CholeraCholera

Dr. Rachel Joshua ThundyilDr. Rachel Joshua Thundyil

AgentAgent

• Gram Negative Bacilli

• Vibrio Cholerae

• Curved, Actively Motile, Flagellated

• Narural Host - Humans

• Transmission – Faeco-oral route

Water

Food

Carriers

Clinical FeaturesClinical Features

• Incubation Period - few hours to 6 days

• 3 Phases - Evacuation Phase

- Collapse Phase

- Recovery Phase

Evacuation PhaseEvacuation Phase

• Abrupt onset

• Painless

• Watery diarrhoea “rice-water” without vomitting

Collapse PhaseCollapse Phase

• Shock – Cold, clammy skin

Tachycardia

Hypotension

CyanosisDehydration – Sunken eyes

Hollow Cheek

Decreased urine output

Recovery PhaseRecovery Phase

• Patient gradually recovers

ComplicaitonsComplicaitons

• Shock

• Convulsions

• Renal Failure

• Aspiration Pneumonia

DiagnosisDiagnosis

• Clinical

• Rectal swab for C & S

TreatmentTreatment

• Rehydration

• Antibiotics

RehydrationRehydration

• Mild dehydration

• Moderate dehydration

• Severe dehydration

Mild DehydrationMild Dehydration

• Use ORS

• 50 ml/kg in the first 4 hours

• 100 ml/kg till diarrhoea stops

Moderate DehydrationModerate Dehydration

• Use ORS

• 100 ml/kg in the first 4 hours

• 10 – 15 ml/kg/hour

Severe DehydrationSevere Dehydration

• Use IV Fluids

• Ringer – Lactate, followed by ORS

AntibioticsAntibiotics

• Doxycyclin 100 mg stat – for adults

• EES for 5 days for children

Thank youThank you