CHOLERA C holera CHOLERA - PowerPoint Presentation

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CHOLERA

C

holera

CHOLERA

Cholera is a serious disease affecting both children and adults.

It is caused by eating or drinking food or water that is contaminated with the bacterium Vibrio cholerae.

It

is an acute secretory diarrheal illness caused by toxin-producing strains of the gram-negative bacterium  Vibrio cholerae.

CHOLERA

Statistics

Researchers have estimated that every year, there are 1.3 to 4.0 million cases of cholera, and 21 000 to 143 000 deaths worldwide due to CHOLERA infection.

The typical incubation period of Cholera is one to two days. The incubation period of cholera is affected by the host’s vulnerability susceptibility and inoculum size. It can take

between 12 hours and 5 days for a person to show symptoms.

CHOLERA INCUBATION

What is the incubation period?

Cholera infection can cause a range

of symptoms of the disease ranging from asymptomatic to severe illness.

In the early phases of disease, abdominal discomfort, cramping and vomiting are other common symptoms.

Vomiting, may begin either before or after the onset of diarrhoea.

CHOLERA

When should Cholera be suspected?

If a patient presents with:

- severe watery diarrhoea with or without vomiting, - development of rapid and severe volume depletion

CHOLERA INCUBATION

What is the incubation period?

Cholera

incubation period is effected by the host’s vulnerability susceptibility and inoculum size.

The typical incubation period of Cholera is one to two days.

The incubation period

can take

between 12 hours and 5 days for a person to show symptoms.

CHOLERA

Cholera symptoms?

Cholera infection can cause a range

of symptoms of the disease. In the early phases of disease, abdominal discomfort, cramping and vomiting are other common symptoms.

Cholera will then cause acute watery diarrhoea with dehydration.

Vomiting, may begin either before or after the onset of diarrhoea.

CHOLERA

Cholera symptoms

and Clinical Manifestations

Cholera infection can cause a range of symptoms of the disease ranging from asymptomatic to severe illness. In asymptomatic intestinal colonization infected people do not develop any symptoms, although the bacteria are present in their faeces for 1-10 days after infection. This means that bacteria are shed back into the environment, potentially infecting other people.

Mild cases of V. cholerae infection may be clinically indistinguishable from other causes of diarrheal illness. In the early phases of disease, abdominal discomfort, cramping and vomiting are other common symptoms. Vomiting, frequently with watery emesis, is common, and may begin either before or after the onset of diarrhoea.

CHOLERA

Cholera symptoms

and Clinical Manifestations

Cholera will then cause acute watery diarrhoea with dehydration. In severe cholera most complications are related to the significant fluid and electrolyte loss from diarrhoea. Cholera stools may contain faecal matter and bile in the early phases of disease. As the disease progresses "cholera gravis" the characteristic symptom is the passage of profuse "rice-water" stool, a watery stool with flecks of mucous. It typically has a fishy odour. The diarrhoea is usually painless, without tenesmus.

Quantity of stool output in severe cases:

In

adults

, the maximal rate of stool excretion can be up to 1 litre/hour.

In children, the maximal rate of stool excretion can be between 10ml and 20 ml/kg/hour.Within 24 hours from the initial onset of vomiting and diarrhoea there is rapid development of hypovolemic shock.Hypovolemic shock is a dangerous condition that happens when you suddenly lose a lot of blood or fluids from your body.

CHOLERA

Patients with severe hypovolemia may have:

Sunken eyes,

Dry mouth,

Cold clammy skin,

Decreased skin turgor; Skin Turgor can be checked by  pulling up the skin on the back of the hand for an adult or on the skin on the abdomen for a child for a few seconds. If the skin does not return to its original state, it is an indication of decreased skin turgor, caused by dehydration. CHOLERA

Patients with severe hypovolemia may have:

Washer woman's hands“; wrinkled hands and feet

Apathy,

Lethargy,

Kussmaul breathing; fast deep breathingPeripheral pulse is rapid and thready, Muscle cramping and weakness.

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Laboratory testing of cholera:

Lab testing patients with cholera might reveal:

-

Hypokalemia

,- Hyponatremia or hypernatremia - Hypocalcemia,- Acidosis Cholera can kill within hours if untreated. 

CHOLERA

Management:

First course of action:

Perform

assessment of fluid loss: Volume status can be readily assessed through simple examination of the: mental status,eyes, mouth,skin, and pulse. 

CHOLERA

Management:

First course of action:

The degree of volume depletion can be categorized by:

Less than 5 percent of body weight – No loss 5 to 10 percent of body weight – Some lossMore than10 percent of body weight – Severe lossBased on physical findings the continuing losses can be estimated as 10 to 20 mL/kg of body weight for each stool or episode of vomiting.

CHOLERA

Management: Treatment

Aggressive volume repletion:

Rehydration replacement fluids can be given orally, except in the cases of severe volume depletion or shock.

Adequate nutrition In severe cases and shock:Topside Support should be sought immediately The Patient Care Protocol – Cholera Management should be followed closely.

CHOLERA

IF CHOLERA IS SUSPECTED:

ADVICE PATIENTS TO TAKE ACTION

Wash your hands thoroughly with soap and clean water every time you use the toilet.

TAKE ACTION: PREPARE A CLEANING SOLUTION

Making safe clean water for cleaning using household bleach

Prepare a solution for cleaning using:

1 measure of bleach

and add it to

9 measures of clean water.

TAKE ACTION:

CLEAN SURFACES

Clean any surfaces and toilets every time you use the area using the solution prepared of 1 measure of bleach + 9 measures of clean water.

TAKE ACTION:DRINK WATER

Keep hydrated and drink an oral rehydration solution.

TAKE ACTION:

RUSH TO HEALTH CLINIC

Visit a health clinic and continue drinking the oral rehydration solution continuously.