Cholera is an acute diarrheal illness caused by infection of the intestine with Vibrio cholerae bacteria. People can get sick when they swallow food or water contaminated with cholera bacteria. The infection is often mild or without symptoms, but can sometimes be severe and life-threatening.
Cholera is an acute diarrheal illness caused by infection of the intestine with Vibrio cholerae bacteria. People can get sick when they swallow food or water contaminated with cholera bacteria. The infection is often mild or without symptoms, but can sometimes be severe and life-threatening.
Cholera is a acute diarrhoeal disease caused by Vibrio cholerae.
Majority of infection are mild or asymptomatic.
IV B.PHARM, 8-SEMESTER ,SOCIAL AND PREVENTIVE PHARMACY.
CHOLERA DISESASE
DEFINITION, SYMPTOMS, CAUSES, TREATMENT, PREVENTION.
A bunch of topic were selected for our subject Communicable Diseases, surprisingly I picked up "Cholera El tor"...
I have done enough research regarding this topic from Brunner and Suddarths MedSurg books and other resources. I collated the ideas and came up to this presentation...
Hope it will be able to help my colleagues, students and those people who needs to know the what, why's, and how of Cholera!
xoxo ^___^
Vibrio cholera and Halophilic vibrio.pptDrmayuribhise
A 4-year-old boy developed severe watery diarrhea and vomiting. The stool collected has a rice water type of appearance. It was sent for bacteriological analysis.
a. What is the probable etiological diagnosis of this condition?
b. Describe in detail the pathogenesis of this condition.
c. Add a note on its laboratory diagnosis.
Which of the following media can be used as transport medium for vibrio?
a. Selenite F broth
b. Nutrient broth
c. Tetrathionate broth
d. Venkatraman–Ramakrishnan medium
All of the following tests can differentiate between classical and El Tor biotypes of V. cholerae, except:
a. β-hemolysis on sheep blood agar
b. Chick erythrocyte agglutination
c. Growth on TCBS agar
d. Polymyxin B (50 IU)
Pathogenesis of V. cholerae involves one of the following second messenger systems:
a. cGMP
b. cAMP
c. Ca2+
d. IP3
Selective media for Vibrio cholerae:
a. TCBS
b. Mannitol salt agar
c. Robertson cooked meat medium
d. Modified Thayer Martin medium
All of the following Vibrio species are halophilic, except:
a. V. cholerae
b. V. parahaemolyticus
c. V. alginolyticus
d. V. vulnificus
O139 (Bengal strain)—all are true, except:
a. Capsulated
b. Toxigenic
c. Clinically similar to El Tor
d. More common than El Tor
All are selective media for V. cholerae, except:
Alkaline peptone water
Alkaline bile salt agar
TCBS agar
Monsur’s agar (GTTTA) medium
Which of the following confirms the isolate of V. cholerae as Hikojima serotype?
a. If agglutinated with Ogawa antisera
b. If agglutinated with Inaba antisera
c. If agglutinated with Hikojima antisera
d. If agglutinated with both Ogawa and Inaba antisera
Gram negative
Rigid, curved rods
“Vibrio” – vibratory motility
Non - sporing
Non - capsulated
Present in marine environments & surface waters worldwide
1854 – observed by Pacini
1883 – first isolated by Koch
Vibrio cholerae Top
V. cholerae was first described as the cause of cholera by Pacini in 1854. Pathogenic V. cholerae
produces a heat-sensitive enterotoxin that causes the characteristic cholera symptoms, including
"rice water stool." The species comprises several somatic (O) antigen groups, including O-group1, which is associated with classical and El Tor biotypes. V. cholerae Ol may have several
serotypes, including Inaba, Ogawa, and Hikojima. V. cholerae non-O1 (referred to in older
literature as nonagglutinable or NAG vibrios) also can cause gastrointestinal disease, though
typically less severe than that caused by V. cholerae O1 (Yamamoto et al., 1983). Serotype O139
is an exception, and produces classic cholera symptoms. This serotype was first identified in
1992 (CWG, 1933) as the cause of a new epidemic of cholera in India and Bangladesh. Non-O1
V. cholerae is found more readily in estuarin! e waters and seafood in the United States than is
the Ol serogroup; however, the 0139 serogroup has not yet been found here. Because this species
can grow in media lacking sodium chloride, it is not considered a halophilic Vibr
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
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This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
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Cholera is a acute diarrhoeal disease caused by Vibrio cholerae.
Majority of infection are mild or asymptomatic.
IV B.PHARM, 8-SEMESTER ,SOCIAL AND PREVENTIVE PHARMACY.
CHOLERA DISESASE
DEFINITION, SYMPTOMS, CAUSES, TREATMENT, PREVENTION.
A bunch of topic were selected for our subject Communicable Diseases, surprisingly I picked up "Cholera El tor"...
I have done enough research regarding this topic from Brunner and Suddarths MedSurg books and other resources. I collated the ideas and came up to this presentation...
Hope it will be able to help my colleagues, students and those people who needs to know the what, why's, and how of Cholera!
xoxo ^___^
Vibrio cholera and Halophilic vibrio.pptDrmayuribhise
A 4-year-old boy developed severe watery diarrhea and vomiting. The stool collected has a rice water type of appearance. It was sent for bacteriological analysis.
a. What is the probable etiological diagnosis of this condition?
b. Describe in detail the pathogenesis of this condition.
c. Add a note on its laboratory diagnosis.
Which of the following media can be used as transport medium for vibrio?
a. Selenite F broth
b. Nutrient broth
c. Tetrathionate broth
d. Venkatraman–Ramakrishnan medium
All of the following tests can differentiate between classical and El Tor biotypes of V. cholerae, except:
a. β-hemolysis on sheep blood agar
b. Chick erythrocyte agglutination
c. Growth on TCBS agar
d. Polymyxin B (50 IU)
Pathogenesis of V. cholerae involves one of the following second messenger systems:
a. cGMP
b. cAMP
c. Ca2+
d. IP3
Selective media for Vibrio cholerae:
a. TCBS
b. Mannitol salt agar
c. Robertson cooked meat medium
d. Modified Thayer Martin medium
All of the following Vibrio species are halophilic, except:
a. V. cholerae
b. V. parahaemolyticus
c. V. alginolyticus
d. V. vulnificus
O139 (Bengal strain)—all are true, except:
a. Capsulated
b. Toxigenic
c. Clinically similar to El Tor
d. More common than El Tor
All are selective media for V. cholerae, except:
Alkaline peptone water
Alkaline bile salt agar
TCBS agar
Monsur’s agar (GTTTA) medium
Which of the following confirms the isolate of V. cholerae as Hikojima serotype?
a. If agglutinated with Ogawa antisera
b. If agglutinated with Inaba antisera
c. If agglutinated with Hikojima antisera
d. If agglutinated with both Ogawa and Inaba antisera
Gram negative
Rigid, curved rods
“Vibrio” – vibratory motility
Non - sporing
Non - capsulated
Present in marine environments & surface waters worldwide
1854 – observed by Pacini
1883 – first isolated by Koch
Vibrio cholerae Top
V. cholerae was first described as the cause of cholera by Pacini in 1854. Pathogenic V. cholerae
produces a heat-sensitive enterotoxin that causes the characteristic cholera symptoms, including
"rice water stool." The species comprises several somatic (O) antigen groups, including O-group1, which is associated with classical and El Tor biotypes. V. cholerae Ol may have several
serotypes, including Inaba, Ogawa, and Hikojima. V. cholerae non-O1 (referred to in older
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typically less severe than that caused by V. cholerae O1 (Yamamoto et al., 1983). Serotype O139
is an exception, and produces classic cholera symptoms. This serotype was first identified in
1992 (CWG, 1933) as the cause of a new epidemic of cholera in India and Bangladesh. Non-O1
V. cholerae is found more readily in estuarin! e waters and seafood in the United States than is
the Ol serogroup; however, the 0139 serogroup has not yet been found here. Because this species
can grow in media lacking sodium chloride, it is not considered a halophilic Vibr
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Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
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2. BACKGROUND
Cholera, is a Greek word, which means the
gutter of the roof. It is caused by bacteria:
Vibrio cholerae, which was discovered in 1883
by Robert Koch during a diarrheal outbreak in
Egypt.
V. cholerae has 2 major biotypes: classical
and El Tor, which was first isolated in Egypt in
1905. Currently, El Tor is the predominant
cholera pathogen worldwide.
3. EPIDEMIOLOGY
Crowding & gathering of people during
religious rituals (e.g. Muslims pilgrimage
to Mecca or Hindu swimming festivals in
holy rivers) enhance the spread of
infection.
Index cases when travelled back to their
homes may pass the organism to at risk
individuals leading to secondary epidemic
or small scale infection.
4. In 1994, 94 countries reported 385,000 cases of
cholera to WHO, but the number reported in 1998
was 121,000. 89% of these cases were reported
from Africa.
REPORTED CASES
The number of cholera patients worldwide is
uncertain because many cases are unreported.
The number of cases is increased during
epidemics & is affected by environmental
factors.
5. TRANSMISSION
Cholera is transmitted by the fecal-oral route
through contaminated water & food.
The infectious dose of bacteria required to
cause clinical disease varies with the source. If
ingested with water the dose is in the order of
103-106 organisms. When ingested with food,
fewer organisms are required to produce
disease, namely 102-104.
Person to person infection is rare.
6. V. cholerae is a saltwater organism & it is
primary habitat is the marine ecosystem.
Cholera has 2 main reservoirs, man & water.
Animals do not play a role in transmission of
disease.
V. cholerae is unable to survive in an acid
medium. Therefore, any condition that reduces
gastric acid production increases the risk of
acquisition.
TRANSMISSION
7. The same applies to patients with chronic
gastritis secondary to Helicobacter pylori
infection or those who have had a gastrectomy.
The use of antacids, histamine-receptor
blockers, and proton-pump inhibitors increases
the risk of cholera infection and predisposes
patients to more severe disease as a result of
reduced gastric acidity.
HOST SUSCEPTIBILITY
8. AT RISK GROUPS
All ages but children & elderly are more
severely affected.
Subjects with blood group “O” are more
susceptible; the cause is unknown.
Subjects with reduced gastric acid.
9. CLINICAL PICTURE
Incubation period is 24-48 hours.
Symptoms begin with sudden onset of
watery diarrhea, which may be followed by
vomiting. Fever is typically absent.
The diarrhea has fishy odor in the
beginning, but became less smelly & more
watery over time.
10. In severe cases stool volume exceeds 250
ml /kg leading to severe dehydration, shock
& death if untreated.
The classical textbook “rice water”
diarrhea, which describes fluid stool with
very little fecal material, appears within
24h from the start of the illness.
CLINICAL PICTURE
11. CHOLERA IN CHILDREN
Breast-fed infants are protected.
Symptoms are severe & fever is frequent.
Shock, drowsiness & coma are common.
Hypoglycemia is a recognized complication,
which may lead to convulsions.
Rotavirus infection may give similar picture
& need to be excluded.
12. LAB DIAGNOSIS
Organism can be seen in stool by direct
microscopy after gram stain and dark field
illumination is used to demonstrates motility.
Cholera can be cultured on special alkaline
media like triple sugar agar or TCBS agar.
Serologic tests are available to define
strains, but this is needed only during
epidemics to trace the source of infection.
13. OTHER LAB FINDINGS
Dehydration leads to high blood urea &
serum creatinine. Hematocrit & WBC will also
be high due to hemoconcentration.
Dehydration & bicarbonate loss in stool
leads to metabolic acidosis with wide-anion
gap.
Total body potassium is depleted, but serum
level may be normal due to effect of acidosis.
14. TREATMENT
The primary goal of therapy is to replenish
fluid losses caused by diarrhea & vomiting.
Fluid therapy is accomplished in 2 phases:
rehydration and maintenance.
Rehydration should be completed in 4
hours & maintenance fluids should replace
ongoing losses & provide daily requirement.
15. FLUID THERAPY
Ringer lactate solution is preferred over
normal saline because it corrects the associated
metabolic acidosis.
IV fluids should be restricted to patients who
purge >10 ml/kg/h & for those with severe
dehydration.
The oral route is preferred for maintenance &
the use of ORS at a rate of 500-1000 ml/h is
recommended.
16. DRUG THERAPY
The goals of drug therapy are to eradicate
infection, reduce morbidity and prevent
complications.
The drugs used for adults include
tetracycline, doxycycline, cotrimoxazole &
ciprofloxacin.
For children erythromycin, cotrimoxazole
and furazolidone are the drugs of choice.
17. DRUG THERAPY
Drug therapy reduces volume of stool &
shortens period of hospitalization. It is only
needed for few days (3-5 days).
Drug resistance has been described in some
areas & the choice of antibiotic should be
guided by the local resistance patterns .
Antibiotic should be started when cholera is
suspected without waiting for lab confirmation.
18. COMPLICATIONS
If dehydration is not corrected adequately &
promptly it can lead to hypovolemic shock,
acute renal failure & death.
Electrolyte imbalance is common.
Hypoglycemia occurs in children.
Complications of therapy like over hydration
& side effects of drug therapy are rare.
19. PUBLIC HEALTH ASPECTS
Isolation & barrier nursing is indicated
Trace source of infection.
Resume feeding with normal diet when vomiting
has stopped & continue breastfeeding infants &
young children.
Notification of the case to local authorities &
WHO.
20. PREVENTION
Education on hygiene practices.
Provision of safe, uncontaminated, drinking
water to the people.
Antibiotic prophylaxis to house-hold
contacts of index cases.
Vaccination against cholera to travellers to
endemic countries & during public gatherings.
21. CHOLERA VACCINES
The old killed injectable vaccine is obsolete
now because it is not effective.
Two new oral vaccines became available in
1997. A Killed & a live attenuated types.
Both provoke a local immune response in
the gut & a blood immune response.
Cholera vaccination is no more required for
international travellers because risk is small.