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WHY CHOLERA IS
IMPORTANT ????
?
YEAR CASES DEATHS
1950
1965
1975
1985
1995
2005
2009
2010
2011
176,307
43,285
21,955
5,808
3,315
3,156
3,482
5,004
2,341
86,997
12,947
2,302
155
5
6
12
9
10
 Study about cholera
 Applying the study to
control cholera
 AGENT
 HOST
 MODE OF TRANSMISSION
 PATHOGENSIS
 CLINICAL FEATURES
 CARRIER
 LABORATORY DIAGNOSIS
CONTROL OF CHOLERA
Vibrio cholera
Belonging to Vibrio bacteria
•They live in water
•Vibrio cholera is killed by:
Heating for 30 min at 56*C
By drying in sunlight
Bleaching powder
•El tor is more resistant than classical
•They produce a toxin called
ENTEROTOXIN
 AGENT
 HOST
 MODE OF TRANSMISSION
 PATHOGENESIS
 CLINICAL FEATURES
 CARRIER
 LABORATORY DIAGNOSIS
CONTROL OF CHOLERA
HOST
 CHOLERA AFFECTS ANY AGE
 AFFECTS BOTH SEX
ECONOMICALLY POOR
AND LACK OF EDUCATION
 AGENT
 HOST
 MODE OF TRANSMISSION
 PATHOGENESIS
 CLINICAL FEATURES
 CARRIER
 LABORATORY DIAGNOSIS
CONTROL OF CHOLERA
Faecally
contaminated water
Contaminated food and
water
Overcrowding
 AGENT
 HOST
 MODE OF TRANSMISSION
 PATHOGENESIS
 CLINICAL FEATURES
 CARRIER
 LABORATORY DIAGNOSIS
CONTROL OF CHOLERA
 Entry is through oral route
 Get adhered to small intestine
 Incubation period is 2- days
 Causes many symptoms
 Get excreted to faeces and
vomiting
• AGENT
• HOST
• MODE OF TRANSMISSION
• PATHOGENESIS
• CLINICAL FEATURES
• CARRIER
• LABORATORY DIAGNOSIS
CONTROL OF CHOLERA
Suspected
In an area where the disease is not known to
be present: severe dehydration or death from
acute watery diarrhoea in a patient aged 5
years or more;
In an area where there is cholera endemic:
acute watery diarrhoea, with or without
vomiting in a patient aged 5 years or more
Epidemic ongoing: acute watery diarrhoea
with or without vomitting
Confirmed
A suspected case that is laboratory-
confirmed.( Isolation of Vibrio cholerae O1 or
O139 from stools in any patient with diarrhoea
is the laboratory criteria for diagnosis)
• Stage of evacuation
• Stage of collapse
• Stage of recovery
• Sunken eyes
• Hollow cheeks
• Scaphoid abdomen
• Washerman hand and
feet
• Loss of elasticity of skin
• Sub-normal temperature
• Absent pulse
• Low BP
• Shallow and quick respiration
• Oliguria
 AGENT
 HOST
 MODE OF TRANSMISSION
 PATHOGENESIS
 CLINICAL FEATURES
 CARRIER
 LABORATORY DIAGNOSIS
CONTROL OF CHOLERA
1)PRE-CLINICAL/INCUBATORY CARRIER- INCUBATION
PERIOD 1-5 DAYS
2)CONVALESCENT CARRIER-ARE PATIENTS WHO
RECOVERED BUT STILL CONTINUE TO EXCRETE VIBRIOS
3)
 AGENT
 HOST
 MODE OF TRANSMISSION
 PATHOGENESIS
 CLINICAL FEATURES
 CARRIER
 LABORATORY DIAGNOSIS
CONTROL OF CHOLERA
LABORATORY DIAGNOSIS OF CHOLERA
oLoss of at least 10% of body weight
oHypovolemic shock
oLow blood pressure
oRapid, weak, or undetectable
peripheral pulse
oSkin has lost normal turgor
(“tenting”)
oMouth is very dry
oThinking is dulled
epidemiology and outbreak investigations of cholera
epidemiology and outbreak investigations of cholera
epidemiology and outbreak investigations of cholera
epidemiology and outbreak investigations of cholera
epidemiology and outbreak investigations of cholera

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epidemiology and outbreak investigations of cholera