cholera2.pptx
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This document summarizes the history and key details about cholera and its causative agent, Vibrio cholerae. It outlines the 8 pandemics of cholera that have occurred since 1817, with the first reaching parts of Asia, Africa, and Latin America. John Snow discovered the waterborne transmission of cholera in 1855. Filippo Pacini first discovered and described V. cholerae under the microscope in 1854. Robert Koch rediscovered it in 1884. V. cholerae is a gram-negative, comma-shaped bacteria that secretes an enterotoxin causing fluid hypersecretion and diarrhea through activation of chloride channels in the small intestine. Transmission is through the fecal-oral route via
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- 1. Cholera and Dysentry Sudha kanesh BAMS 2nd year
- 2. History • Origins in India, cases reported as early as 1563 • About 8 pandemics to date – 1817-`23: First Pandemic – 1829-`50: Second Pandemic – 1852-`60: Third Pandemic* Pacini – 1863-`79: Fourth Pandemic – 1881-`96: Fifth Pandemic * Koch – 1899-`1923: Sixth Pandemic – 1961-?: Seventh Pandemic – 1992-?: Eighth Pandemic
- 3. History • First pandemic spreads from India to South, Central Asia, Middle East and Russia • Second pandemic reaches England • Pandemics in 1800’s deadly • All pandemics reach Africa • First pandemic reaches Latin America in 19 91
- 4. Distribution
- 5. Causative Agent Discovery • 19th Century: What is Cholera? • Miasma Theory • Blood Generation Theory • Germ Theory
- 6. Causative Agent Discovery • John Snow (1813-185 8): • Water borne transmiss ion of Cholera (1855)
- 7. Discovery • Filippo Pacini (1812-1883 ) – 1854: Cholera reaches Flore nce, Italy. Pacini discovers causative agent – Publishes “Microscopical O bservations and Pathologica l Deductions on Cholera” – 1965: Bacterium named Vib rio cholerae Pacini 1854
- 8. Discovery • Robert Koch (1843-19 10) • 1884: Rediscovers Vi brio cholerae
- 9. Vibrio cholerae Morphology • Gram negative • Comma shaped • Sheathed, polar flagellum • 1.4-2.6µm x 0.5-3µm
- 10. Physiology • Facultative anaerobic • Asporogenous • Growth stimulated by Na Cl • pH 6 - 10, Acid labile • Temperature 18 - 37ºC
- 11. Virulence & Pathogenicity Ingestion of V. cholerae Resistant to gastric acid Colonize small intestine Virulence of Non-toxigenic V. cholerae O1 strain not well understood
- 12. Toxigenic V. cholerae Pathogenic ity • Colonization factors (the TcpA pilus) • Production of enterotoxin • Associated outer membrane pro teins on enterocytes e.g. adenyl ate cyclase
- 13. Secrete enterotoxin Enterotoxin binds to intestinal cells Chloride channels activated Release Large quantities of electrolytes & bicarbonates Fluid hypersecretion Diarrhea Dehydration
- 14. Transmission • Fecal-oral route • Entry = oral • Discharge = fecal
- 15. Transmission • Humans only reservoirs • Bacterium transmitted via contaminated water, food • Carriers: houseflies and ot her insects • Person to person transmiss ion?
- 16. Symptoms • 1-3 day Incubation Period • Mild diarrhea Sudden severe diarrhea • Mucus and intestinal tissue visible in feces • Muscle cramps • Scaphoid abdomen • Vomiting • Loss of skin turgor • Weak pulse
- 17. Diagnosis • Clinical symptoms • Isolation of V. cholerae from stool – Live V. cholerae in stool (ca. 1.0 x 108 cells per ml) – Identification via dark-field microscopy • Measurement of serum antibodies using ELISA – Antibacterial antibodies: vibriocidal assays – Antitoxin antibodies
- 18. Methods of Cure Chemotherapeutic • Antibiotics (tetracycline) Immunological • Local mucosal immune response to V. cholerae • Serological antivibrio antibodies • Antitoxin antibodies To Ease Symptoms • Oral Rehydration • Intraveneous Rehydration
- 19. Prevention & Control • Immunization – Active Immunity induced by: • attenuated V. cholerae • Toxoid (not good antigen) • Preventing contamination of fo od and water e.g. boiling water , covering food • Education – Personal and domestic hygiene • Prevention of contamination of water supplies – Improvement of sewage systems
- 32. Thank you