CHOLERA

STUDENT PRESENTER : SONIKA MERCY GEORGE

DATE: JULY 30, 2021

 INTRODUCTION

Cholera is an acute diarrhoeal disease

caused by Vibrio Cholera. Typical
cases characterized by the sudden
onset of profuse, effortless, watery
diarrhoea followed by vomiting, rapid
dehydration, muscular cramps and
suppression urine.
 DEFINITION

An infectious sometimes fatal disease of the

small intestine caused by the bacterium vibrio
cholera. It is spread from contaminated water
and food and causes severe diarrhoea,
vomiting and dehydration.
Cholera remains a global threat to public
health and a key indicator of lack of social
development.
 EPIDEMIOLOGICAL
FEATURES
Cholera is both an epidemic and endemic disease.

HOSTS (Vibrio
ages, environmental
(All(Poor
AGENT
Environment both
Cholera)
sexes)
factors
 ETIOLOGICAL
FACTORS/AGENT
1. The Organism is a slightly curved rod
(comma-shaped), Gram negative and motile
with a polar flagellum.
2. The organism survives well at ordinary
temperatures ranging from 22-40°C.
3. They survive longer in refrigerated foods.
4. An enterotoxin, cholerapen, is elaborated
by a organism as it grows in the intestinal
tract.
 CHOLERA
PATHOGNOMONIC SIGN
Rice water stools
INCUBATION PERIOD
The incubation period ranges from a few hours
to 5 days, usually one to three days.
PERIOD OF COMMUNICABILITY
The organisms are communicable during the
stool-positive stage, usually a few days after
recovery, however, occasionally may the
carrier have the organism for several months.
MODE OF TRANSMISSION

1. Fecal transmission passes via the oral route

from contaminated water, milk and other
foods.
2. The organisms are transmitted. through the
ingestion of food or water contaminated with
the stools or vomitus of a patient.
3. Flies, soiled hands and utensils. also serve
to transmit the infection.
 CLINICAL FEATURES

There are three stages:

i) Evacuation
ii) Collapse
iii) Recovery
The severity of cholera is dependent on the
rapidly and the duration of fluid loss.
CLINICAL FEATURES (CONT)

i) STAGE OF EVACUATION
The onset is abrupt with profuse
painless, watery diarrhoea followed
by vomiting. The patient may pass
as many as 40 stools in a day.
 CLINICAL FEATURES
ii) STAGE OF COLLAPSE
• Sunken Eyes.
• Hollow checks.
• Scaphoid abdomen.
• Washer-man hand and feet.
• loss of elasticity of skin.
• Sub-normal temperature.
• Absent pulse.
• Low BP.
• Shallow and quick Respiration.
• Oliguria
CLINICAL FEATURES
iii) STAGE OF RECOVERY
If death does not occur the patient shows
signs of clinical improvement.
→ BP begins to raise, temperature returns to
normal and urine secretion is re established.
If anuria persists the patient may die renal
failure, severe cholera occurs in 5 to 10% of
cases.
 LABORATORY DIAGNOSIS

i) Collection Stool
ii) Collection vomitus
iii) Water
iv) food samples
v) Transportation
vi) Direct examination
vii) Culture method.
CONTROL OF CHOLERA

1. VERIFICATION OF THE DIAGNOSIS

Confirmation of the diagnosis as early as possible.

2. NOTIFICATION
Educate the vulnerable group regarding the disease.

3. EARLY CASE FINDING

An aggressive search for the cases should be made in the
community.
CONTROL OF CHOLERA
4. ESTABLISHMENT OF TREATMENT CENTERS
The mild dehydrated patients should be treated at home with ORS. Severely
dehydrated patients requiring 1V fluids.

5. REHYDRATION THERAPY
Mortality rate have been brought down to less than by effective rehydration
therapy.

6. ADJUNCTS TO THERAPY
Antibiotics should be given as soon as vomiting has stopped which is usually
after 3-4 hours of oral rehydration
Eg. fluroquinolones, tetracycline, ampicillin.
CONTROL OF CHOLERA
7. SANITATION MEASURES
i) Water control
ii) Excreta disposal
iii) Food sanitation
iv) Disinfection.
 NURSING MANAGEMENT

1. Medical aseptic protective case must be

provided. Hand washing is imperative before any
food item is handled.
2. Enteric isolation must be observed.
3. Vital signs must be recorded accurately.
4. Intake and output must be accurately measured.
5. A thorough and careful personal hygiene must
be provided.
 NURSING MANAGEMENT

6. Excreta must be properly disposed.

7. Concurrent disinfection must be applied.
8. Food must be properly prepared.
9. Environmental sanitation must be
observed.
10. Weight of the patient provides if there is
deficit.
THANK YOU