cholera (kiriti guha roy, emmanuel)

8/11/2019 CHOLERA (Kiriti Guha Roy, Emmanuel)

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Cholera:The Killer

By:

Emmanuel Fonsa-Etoke

Kiriti Guha Roy


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Cholera is an acute intestinal infectioncaused by ingestion of food or watercontaminated with the bacterium Vibriocholerae. It has a short incubation period,

from less than one day to five days, andproduces an enterotoxin that causes acopious, painless, watery diarrhoea that canquickly lead to severe dehydration and deathif treatment is not promptly given. Vomitingalso occurs in most patients.

Infectious dose is 100,000 organisms through`Fecal-Oral Route`

What is cholera?


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Copious painless watery diarrhoea:- Diarrhoeal diseases are a leading cause of death, mainly in

children and especially in the developing countries. Every year an estimated

3 to 5 million cholera cases, resulting in 100 000 to 120 000 deaths occurring

worldwide.

Vomiting of clear fluid- These symptoms usually start suddenly, one to five days after

ingestion of the bacteria leading to vomiting of clear fluid and may have

a fishy odor.

Nausea and malaise- They bind to the emetic reflex center causing nausea and

vomiting.

Effects Cholera in our body?


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Other symptoms

Irritability- Abnormal or excessive sensitivity to stimuli; It is

usually used to refer to anger or frustration.

Drowsiness- Neurobehavioral responses, including alternating

periods of drowsiness and restlessness.

Droopy eyes

- A drooping eyelid is also called ptosis. In thiscondition, the border of the upper eyelid falls to a lower position

than normal.

Having a dry mouth with extreme thirst

- Due to dehydration; Dry mouth, also calledXerostomia occurs. This is a condition that usually results from

decreased production of saliva.


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Other symptoms

Dry/shriveled skin:

- Dry and shriveled skin that's slow to bounce back

when pinched into a fold. This is called Washer woman hands

(loss of skin elasticity) are a sign of the dehydration.

Decrease in urination:

- Decreased urine output means that you produce

less than 500 milliliters of urine in 24 hours.


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Other symptoms

A very low blood pressure:

-Low blood volume causes a drop in blood pressure

and a drop in the amount of oxygen in your body. If untreated,

severe hypovolemic shock can cause death in a matter of

minutes.

An irregular heart beat:

- If untreated, cholera can cause a hypovolemic

shock, an emergency condition in which rapid fluid and blood

loss can bring down the hearts ability to pump enough blood

and oxygen to the body, leading to circulatory collapse, acuterenal failure, multi-organ failure, coma, and ultimately death.


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Any contaminated

Surface or well water Seafood Raw fruits and vegetables Grains

Sources of infection

Modes of transfer

Unwashed hands Flies Unwashed or uncooked fruits & vegitables


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Cholera remains an ever-present risk in many countries. New outbreaks can

occur sporadically in any part of the world where water supplies, sanitation,

food safety, and hygiene are inadequate. The greatest risk occurs in

overpopulated communities and refugee settings characterized by poor

sanitation and unsafe drinking water.

So population who are near or have access to the following are at risk:-

Contaminated (feces) Surface or well water Seafood (uncooked) Raw fruits and vegetables (unwashed) Grains



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Modes of transfer

A person can become infected by drinking water or eating food

contaminated by the bacterium. Common sources of foodborne infection

include raw or poorly cooked seafood, raw fruit and vegetables, and other

foods contaminated during preparation or storage.

Bacteria present in the faeces of an infected person are the main source of

contamination. The bacterium can also live in the environment in brackish

rivers and coastal waters. The disease can thus spread rapidly in areas where

sewage and drinking water supplies are inadequately treated.

Unwashed hands

Flies Unwashed or uncooked fruits & vegetables


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Epidemiology

Cholera have been reported from all regions of the world.

Fortunately, after several years of steady increase(since 2007), the number ofcholera cases reported to WHO, showed an important decrease in 2012.

Cumulative total of 245,393 cases were reported including 3,034 deaths i.e. 58%

decrease in number and a 17% decrease in the number of countries infected by

this compared to 2011.


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Epidemiology


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Epidemiology


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Epidemiology

2011-2013

2012

Although the number of cholera cases reported world wide decreased during 2012, the Hispaniola Island

and several African countries continue being affected by severe epidemics. This, and the fact that the

cholera death toll remains unacceptably high, shows clearly that this disease remains a significant

unresolved public health problem.

A cumulative total of 245 393 cases were reported including 3034 deaths with a case-fatality rate (CFR) of

1.2% (Table 1), representing a 58% decrease in number of cases compared with the previous year. In 2012, a

total of 48 countries from all continents reported cholera cases to WHO, a 17% decrease in the number of

countries compared with 2011

A total of 58 countries reported a cumulative total of 589 854 cases including 7816 deaths with a case

fatality rate (CFR) of 1.3%, representing an increase of 85% in number of cases compared with the previous

year. For the second consecutive year the proportion of cases reported from Africa was less than 50% of the

global total. The increase in number of global cases compared with 2010 is the result of a major outbreak,

which started in October 2010 in Haiti and is still ongoing. As in previous years, trends and annual figuresprovided in this report exclude the estimated 500 000 700 000 annual cases labelled acute watery

diarrhoeain south-eastern and central Asia.

Overall, the number of deaths increased by 3.5% from 7543 in 2010 to 7816 deaths (CFR, 1.3%) in 2011. Of

the 33 countries that reported deaths from cholera, 23 were from the African continent accounting for 4183

deaths or 53% of the global total, while in the Americas, Dominican Republic and Haiti reported

3205 deaths or 41% of the global total.

2011


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Cholera Treatment and Prevention

Health Organization

Drinking : Filtered and boiled water

Preparing food or drinks : Clean Environment

Washing : Face and hands

Washing dishes and utensils : Detergent

Washing fruits and vegetables

Oral rehydration solution (ORS)

Self Precautionary Methods

Organization and coordination of the outbreak response Surveillance, outbreak detection and laboratory support Case management and logistics Oral rehydration solution (ORS) Infection prevention and control Social mobilization Vaccination, water, hygiene and sanitation


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Drink and use safe water

1. Bottled water with unbroken seals and canned/bottled carbonated beverages are safe to drink and use.

2. Use safe water to brush your teeth, wash and prepare food, and to make ice.

3. Clean food preparation areas and kitchenware with soap and safe water and let dry completely before reuse.

To be sure water is safe to drink and use

1. Boil it or treat it with a chlorine product or household bleach.

2. If boiling, bring your water to a complete boil for at least 1 minute.

3. If a chlorine treatment product is not available, you can treat your water with household bleach. Add 8

drops of household bleach for every 1 gallon of water (or 2 drops of household bleach for every 1 liter of

water) and wait 30 minutes before drinking.

4. Always store your treated water in a clean, covered container.

Wash your hands often with soap and safe water

1. Before you eat or prepare food

2. Before feeding your children

3. After using the latrine or toilet

4. After cleaning your childs bottom

5. After taking care of someone ill with diarrhea

6. If no soap is available, scrub hands often with ash or sand and rinse with safe water.

Use latrines or bury your feces (poop); do not defecate in any body of water

1. Use latrines or other sanitation systems, like chemical toilets, to dispose of feces.

2. Wash hands with soap and safe water after defecating.

3. Clean latrines and surfaces contaminated with feces using a solution of 1 part household bleach to 9 parts

water.


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Drink and use safe water

1. Bottled water with unbroken seals and canned/bottled carbonated beverages are safe to drink and use.

2. Use safe water to brush your teeth, wash and prepare food, and to make ice.

3. Clean food preparation areas and kitchenware with soap and safe water and let dry completely before reuse.

To be sure water is safe to drink and use

1. Boil it or treat it with a chlorine product or household bleach.

2. If boiling, bring your water to a complete boil for at least 1 minute.

3. If a chlorine treatment product is not available, you can treat your water with household bleach. Add 8

drops of household bleach for every 1 gallon of water (or 2 drops of household bleach for every 1 liter of

water) and wait 30 minutes before drinking.

4. Always store your treated water in a clean, covered container.

Wash your hands often with soap and safe water

1. Before you eat or prepare food

2. Before feeding your children

3. After using the latrine or toilet

4. After cleaning your childs bottom

5. After taking care of someone ill with diarrhea

6. If no soap is available, scrub hands often with ash or sand and rinse with safe water.

Use latrines or bury your feces (poop); do not defecate in any body of water

1. Use latrines or other sanitation systems, like chemical toilets, to dispose of feces.

2. Wash hands with soap and safe water after defecating.

3. Clean latrines and surfaces contaminated with feces using a solution of 1 part household bleach to 9 parts

water.


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Yes,there is a vaccine for cholera, but it only gives you 25% to 50% immunity from thedisease and is effective up-till 2 years or less.

Few Names:

Shanchol : India

Dukoral : Sweden

mORC-Vax : Vietnam

Vaccine for cholera?


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7 FACTS ON CHOLERA

Cholera is an acute diarrhoeal disease that can kill within hours if left untreated.

There are 100,000120,000 deaths due to cholera every year of which only a smallproportion are reported.

Up to 80% of cases can be successfully treated with oral rehydration salts (ORS)

About 75% of people infected with Vibrio choleraedo not develop any symptoms

Typical at-risk areas of cholera include slums with limited access to safe drinking waterand lack of proper sanitation

Cholera is a preventable disease provided that safe water and proper sanitation aremade available

Safe and effective oral cholera vaccines are now part of the cholera control package


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http://www.youtube.com/watch?v=jG1VNSCsP5Q


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What is Cholera?

Cholera is an infectious disease thatcauses severe watery diarrhea, whichcan lead to dehydration and even

death if untreated. The danger is notfrom the diarrhea, but instead from thedehydration it produces. It is caused byeating food or drinking water that iscontaminated.

What bacteria causes


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What bacteria causesChloera?

Vibrio cholera is the bacteria thatcauses cholera.

The bacterium is usually found in foodor water contaminated by feces froma person with the infection.


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Chronology of a pandemic

Throughout history, populations allover the world have sporadicallybeen affected by devastatingoutbreaks of cholera. Records fromHippocrates (460-377 BC) and Galen(129-216 AD)

1817 from its endemic area in South-

East Asia

In 1961, the 7th cholera pandemicwave began in Indonesia andspread rapidly to other countries inAsia

1991 to Latin America, which hadbeen free of cholera for more thanone century.

1992 in Bangladesh

Haiti 2010


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Rate of infection

Cholera is most common in areas thatlack clean water sources andsanitation services. Areas like refugeecamps and urban slums, where peoplelive in close proximity with little to noaccess to clean water and sanitationfacilities are at a very high risk of

experiencing a cholera epidemic.

Symptoms, including severe waterydiarrhea, can surface in as little as twohours or up to five days after infection,and can then trigger extreme

dehydration and kidney failure. Withsuch a short incubation period, choleracan easily explode into an outbreak


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There are an estimated 35 millioncholera cases and 100 000120 000deaths due to cholera every year.

Filippo Pacini discovered the cholerabacteria in 1854.

Cholera was prevalent in the U.S. inthe 1800s before modern water andsewage treatment systemseliminated its spread bycontaminated water

The first cholera pandemic occurredin the Bengal region of India startingin 1817 through 1824

Key facts


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Prevention/Treatment

Effective control measures rely onprevention, preparedness andresponse.

Up to 80% of cases can be successfullytreated with oral rehydration salts.

Provision of safe water and sanitation iscritical in reducing the impact ofcholera and other waterbornediseases.

Oral cholera vaccines are consideredan additional means to controlcholera, but should not replaceconventional control measures.

Control Measures

PPE


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PPE

The best personal protection equipment against cholera are gloves.

The main route of exposure is through ingestion. Contaminated food byflies.

It can be also be transmitted through contact i.e. People carrying thebacteria on their hands

Mask


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Social and Economic impact

Other people would be infected

Disruption of social and economic structure

impede development in the affected communities

Affects trade and tourism due to restrictions on personsand goods.

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646

Evaluation


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