CHOLERA EL TOR

22 Ilagan, Isabelle Louise F.

23 Inumerable, Myzhel S.
24 Jain, Natasha R.
3C-PH

I. Definition
- An acute, sometimes explosive, bacterial enteric
disease caused by a toxin produced by Vibrio cholerae
in the small intestine
- Infectious disease characterized by profuse watery
diarrhea and vomiting
- Rapidly leads to dehydration and death
- Discovered in El Tor, Egypt by E. Gotschlich

II. Synonyms
Asiatic cholera
Cholera bacillus
Cholera infantum
Cholera morbus
Chicken cholera
Hog cholera
Sporadic cholera

III. Morphological Description

Member of the family Vibrionaceae
Facultatively anaerobic, Gram negative, non-spore
forming curved rod about 1.4.-2.6 mm long capable of
respiratory and fermentative metabolism
Bacterium is oxidase positive , reduces nitrate and
motile by the means of a single, sheathed, polar
flagellum
Survives well at ordinary temperature and can grow well
in temperature of 22-40 degrees centigrade

IV. Mode of Transmission

Oral and fecal method
Drinking contaminated water and eating partially
uncooked food fertilized with fecal matter
Survives in the highly acidic part of the stomach
Sticks to the wall of the intestine to reproduce

V. Signs and Symptoms

Abrupt onset of massive diarrhea
Rice-watery stool
Vomiting
Muscle cramps
Dehydration
Sunken eyes and washer-womans hand
Low blood pH
Low blood pressure
Tachycardia

Rice- watery stool

VII. Diagnostic/ Laboratory tests

Rectal swab
Stool exam
CBC
Serum electrolytes
ECG
Antisera
Elevated Hct/ Neutrophil CT

VII. Diagnostic/ Laboratory tests

K+ (low normal or high) and anion gap acidosis
Assess severity of volume depletion
Serogroup confirmation (Either O1 or O139)
Darkfield Phase contrast microscopy of stool
- shows the highly motile vibrios darting through the field
- used to screen liquid or rice-water fecal specimens for V.
cholerae.

VIII. Period of Communicability

Organism is communicable during stool positive stage
and a few days after recovery
Can remain in the system of the carriers for months or
even years

IX. Incubation Period

Cholera has the shortest incubation period of any
infection: ranges from a few hours to 5 days but usually
1-3 days.

X. Prognosis
Can range depending on the severity of the dehydration
and how quickly the patient is given and responds to
treatments
Mortality rates in untreated cholera can be as high as
50%-60% during large outbreaks but can be reduced to
about 1% if treatment protocols are rapidly put into
action

XI. Treatment
Rapid IV infusion of alkaline saline solution
Oral therapy rehydration
Maintenance of the volume of fluid and electrolyte lost
after rehydration
Antibiotic administration

Tetracycline 500 mg every 6 hrs for 3 days

Furazolidone 100 mg every 6 hrs for 3 days
Chloramphenicol 500 mg every 6 hrs for 3 days
Cotrimoxazole 8mg/kg for 3 days

XII. Preventive/ Control measures

Vaccination
Environmental Sanitation

Excreta disposal
Water Supply Sanitation
Food sanitation
Fly control
Disinfection
Proper disposal of dead patients