Transcript Cholera Dr. Rachel Joshua Thundyil

Cholera
Dr. Rachel Joshua Thundyil
Agent
• Gram Negative Bacilli
• Vibrio Cholerae
• Curved, Actively Motile, Flagellated
• Narural Host - Humans
• Transmission – Faeco-oral route
Water
Food
Carriers
Clinical Features
• Incubation Period - few hours to 6 days
• 3 Phases - Evacuation Phase
- Collapse Phase
- Recovery Phase
Evacuation Phase
• Abrupt onset
• Painless
• Watery diarrhoea “rice-water” without
vomitting
Collapse Phase
• Shock – Cold, clammy skin
Tachycardia
Hypotension
Cyanosis
Dehydration – Sunken eyes
Hollow Cheek
Decreased urine output
Recovery Phase
• Patient gradually recovers
Complicaitons
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Shock
Convulsions
Renal Failure
Aspiration Pneumonia
Diagnosis
• Clinical
• Rectal swab for C & S
Treatment
• Rehydration
• Antibiotics
Rehydration
• Mild dehydration
• Moderate dehydration
• Severe dehydration
Mild Dehydration
• Use ORS
• 50 ml/kg in the first 4 hours
• 100 ml/kg till diarrhoea stops
Moderate Dehydration
• Use ORS
• 100 ml/kg in the first 4 hours
• 10 – 15 ml/kg/hour
Severe Dehydration
• Use IV Fluids
• Ringer – Lactate, followed by ORS
Antibiotics
• Doxycyclin 100 mg stat – for adults
• EES for 5 days for children
Thank you