Cholera


Cholera

Description of cholera

Cholera is an infectious disease characterized by severe, life-threatening diarrhea and vomiting.This disease is derived from the Greek word “kholera” which indicates diarrhea.

He described since ancient times and in 1813 was Robert Koch discovered the bacterium Vibrio cholerae původce-. This bacterium is found in two biotypech- classical biotype El Tor biotype or, which is more resistant to adverse environmental conditions.

In 1961, biotype El Tor pandemic caused cholera, which began in the Philippines and spread in Asia, Africa and Europe, and also occurred in the former Czechoslovakia.

In the years 1991- 1994 was the world’s latest cholera epidemic that occurred in South America, and its originator was rediscovered biotype bacteria called O139 Bengal, very resistant to treatment.In faith it had nearly 10,000 deaths.

Risk factors for cholera

Disease typically affects only humans, rarely it was also evidence of transmission to animals. They are the source of animals (especially oysters, fish) living in water contaminated by the feces of a sick man. Vibrio are able to multiply in their bodies, so people become infected by ingestion ofundercooked fish.

It is also possible and direct transmission by drinking contaminated water, in which Vibrio can survive for several years.

Disease occurs after ingestion of at least 1 million bacteria (this number is valid for a healthy adult). For smaller amounts may not happen, because the bacteria are destroyed and the acidic gastric juice into the small intestine where it operates, not even reach. When there but penetrate, they begin to proliferate and produce cholera toxin (choleragen) which binds to a receptor in the cell membrane of the lining of the intestine. Channel is damaged and as a consequence the extreme fluid secretion into the small intestine. Intestinal lining itself remains intact.

Sensitivity to disease is also conditional on other faktory- example taking medication to reduce the acidity of gastric juices (antacids) may relieve the infection, because the bacteria are destroyed in the stomach. Of course, they are also sensitive to people suffering from immune disorders, ormalnourished.

Preventing cholera

Before traveling to areas where cholera is endemic (especially the catchment area of the Ganges, Brahmaputra and Indus), it is recommended to vaccinate. Currently used combined vaccine comprising firstly modified cholera toxin and killed bacteria, which is applied by ingesting (orally).However, it is not completely reliable, only slightly increases the immunity to diseases and the effectiveness lasts for about 6 months.

The most effective prevention remains the observance of personal hygiene, especially washing hands thoroughly before eating and after using the toilet, disinfecting water, or boiling before use.

In areas where cholera is recommended to avoid eating undercooked fish, seafood, do not drink tap water and do not cool drinks with ice cubes made from water unpacked.

After the outbreak of the disease is time for secondary prevention, which consists in preventing the spread of infection and the gradual elimination of sources of infection. In particular, thecollection of faeces of patients and their disinfection, disinfect, also, all the waste water before it is discharged into the environment. Also, the area in which the infection is discovered, it must be properly marked. Drinking water must be filtered before use, chlorinated and overcooked.

symptoms of cholera

Infection begins to manifest itself in a few hours to 5 days after ingestion of contaminated food or water. Typically there is a sudden pain and cramps and diarrhea appear. It is watery, stool has a character murky brownish or grayish fluid in which they swim flakes of mucus resembles rice concoction. Diarrhea is very persistent, leaving stool spontaneously, without compulsion, and at very short intervals.

Sick can lose up to one third of body weight within a few hours.

Diarrhea usually occurs vomiting, the vomit look like stools.

Extreme loss of body water and ions lead to rapidly developing dehydration, blood pressure drops sharply and it is very hard to measure. Heart attempts to maintain adequate blood circulation and the reduced volume of blood, and thus operates at a higher frequency, pulse on arteries but because of reduced blood pressure, weakly palpable.

Patient skin is dry, it is covered with sticky sweat, and has reduced tension (turgor). This voltage is determined by creating algae on the skin, which is only slowly equalized (while in normally hydrated body is aligned almost immediately).

Body temperature drops, the mucous membranes of the oral and nasal cavities are substantially dried-up, the tongue is covered with a coating. The patient complains of thirst and muscle cramps, has sunken eyeballs, it is lethargic, unusually tired or sleepy. There is decreased until completely stopped, urine and tears.

In infants (children under 1 year of age) with dehydration manifested also by reducing the large fontanelle (ligament chips on the head) below the level of the neighborhood.

treatment of cholera

The disease is demonstrated by removing the stool sample which is sent to the laboratory for kultivaci- therefore grow bacteria on special broth. It also shows the presence of antibodies in the blood of a patient against the bacterium itself, or to its toxin.

For suspected cholera (that is, persons suffering from diarrhea without fever, who have returned from endemic regions) is required hospitalization in isolation wards.

Therapy should be initiated as soon as possible, it is mainly about rehydration, thus priming the patient that he can save lives.

During the course of the disease lighter just drink a lot, with serious conditions (when weight loss greater than 10%), it is necessary rehydration infusions, except where water is supplemented lost ions. Rapid rehydration, particularly in the elderly, is an effective prevention of impending myocardial infarction.

In more severe course of the disease are administered antibiotics to prevent further propagation of bacteria in the small intestine (having a bacteriostatic effect). They are used in particulartetracyclines, may also be used chloramphenicol or co-trimoxazole.

How do I help myself

Here, the best treatment is a thorough prevention of disease.
During its development, it is necessary to seek professional help. In addition to endangering the life of the patient himself, it is also important for prevention of further spread of the infection in its vicinity.

complications of cholera

If untreated cholera can occur ** within a few hours of death cause is circulatory failure. For the elderly or people with heart disease are also at increased risk of myocardial infarction **,which can occur as a result of the accelerated rate of cardiac events due to the provision of an adequate blood pressure even at high fluid loss.

Cholera is also dangerous for pregnant women, especially women in the first trimester of pregnancy threatened abortion of the fetus. At a later stage of pregnancy can rapidly progressive dehydration constitute a stress to the body, and this can lead to premature birth.

In the past, if untreated disease deaths in more than 50% cases, while now, with early initiation of appropriate therapy, the mortality rate dropped below 1%.

Other names: infectious cholera, an Asian cholera, cholera epidemic, cholera El Tor cholera unspecified

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