13.

3 Cholera Vochelle Rodrigues 6 PUSC

Introduction
Cholera is a water-borne disease which mainly affects countries where there is no proper sanitation or clean water supplies. a major health threat in developing cities of Asia, Africa, and Latin America. causative agent, Vibrio cholera, a comma-shaped bacterium with a distinctive flagellum.

Causes
The bacteria enter the body via ingestion of contaminated food or water The incubation period: 1-5 days

reach the small intestine rapidly multiply secrete the enzyme neuraminidase and the exotoxin choleragen

Sodium ions and water follow the loss of Cl ions, causing diarrhoea

stimulates the epithelial cells to secrete large quantity of chloride ions into the lumen of small intestine

Neuraminidase alters some of the surface proteins on the membranes of epithelial cells in the small intestine

Modes of transmission
Infected people pass out large numbers of bacteria in their faeces which may contaminate water supplies is used to prepare food or drink, or even to wash utensils, the infection is likely to spread to others. Direct contamination of food with faeces of a person infected with cholera as a result of poor hygiene. Filter feeders, oysters and mussels will have high concentrations of cholera bacteria because sewers discharge straight into the sea. Shellfish is often eaten raw or partially-cooked.

Sign and Symptoms

About 75% of infected people do not develop symptoms. About 20% more do have severe symptoms. The typical symptoms :very water and cloudy-looking diarrhoea (rice water diarrhoea)
vomiting electrolyte imbalance

Treatment
Oral rehydration therapy (ORT): - to replace fluid and electrolyte (salt and glucose) which may be drunk or intravenously. Antibacterial drugs (antibiotics) - such as doxycycline, erythromycin and tetracycline to shorten the duration of the infection and to reduce the severity of the symptoms.

Prevention
The supply of clean and safe drinking water such as

mineral water and boiled water. Health education. Proper sewage treatment, sanitation and drainage. Control of flies which may transfer faecal matter to exposed food. Isolation of patients and hygienic disposal of faeces and vomit of patients.

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