Brief description of Cholera Epidemic and Prevention.

1. Cholera:
Brief Epidemiology &
Prevention
DR. Rambadan P. Chauhan
MD (PSM), ACME (MET)
Professor-Community Medicine
BKLWR Medical College- Sawarde, District-Ratnagiri
chauhanrambadan@gmail.com
5/11/2021 1
Dr Rambadan Chauhan

2. Lecture Objectives: (Cholera)
At the end of lecture you {student (s)}
should be able to understand,
Epidemiology of Cholera
Prevention of cholera

3. Cholera
Agent: Vibrio Cholerae 2 types :Classical & Eltor.
El-Tor: 3 sub types Ogawa,Hikojima & Inaba .
MCC=El Tor Hybrid
Host: All ages & sexes.
Environment: Pilgrimage, marriage, fairs &
festivals, Poor sanitation.
MOT: Feco-oral routine. Contaminated drinks &
foods

4. Cholera
Incubation Period: Common: 1-2 days Range: few hours to 5 days
Infective Material: Stool and vomit of cases and carriers.
Carrier types: Incubatory 1-5 days. Convalescent carriers 2-3
weeks. Contact/Healthy carriers for 10 days. Chronic Carriers from
3 months to 10 years. Reservoir-Gall bladder.
Clinical Features: Profuse painless watery diarrhea with vomiting.
Rapid severe dehydration. 3stages-Evacuation, collapse &
recovery/death.
Investigations: 1.Microscopy-Gram negative with curved rod with
characteristic scintillating type of movements. 2.Culture
3.Biochemical tests 4.Serology etc

5. Cholera: Primary Prevention
Primary Prevention:
1.Safe water and sanitary latrines.
2.Hand washing with soap and water.
3.Health education
Specific Protection:
Cholera vaccine: 3 months before Pilgrimage,
marriage, fairs & festivals.
3 types of oral vaccines: 1. Dukoral (WC-rBS)
2.Sanchol and mORCVAX 3. Euvichol
Dosage Schedule: initially 2/3 doses with 1 week
to 1 month interval. Boosters every 3 years.
Age: 2 years and above

6. Cholera:Secondary Prevention
EDAT: V NEERAC
1.Verification of diagnosis : Hanging drop & Biochemical
tests
2.Notification: Local-National & International
3.Early case finding: The users of the contaminated source
4.Establishment of treatment centres : Temporary/Regular
5.Rehydration therapy: ORS & IVT [75-100 ml/kg/day],
Rapid.
6.Antibiotics- Ciprofloxacin, Azithromycin, Tetracyclines.
7.Chemoprophylaxis to contacts – tetracyclines,
doxycyclines

7. Cholera: Tertiary Prevention
Disability Limitation:
Investigation of the epidemic to spot the source and
do the needful.
Sanitation: Water supply-Excreta disposal-Fly
control-Disinfection [WEFD]
Rehabilitation:
Vocational support to the family if the head of
family is the lost. [Intersectoral co-operation]
Psychological: Moral support to the family of a dead
patient.

8. Assignment
Write short notes : 5 marks each
1.Epidemilogy of Cholera
2.Immunoprophylaxis against Cholera
3.Early diagnosis and treatment of Cholera
Long Answer questions: 10 marks
Describe the epidemiology of cholera.

9. THANKS