Cholera is an infection of the small intestine caused by the bacterium Vibrio cholerae. The main symptoms are severe watery diarrhea and vomiting which can lead to dehydration and death if untreated. It is transmitted when a person ingests food or water contaminated with feces or vomit from an infected individual, even those who are asymptomatic. Proper sanitation practices such as boiling water, handwashing, and preventing contamination of water supplies are effective ways to prevent the spread of cholera.

2. Cholera is an infection in the small intestine caused by
the bacterium Vibrio cholerae. The main symptoms are
profuse, watery diarrhea and vomiting. Transmission
occurs primarily by drinking water or eating food that has
been contaminated by the feces of an infected person,
including one with no apparent symptoms.

3. The Bacteria that causes Cholera

4.  Acute infectious disease
 is often fatal
 characterized by severe
vomiting, diarrhoea, and
collapse

5. Caused By: Vibrio cholerae
•Indirect transmission
Vehicle borne
•Reaches water through:
Vomiting
Diarrhoea
•Carriers active or passive
•Produces toxins in sml intestines that
cause severe diarrhoea and
dehydration

6.  Through:
 Contaminated water
 Contaminated food
 Eating with unwashed hands
 Also house flies and other
insects

8. The primary symptoms of cholera are profuse, painless diarrhea
and vomiting of clear fluid. These symptoms usually start suddenly,
one to five days after ingestion of the bacteria. The diarrhea is
frequently described as "rice water" in nature and may have a fishy
odor.
An untreated person with cholera may produce 10 to 20 liters (3 to
5 US gal) of diarrhea a day with fatal results. For every symptomatic
person, 3 to 100 people get the infection but remain asymptomatic.
Cholera has been nicknamed the "blue death" due to a patient's
skin turning a bluish-gray hue from extreme loss of fluids.

10. If the severe diarrhea is not treated with intravenous rehydration, it
can result in life-threatening dehydration and electrolyte
imbalances.The typical symptoms of dehydration include low blood
pressure, poor skin turgor (wrinkled hands), sunken eyes, and a
rapid pulse.
A person with severe
dehydration due to cholera -
note the sunken eyes and
decreased skin turgor which
produces wrinkled hands

11.  Host drinks water
 Bacteria moves through the stomach
 Reach the intestine & produce flagella
 Propel through mucus of the sm.
intestine
 Produce toxin causing diarrhea
 Feces carry new bacteria into drinking
water

13. When consumed, most bacteria do not survive the acidic conditions of
the human stomach. The few surviving bacteria conserve their energy
and stored nutrients during the passage through the stomach by
shutting down much protein production.
When the surviving bacteria exit the stomach and reach the small
intestine, they need to propel themselves through the thick mucus that
lines the small intestine to get to the intestinal walls where they can
thrive. V. cholerae bacteria start up production of the hollow cylindrical
protein flagellin to make flagella, the cork-screw helical fibers they
rotate to propel themselves through the mucus of the small intestine.

14. Once the cholera bacteria reach the intestinal wall they no longer
need the flagella to move. The bacteria stop producing the protein
flagellin to conserve energy and nutrients by changing the mix of
proteins which they express in response to the changed chemical
surroundings. On reaching the intestinal wall, V. cholerae start
producing the toxic proteins that give the infected person a watery
diarrhea.
This carries the multiplying new generations of V. cholerae bacteria
out into the drinking water of the next host if proper sanitation
measures are not in place.
Advanced Mechanism Structure Next

16. Stage 1 Stage 3
 Vomiting  Start to recover
 Muscle cramps  Mild to severe diarrhoea
 Sudden onset and watery,  Shock and dehydration
painless diarrhea  Loss of important minerals
 Stool has a characteristic “rice and electrolytes
water” appearance (gray,
slightly cloudy with bits of  Intense thirst
mucus, and a slightly sweaty  Reduced urination
odor)  Muscle cramps/weakness
Stage 2
 Dehydration, Thirst and Shock
 Cold Skin, sunken Eyes, weak
pulse and feint high-pitched
voice
 Reduced urine
 Muscle cramps and Muscle
weakness

17.  Oral Rehydration Therapy (ORT)
 Solution of salts and sugars, taken by the mouth
 Also homemade solutions (water, sugar, table
salt, baking soda, and fruit)
 Sometimes intravenous

18.  Tetracycline
 Shortens the course of the disease
 Weaken the symptoms.

19.  Squatter camps
 Bad hygiene
 Unsafe preparation of food
 Drinking contaminated water
 To bathe / swim in contaminated water

20.  Immunization
 Boiling water, covering food
 Education
 Personal and domestic hygiene
 Prevention of contamination of water supplies
 Improvement of sewage systems
 Access to health care

21. Although cholera may be life-threatening, prevention of
the disease is normally straightforward if proper
sanitation practices are followed. In developed countries,
due to nearly universal advanced water treatment and
sanitation practices, cholera is no longer a major health
threat.