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  1. 1. GROUP 2 C A L U A G , R E D M O N D F E R N A N D E Z , K H R I S T I N E C A Y E I N F A N T A D O , M A . K A T R I N A L A S T I M O S A , J E S S A G O R O S P E , S H A R M A I N E M A N G A O A N G , A U D E Z A J E M
  2. 2. CASE 1  An 8-year old male having diarrhea and abdominal stress is brought to a medical clinic by his mother. He had just returned from a weekend camping trip with friends where the abdominal pain began two days before his return home. Examination of the patient indicates he has a fever and fecal examination presents a bloody stool. A Gram stain reveals curved, gram-negative rods.
  3. 3. What organism is most likely responsible for the patient’s symptoms? Vibrio cholerae
  4. 4. Ways the patients could have been exposed to the organism.  The patient went camping and he might drank water or have eaten food contaminated with cholera bacterium.  He might even swim in a sea and in some cases drunk water contaminated with cholera bacterium.
  5. 5. How food or water can become contaminated with Vibrio cholerae  Cholera germs are found in the feces (poop) of infected people.  Cholera is spread when feces (poop) from an infected person gets into the water people drink or the food people eat.  Cholera is not likely to spread directly from one person to another.
  6. 6. Feces of infected person Sewage/ water Ingestion of seafood that has been exposed to feces carrying the bacteria
  7. 7. Feces of infected person Sewage/ water Drank water contaminated with cholera bacterium
  8. 8. What complications can result from diarrhea? 1. Dehydration  This is the most common acute complication.
  9. 9. Malnutrition
  10. 10. In severe cases, what antibiotic could be given to shorten the duration of the symptoms?  Tetracycline (Sumycin ),  Doxycycline (Vibramycin , Oracea, Adoxa , Atridox ,)  Furazolidone(Furoxone )  Erythromycin (E-Mycin , Eryc , Ery-Tab , PCE , Pediazole , Ilosone )  Ciprofloxacin (Cipro , Cipro XR , Proquin XR )  Bactrim
  11. 11. Disease: Cholera disease causes a lot of watery diarrhea and vomiting. Cholera diarrhea can look like cloudy rice water.
  12. 12. Causes of the disease Ingestion of contaminated water and food  passed into the stomach in food  accumulate produce bacterial toxin  affects the absorption of water in the small intestine  symptoms of the disease  fluid loss
  13. 13. Signs and symptoms:  Diarrhea  Rapid onset of water associated with stool (rice water)  Vomiting, frequently watery, is common and may begin before or after diarrhea.  Onset 2-3 days after ingestion  Death 60% if untreated, 1% if treated for fluid loss
  14. 14. Prevention 1. Drink and use safe water  Drink only bottled, boiled, or chemically treated water  To disinfect your own water: boil for 1 minute or filter the water and add 2 drops of household bleach or ½ an iodine tablet per liter of water. (Chlorox ) (Zonrox ) (Chlor-floc )
  15. 15. 2. Wash your hands often with soap and safe water. 3. Use latrines or bury your feces (poop); do not defecate in any body of water. 4. Cook food well (especially seafood), keep it covered, eat it hot, and peel fruits and vegetables. 5. Clean up safely—in the kitchen and in places where the family bathes and washes clothes
  16. 16. VACCINES  Dukoral (manufactured by SBL Vaccines) which is World Health Organization (WHO) prequalified and licensed in over 60 countries,  ShanChol (manufactured by Shantha Biotec in India), which is licensed in India and is pending WHO prequalification.
  17. 17. Laboratory Diagnosis • Isolation of bacteria from extra- intestinal environment or stool samples (culture of a stool specimen or rectal swab.) • Specimens are collected: • Gram Stain show sheets of curved Gram negative rods  Cary Blair media is ideal for transport  Selective thiosulfate–citrate–bile salts agar (TCBS) is ideal for isolation and identification.
  18. 18. Treatment Rehydration & supportive therapy Doxycycline or tetracycline ***Untreated: 60% fatality ***Treated: <1% fatality