Department of Physiotherapy, SHUATS

1. CHOLERA
COMMUNITYMEDICINE
SUBMITTEDTO:-
MRS.SURABHISHRIVASTAVA
ASSISTANT PROFESSOR
DEPARTMENTOFPHYSIOTHERAPIEST
(SHUATS)
SUBMITTED BY :-
RISHI RAJ
ID NO. – 21 BPHY006
BPT 3RD YEAR

2. CHOLERA
CONTEXT
□ INTRODUCTION
□ CAUS
AT
IVE AGENT
□ EPIDEMIOLOGY
□ TRANSMISSION
□ PATHOPHYS
IOLGY
□ CLINICAL FEATURES
□ DIAGNOSIS
□ TREATMENT
□ COMPLICAT
ION

3. INTRODUCTION
WHATIS CHOLERA ?.
□ Cholerais a life-threatening diarrheal
illness caused by cholera toxin-producing
strains of Vibrio cholerae.
□ It is usually spread through contaminated
water.

4. CAUSATIVE
□ A bacterium calledVibrio ch
A
oG
ler
E
ae
N
ca
T
uses cholera infection.
□ The deadly effects of the disease are the result of a toxin the bacteria
producesin the small intestine.
□ The toxin causesthe body to secrete enormousamounts of water, leading
to diarrhea and arapid loss of fluids and salts(electrolytes).
□ Choleracausessevere diarrhea and dehydration.

5. EPIDERMIOLOGY
□ Choleracan be endemic or epidemic.
□ A cholera outbreak/epidemic can occurin both endemic countries and
in countries where cholera does not regularly occur.
□ Choleratransmission is closely linked to inadequate accessto clean water
and sanitation facilities.
□ Typical at-risk areas include peri-urbanslums,aswell ascamps for
internally displacedpersonsor refugees.
□ Uninfected dead bodies have never been reported asthe sourceof
epidemics.

6. TRANSMISSION
□ Contaminated water suppliesare the main sourceof cholera
infection.
□ The bacterium can befound in:
1. Surface or wellwater.
2. Seafood.
3. Raw fruits and vegetables.
4. Grains.

7. PATHOPHYSIOLOGY
□
□ Transmission — Vibrio cholerae is transmitted via the fecal-oral route; this
includes transmission within households or between close contacts, as well as
outbreaks related to contaminated food and water.
In endemic regions, V.cholerae in the water are an important
reservoir of the organism; V.cholerae can live on chitinous plankton .
□ Individuals with severe cholera excrete as many as 1010 to 1012 organisms
per liter of stool. Recently shed organisms may be more infectious than
organisms from the aquatic environment .
□
□ Risk factors — Cholera is associated with people whose incomes are
below federal poverty thresholds and lack of access to safe food, water,
and adequate sanitation .
Large cholera epidemics often occur in populations
impacted by natural disaster or human conflict .

8. CLINICAL
FEATURES

9. DIAGNOSIS
□ Most cases of choleraare presumptively diagnosed
based on clinical suspicion in patients who present with
severe acutewatery diarrhea.
□ Thediagnosis can be confirmed by isolation of V.
cholerae from stool cultures performed onspecific
selective media.

10. TREATMENT
□ Cholera is aneasily treatabledisease.
□ The majority of people canbe treated successfullythrough prompt administration of
oral rehydration solution(ORS).
□ TheORSstandard sachet is dissolved in 1litre (L) of cleanwater.
□ Adult patients may require up to 6 L ofORSto treat moderate dehydration on the first day.
□ Severely dehydrated patients are at risk of shockand require the rapid administration
of intravenous fluids.
□ These patients are also given appropriate antibiotics to diminish the duration of
diarrhoea, reduce the volume of rehydration fluids needed, and shorten the amount and
duration of V. cholerae excretion in their stool.
□ Zinc is an important adjunctive therapy for children under 5, which also reduces the
duration of diarrhoea and may prevent future episodes of other causes of acute watery
diarrhoea.

11. TREAMENT
ORAL CHOLERAVACCINES
□ Currently there are 3oral cholera vaccines(Dukoral ,Shanchol and Euvichol – Plus).
□ All 3vaccinesrequire 2doses for full protection.
□ Dukoral is administered with abuffer solution that, for adults,
requires 150ml of clean water.
□ It canbe given to all individuals over the age of 2 years.
□ There must be aminimum of 7days, and no more than 6 weeks, delay between each
dose.
□ It is mainly usedfor travellers.
□ Two dosesof Dukoral provide protectionagainst cholera for 2 years.

12. TREATMENT
ORAL CHOLERA VACCINES
□ Shanchol and Euvichol - Plus have the samevaccineformula, produced by
2 different manufacturers.
□ They are given to all individuals over the age of 1year.
□ There must be aminimum of 2 weeks delay between eachdoseof these
2 vaccines.
□ Two dosesof Shanchol and Euvichol-Plus provide protection against cholera
for at least 3years, while 1dose provides short term protection.

13. COMPLICATION
iii.
□ Choleracan quickly becomefatal.
□ Although shockand severedehydration are the worst complications of cholera,
other problems canoccur,suchas:
i. Low blood sugar (hypoglycemia) :- Dangerously low levels of blood sugar (glucose) —the
body's main energy source—canoccurwhen people become too ill to eat.
ii. Low potassium levels:- People with cholera lose large quantities of minerals, including
potassium, in their stools and interferewith heart and nerve function are life-threatening if
it level is less.
Kidney failure :- Whenthe kidneys lose their filtering ability, excess amounts of fluids, some
electrolytes and wastes build up in the body —a potentially life-threatening condition.
kidney failure often accompanies shock.

14. THAN
K
YOU