I need information asbout cholera disease
A little from the CDC is below. Want to be more specific about what
information you want, and why you are asking on a cat group?
Microbiology. Cholera is caused by V. cholerae serogroup O1 strains that
produce cholera toxin. The Latin American epidemic strain is biotype El
Tor, serotype Inaba. This strain can be distinguished from the strain of
V. cholerae O1 that is endemic to the U.S. Gulf Coast by hemolysin
production and by molecular subtyping techniques (7).
Clinical Suspicion. Cholera should be suspected in a patient with severe
watery diarrhea, vomiting, and dehydration. The illness is often
accompanied by marked leg cramps, caused by electrolyte disturbances.
However, the spectrum of V. cholerae O1 infection ranges from
asymptomatic infection (75% of infections) through mild diarrhea to the
most severe and clinically recognizable form (5%). Clinical suspicion
should be increased for persons returning from areas known to have
epidemic cholera or for persons with a recent history of ingestion of raw
or undercooked shellfish.
Diagnosis. Cholera is diagnosed by isolation of toxigenic V. cholerae
serotype O1 from feces. Other serogroups of V. cholerae, and nontoxigenic
V. cholerae O1, may be isolated from stools of patients with diarrhea,
but these bacteria are not associated with epidemic cholera. Culture of
rectal swabs or fecal specimens on thiosulfate citrate bile salts sucrose
(TCBS) medium should be requested for any patient suspected to have
cholera. Suspected isolates of V. cholerae should be submitted to public
health laboratories for confirmation. Serologic diagnosis may also be
made by the presence of a changing titer of vibriocidal antibodies.
Treatment. Patients suspected of having cholera should be treated
aggressively while awaiting culture results. In both adults and children,
fluid and electrolyte losses should be replaced by rehydration therapy.
All but severely dehydrated adults and children can be managed largely or
completely with oral rehydration solution (ORS) (8). Patients with mild
to moderate vomiting will absorb ORS taken in small sips. At present,
World Health Organization ORS packets (WHO-ORS,* Jianas Brothers, St.
Louis), RicelyteTM (Mead Johnson), and RehydralyteR (Ross Laboratories)
are the only oral solutions available in the United States that contain
the proper balance of electrolytes for treating cholera. WHO-ORS is
available from the manufacturer; the other two products are available
over the counter. If ORS is not available, rehydration therapy should
begin with intravenous fluids.
Intravenous therapy is necessary for patients who are severely dehydrated
or in hypovolemic shock. The severely dehydrated cholera patient may have
lost more than 10% of body weight and will need rapid volume replacement
with Ringer’s Lactate solution, the only solution readily available in
the United States with the electrolyte composition needed for treating
cholera (9,10). Normal saline is less effective for treatment but can be
used if Ringer’s Lactate is unavailable (10). Severely dehydrated adults
may require several liters of fluid immediately to restore an adequate
circulating volume. As soon as the patient is hemodynamically stable,
oral therapy may be substituted. Patients with cholera have substantial
on-going fluid losses that also need to be replaced.
Antimicrobial drugs are a useful adjunctive therapy, decreasing the
duration of both diarrhea and bacterial shedding and diminishing the
volume of fluid replacement needed for treatment. Antibiotics with
demonstrated effectiveness include doxycycline, tetracycline,
trimethoprim-sulfamethoxazole (TMP-SMX), erythromycin, and furazolidone
(9,10). Adults may be treated with a single 300-mg dose of doxycycline.
Children may be given TMP-SMX twice a day for 3 days at a dose of 5 mg/kg
of TMP and 25 mg/kg of SMX.