cholera - jc caballes

7/31/2019 Cholera - Jc Caballes

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INTRODUCTION

An infection of the S.I. characterized by large

amt of diarrheaMode of Transmission: Ingestion

Reservoir: Unsanitized environment and human

carriers

**Easily treated but easily fatal s/t immediate DHN


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CAUSE

Causative Agent: Vibrio cholerae

Lives either in: environment (stagnant water,

seafoods, raw vegetables and fruits)

Human carrier (transmitted in the stool)

Secretes CTX, a toxin release of

H2O in the S.I.


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**about a full glass of

contaminated H2O is neededto cause CHOLERA


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RESERVOIR/SOURCES

Surface or well water.

Cholera bacteria can lie dormant in water for

long periods, and contaminated public wells

are frequent sources of large-scale cholera

outbreaks.


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RESERVOIR/SOURCES

Seafood.

Eating raw or undercooked seafood,

especially shellfish, that originates from certain

locations can expose you to cholera bacteria.


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RESERVOIR/SOURCES

Raw fruits and vegetables.

Raw, unpeeled fruits and vegetables are

frequent sources of cholera infection in areas

where cholera is endemic.

In developing nations, uncomposted manure

fertilizers or irrigation water containing raw

sewage can contaminate produce in the

field.


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RESERVOIR/SOURCES

Grains.

In regions where cholera is widespread, grains

such as rice and millet that are contaminated

after cooking and allowed to remain at room

temperature for several hours become a

medium for the growth of cholera bacteria .


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RISK FACTORS

** Everyone is susceptible to cholera, with the

exception of infants who derive immunity from nursing

mothers who have previously had cholera.

Exposure to contaminated or untreated drinking

water

Eating contaminated food s/a seafoods, etc.

Living in or traveling to areas where there is

cholera


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RISK FACTORS

Hypochlorydia/Achlorydia

V. cholerae cant survive in acidic env.

Type O blood

For reasons that aren't entirely clear,

people with type O blood are twice as

likely to develop cholera as are people

with other blood types.


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PATHOPHYSIOLOGY

Ms. Manla Lamut went to India

she ate contaminated seafood

V. cholerae enters GIT

bacterium secretes CTX


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SIGNS AND SYMPTOMS

Diarrheas/t CTX seretion

SuddenWatery (rice -water stool) has a "fishy" odor

Abdominal crampss/t diarrhea


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SIGNS AND SYMPTOMS

Rapid DHN sx: Sunken "soft spots" (fontanelles) in infants Dry mucus membranes or mouth Dry skin Excessive thirst

Glassy or sunken eyes Lack of tears Low urine output Lethargy

s/t

DHN
http://en.wikipedia.org/wiki/File:Adult_cholera_patient.jpg


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A person with severe dehydration due

to cholera. Note the sunken eyes and

decreased skin turgor which

produces wrinkled hands ("Washer

Woman's Hand" sign).
http://en.wikipedia.org/wiki/File:Adult_cholera_patient.jpghttp://en.wikipedia.org/wiki/File:Adult_cholera_patient.jpghttp://en.wikipedia.org/wiki/File:Adult_cholera_patient.jpghttp://en.wikipedia.org/wiki/File:Adult_cholera_patient.jpghttp://en.wikipedia.org/wiki/File:Adult_cholera_patient.jpghttp://en.wikipedia.org/wiki/File:Adult_cholera_patient.jpghttp://en.wikipedia.org/wiki/File:Adult_cholera_patient.jpg


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DIAGNOSTICS

Rapid cholera dipstick tests

Blood CultureMust be done @ night bec. Microfilariae

proliferate more @ night

Stool Culture


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MEDICAL MANAGEMENT

GOAL: Fluid replacement STAT!!!

Rehydration.The ORS solution is available as a powder that

can be reconstituted in boiled or bottled

water.

Without rehydration, approximately half the

people with cholera die.


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MEDICAL MANAGEMENT

Intravenous fluids.

During a cholera epidemic, most people canbe helped by oral rehydration alone, but

severely dehydrated people may also need

intravenous fluids.


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MEDICAL MANAGEMENT

Zinc supplements.

Research has shown that zinc may decreaseand shorten the duration of diarrhea in

children with cholera.


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NURSING INTERVENTIONS

o Monitor UO to determine how severe thefluid loss is .

o Encourage OFI to replace fluid loss .

o Encourage bed rest to conserve energy .

o Admin meds as prescribed.


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PROGNOSIS

Severely fatal

if untreated immediately.


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PREVENTION

Proper hand washing

Done after going to the toilet or beforehandling foods.

Rub soapy, wet hands together for at least 15

seconds before rinsing.If soap and water aren't available, use an

alcohol-based hand sanitizer.


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PREVENTION

Drink only safe water, including bottled

water or water you've boiled or disinfected yourself.

Use bottled water even to brush your

teeth if you are in an endemic area.


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PREVENTION

Hot beverages are generally safe, as

are canned or bottled drinks, but wipethe outside before you open them.

Eat food that's completely cooked

and hot and avoid street vendor food,

if possible.


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PREVENTION

Avoid sushi, as well as raw or

improperly cooked fish and seafood ofany kind.

Stick to fruits and vegetables that you

can peel yourself, such as bananas,

oranges and avocados.


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PREVENTION

Be wary of dairy foods, including ice

cream, which is often contaminated,and unpasteurized milk.

Prevaccinate if to be exposed to thebacteria


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UPDATES

IVI receives WHO Prequalification for New

Oral Cholera VaccineShanchol, a new oral cholera vaccine developed

through the International Vaccine Institute (IVI)

ready to use in a single-dose vial and is administered

orally, which facilitates its implementation in large-

scale immunization programs.


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THINGS TO REMEMBER:

V ibrio cholerae C TX toxin diarrhea

H ighly fatal if untreated

O ral route L arge loss of body fluids (severe DHN) mostdangerous complication

E xtraction of bld specimen for bld culture (dxc) R ice-water stool (hallmark)

A bx therapy (Azithromycin/doxycycline) mainstay

E vening extraction


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cholera - jc caballes

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