body fluids leads to
dehydration and shock. This may result in sunken eyes, cold skin, decreased skin elasticity and
wrinkling of hand and feet. Symptoms star two hour to five day after exposure. Without prompt
rehydration, death can occur within hours of the onset of symptoms.

Cholera remains a global threat to public health and an indicator of inequity and lack of social
development. An estimated 2.9 million cases and 95,000 deaths accur each year around the world due
to cholera. A single diarrhea episode can cause a one-million-fold increase of bacterial numbers in the
environment, according to the National Institute of Allergy and infectious Diseases.
WHAT THE SICKNESS

VIBRIO CHOLERAE

Cholera is An infectious disease characterized by intense vomiting and profuse watery diarrhea and
that rapidly leads to dehydration and often death. Cholera is caused by infection with the bacteria
Vibrio cholerae, which may be transmitted via infected fecal matter, food, or water. With modern
sanitation, cholera is no longer as common as it once was, but epidemics still occur whenever people
must live in crowded and unsanitary conditions, such as in refugee camps. The disease is treated with
intravenous fluids and with antibiotics. Cholera has also been known as Asian cholera, due to its one-
time prevalence in that area of the world.
HOW IT HAPPEN

Cholera infection is spread through the consumpation of contaminated food or water. If the patient
doest not wash his hand cleanly, it can spread to others. The cause at this ingestion is due to the
bacterium like Vibrio Cholera Bacteria. These are several factors that can cause an outbreak. Among
them are environment factors, V cholera can exist in saline water and often lives in marin areas along
with plankton. Levels are usually hight in areas with poor drainage systems. Besides, human factors
people living in the outbreak of this epidemic often have low rates of infection probably because they
were infacted with this virus in childhood. An individual with an immune problem if more prone to
this infection and can cause servere compilcations.
WHEN IT HAPPENT

Cholera happen when seven cholera pandemic haveaccurred in the past 200 years with the first
cholera pandemic when it emeraged out of the Ganges Delta with and outbreak in Jessore, India in
1817 stemming from contaminated rice. The disease quickly spread throughout most of Indian. Death
in between 1817 and 1860, in the first three pandemics of the nineteenth century, are estimated to
have exceeded 15 million people. Another 23 million died between 1865 and 1917, during the next
three pandemics. Cholera deaths in the Russian Empire during a similar time period exceeded 2
million. Between 1816 and 1923, the first six cholera pandemics occurred consecutively and
continuously over time. Increase commerce, migration and pilgrimage are credited for its transmission.
Late in this period (particularly 1879-1883), major scientific breakthroughs toward treatment of
cholera develop

By 1820, cholera had spread to Thailand, Indonesia (killing 100,000 people on the island of java
alone) and the Philippines. From Thailand and Indonesia, the disease made its way to China in 1820
and Japan in 1822 by way of infected people on ships. The cholera pandemics (six subsequent) killed
millions of people across all continents. The current cholera pandemic happened or started in South
Asia in 1961, and reached Africa 1971 and the Americas in 1991. Cholera is now endemic in many
countries. After a long hiatus, the seventh cholera pandemic spread in 1961. The pandemic subsided
in 1970s,but continued on a smaller scale, with outbreaks across the developing world to the current
day. Epidemics occurred after wars, civil unrest, or natural disasters, when water and food supplies
become contaminated with vibrio cholera, and also due to crowded living conditions and poor
sanitation
WHERE IS OUTBREAK

The first cholera pandemic occurred in the Bengal region of India, near Calcutta starting in 1817
through 1824. The disease dispersed from India to Southeast Asia, the Middle East, Europe, and
Eastern Africa through trade routes.

The second pandemic lasted from 1826 to 1837 and particularly affected North America and Europe
due to the result of advancements in transportation and global trade, and increased human migration,
including soldiers.

The third pandemic erupted in 1846, persisted until 1860, extended to North Africa, and reached
South America, for the first time specifically affecting Brazil.

The fourth pandemic lasted from 1863 to 1875 spread from India to Naples and Spain.

The fifth pandemic was from 1881–1896 and started in India and spread to Europe, Asia, and South
America.

The sixth pandemic started in India and was from 1899–1923. These epidemics were less fatal due to
a greater understanding of the cholera bacteria. Egypt, the Arabian peninsula, Persia, India, and the
Philippines were hit hardest during these epidemics, while other areas, like Germany in 1892 and
Naples from 1910–1911, also experienced severe outbreaks.

The seventh pandemic originated in 1961 in Indonesia and is marked by the emergence of a new
strain, nicknamed El Tor, which still persists (as of 2019) in developing countries.

Cholera did not occur in the Americas for most of the 20th century after the early 1900s in New York
City. It reappeared in the Caribbean toward the end of that century and seems likely to persist.

.
WHAT IS THE SIMPTOMES

Signs and symptoms of cholera dehydration include irritability, fatigue, sunken eyes, a dry mouth,
extreme thirst, dry and shriveled skin that's slow to bounce back when pinched into a fold, little or no
urinating, low blood pressure, and an irregular heartbeat. The symptoms and signs of cholera-related
disease are a watery diarrhea that often contains flecks of whitish material (mucus and some
gastrointestinal lining [epithelial] cells) that are about the size of pieces of rice. The diarrhea is termed
"rice-water stool" (See figure 1) and smells "fishy." Although many bacterial infections may cause
diarrhea, the volume of diarrhea with cholera can be enormous; high levels of diarrheal fluid, such as
250 cc per kg or about 10 to 18 liters over 24 hours for a 154-pound adult, can occur.
HOW TO PREVENT

Prevention of cholera is dependent on acces to safe water,adequate sanitation and basic hygiene
needs. The following materials cover a new global initiative for cholera prevention and control, as
well as the basics of cholera and other diarhell disease prevention.

We must take precautions before cholera. There are several steps to prevent cholera. The first step,
Drink and use safe water. Use safe water to brush your teeth, wash and prepare food, and to make ice.
Clean food preparation areas and kitchenware with soap and safe water and let dry completely before
reuse. To be sure water is safe to drink and use, boil it or treat it with a chlorine product or household
bleach. If boiling, bring your water to a complete boil for at least 1 minute. To treat your water with
chlorine, use one of the locally available treatment products and follow the instructions. For a list of
products distributed by country, visit CDC’s Safe Water System website. If a chlorine treatment
product is not available, you can treat your water with household bleach. Add 8 drops of household
bleach for every 1 gallon of water (or 2 drops of household bleach for every 1 liter of water) and wait
30 minutes before drinking. Always store your treated water in a clean, covered container. Piped
water sources, drinks sold in cups or bags, or ice may not be safe and should be boiled or treated with
chlorine.

Next step, Wash your hands often with soap and safe water before you eat or prepare food and
before feeding your children. Besides that, After using the latrine or toilet, after cleaning your child’s
bottom and after taking care of someone ill with diarrhea should also wash your hands with soap to be
cleaner and safer. If no soap is available, scrub hands often with ash or sand and rinse with safe water.
After that, cook food well especially seafood,keep it covered and peel fruits or vegetable. Be sure boil
it, cook it, peel it or leave it. To cook shellfish like crabs and carryfish be sure until they are very hot
all the way through. Safer,avoid raw foods other than fruits and vegetables you have peeled yourself.

Lastly, surveillance and reposrting of all cases of cholera. The identification, treatment and
identification, treatment and isolation of cholera prevents further spreading of the disease. Education
of mass populations regarding good hygiene and safety practices. Such education can help contain the
bacteria and prevent it from spreading.
CONCLUSION

Cholera is a true emergency that requires clear thinking, its really need logistical support and
appropriate supplies. You will need to rely on your most basic nursing skills to treat these patients
because they had many symtoms. If you can reacting calmly and quickly, you can literally save
thousands of lives.
RECOMMENDATION

 Avoid buying unsafe food such as from hawkers or sidewalk merchants. Always make sure
you eat a full meat
 Wash hand with soap before eating, handling food and after using the toilet
 Boil drinking water or drink bottled water
 Make sure the seafood, fish and meat are cooked properly at the right temperature.
 Get treatment if we have cholera symptoms
 Rinse with clean water after brushing your teeth
REFERENS

Cholera remains an important public health problem yet there are few reliable population-based
estimates of laboratory-confirmed cholera incidence in endemic areas around the world. There are
considerable differences in cholera incidence across these endemic areas but in all sites, children are
the most affected. The study site in Africa had the highest cholera incidence consistent with a growing
impression of the large cholera burden in Africa. Burden estimates are useful when considering where
and among whom interventions such as vaccination would be most needed.

Cholera is a bacterial disease usually spread through contaminated water. Cholera causes severe
diarrhea and dehydration. Left untreated, cholera can be fatal within hours, even in previously healthy
people. Modern sewage and water treatment have virtually eliminated cholera in industrialized
countries. But cholera still exists in Africa, Southeast Asia and Haiti. The risk of a cholera epidemic is
highest when poverty, war or natural disasters force people to live in crowded conditions without
adequate sanitation. Cholera is easily treated. Death from severe dehydration can be prevented with a
simple and inexpensive rehydration solute.

Next, be found a Symptoms. Most people exposed to the cholera bacterium (Vibrio cholerae)
don't become ill and don't know they've been infected. But because they shed cholera bacteria in their
stool for seven to 14 days, they can still infect others through contaminated water. Most cases of
cholera that cause symptoms cause mild or moderate diarrhea that's often hard to tell apart from
diarrhea caused by other problems. Others develop more-serious signs and symptoms of cholera,
usually within a few days of infection. Symptoms of cholera infection can include Diarrhea. Cholera-
related diarrhea comes on suddenly and can quickly cause dangerous fluid loss as much as a quart
(about 1 liter) an hour. Diarrhea due to cholera often has a pale, milky appearance that resembles
water in which rice has been rinsed. Nausea and vomiting. Vomiting occurs especially in the early
stages of cholera and can last for hours.Dehydration. Dehydration can develop within hours after
cholera symptoms start and range from mild to severe. A loss of 10% or more of body weight
indicates severe dehydration. Signs and symptoms of cholera dehydration include irritability, fatigue,
sunken eyes, a dry mouth, extreme thirst, dry and shriveled skin that's slow to bounce back when
pinched into a fold, little or no urinating, low blood pressure, and an irregular heartbeat. Dehydration
can lead to a rapid loss of minerals in your blood that maintain the balance of fluids in your body.
This is called an electrolyte imbalance.

Among those risk, The risk of cholera is slight in industrialized nations. Even in areas where it
exists you're not likely to become infected if you follow food safety recommendations. Still, cases of
cholera occur throughout the world. If you develop severe diarrhea after visiting an area with active
cholera, see your doctor. If you have diarrhea, especially severe diarrhea, and think you might have
been exposed to cholera, seek treatment right away. Severe dehydration is a medical emergency that
requires immediate care. Risk factors, everyone is susceptible to cholera, with the exception of infants
who get immunity from nursing mothers who have previously had cholera. Still, certain factors can
make you more vulnerable to the disease or more likely to have severe signs and symptoms.

Lastly,risk factors for cholera include, poor sanitary conditions. Cholera is more likely to flourish
in situations where a sanitary environment including a safe water supply is difficult to maintain. Such
conditions are common to refugee camps, impoverished countries, and areas afflicted by famine, war
or natural disasters. Reduced or nonexistent stomach acid. Cholera bacteria can't survive in an acidic
environment, and ordinary stomach acid often serves as a defense against infection. But people with
low levels of stomach acid such as children, older adults, and people who take antacids, H-2 blockers
or proton pump inhibitors lack this protection, so they're at greater risk of cholera.Household exposure.
You're at increased risk of cholera if you live, with someone who has the disease.Type O blood, for
reasons that aren't entirely clear, people with type O blood are twice as likely to develop cholera
compared with people with other blood types. Raw or undercooked shellfish. Although industrialized
nations no longer have large-scale cholera outbreaks, eating shellfish from waters known to harbor the
bacteria greatly increases your risk.Complications. Cholera can quickly become fatal. In the most
severe cases, the rapid loss of large amounts of fluids and electrolytes can lead to death within hours.
In less extreme situations, people who don't receive treatment can die of dehydration and shock hours
to days after cholera symptoms first appear. Although shock and severe dehydration are the worst
complications of cholera, other problems can occur, such as:

Low blood sugar (hypoglycemia). Dangerously low levels of blood sugar (glucose) the body's
main energy source can occur when people become too ill to eat. Children are at greatest risk of this
complication, which can cause seizures, unconsciousness and even death. Low potassium levels.
People with cholera lose large quantities of minerals, including potassium, in their stools. Very low
potassium levels interfere with heart and nerve function and are life-threatening. Kidney failure.
When the kidneys lose their filtering ability, excess amounts of fluids, some electrolytes and wastes
build up in the body a potentially life-threatening condition. In people with cholera, kidney failure
often accompanies shock.
REFERENS

1. https://www.history.com/topics/inventions/history-of-cholera
2. https://www.google.com/search?q=cholera&tbm=isch&chips=q:cholera,g_1:vibrio:zN0UMF
3. O7EVQ%3D&hl=enGB&ved=2ahUKEwid4tfjwK7pAhVJOCsKHfzACHEQ4lYoAXoECAE
QFw&b
4. https://www.medicinenet.com/script/main/art.asp?articlekey=6534
5. https://www.webmd.com/a-to-z-guides/cholera-faq#1
6. https://www.cdc.gov/cholera/preventionsteps.html
7. https://hesperian.org/wp-content/uploads/pdf/environmental/Cholera_Emergency.pdf
8. https://en.wikipedia.org/wiki/Cholera_outbreaks_and_pandemics