Cholera

Cholera.  Photo from www.wissen.de

What is it?

Cholera — It is an acute infectious disease, particularly relating to dangerous infections. Because of ability in a short time to hit a significant number of people (to cause an epidemic) and50 percent death if untreated, may be considered as a biological weapon.

The causative agent of cholera is Vibrio cholerae (Vibrio cholerae) — slightly curved rod, vaguely resembling a comma. Vibrio have flagella, which allows them to move very quickly. The microorganism was discovered by famous German scientist Robert Koch in 1883.

There are two types of vibrio — a classic andEl Tor — And both of them are dangerous to humans. They are part of the flora of the many ponds are found even in theMoscow River. The decisive question — most of these vibrios per unit volume of water. In order to get sick with cholera, it is necessary to swallow from a million to a trillion microorganisms.

Such a large variation due to the extreme instability of the pathogen to hydrochloric acid, which is in our stomach. If the acidity is reduced (for example, atrophic gastritis) or hydrochloric acid significantly mixed (when using a large amount of liquid), the amount of Vibrio required for infection, reduced 100 thousand times.

Best vibrio proliferates at 30-40° C, so it is especially numerous in the waters of India, Asia and Africa. Exciter almost instantly killed by boiling at 50 ° C — for 30 minutes. Does not make a microbe, and drying and direct sunlight would kill him within the hour.

On the surface of fruits and vegetables, such as watermelon, vibrio can live up to 5 days. The only source of infection — the patient man vibrionositel or out of the region, troubled by cholera, releasing agent with feces or vomit. This method of transmission of epidemiologists call the fecal-oral route.

What if this happens?

Main events begin in the human body when a critical mass of vibrio gets from the stomach into the small intestine. It is warm and humid, the environment is alkaline, which is suitable for mass reproduction microbial pests.

The incubation period lasts from several hours to2-3days.

During his turbulent life of vibrio produce the toxin — choleragen. The toxin causes extensive exudation of tissue into the lumen of the small intestine. And it starts powerful, so-called profuse diarrhea. A general intoxication causes uncontrollable vomiting. Man begins to pour out of a huge amount of liquid.

Clinical severity depends on many factors — the state of the organism, the number of agents lie inside, etc. When worn forms possible single liquid stool, and weak manifestations of intoxication. There is also a form of asymptomatic carriage — when the person does not feel sick, but released into the environment a huge number pathogens.

The classical picture of cholera — is frequent, up to 10 or more times a day, and diarrhea. Fluid loss is enormous — up to 20 liters per day, and in each milliliter contains up to a billion vibrio.

As a result of the massive loss of fluid is blood thickening and dehydration. The patient's condition deteriorated rapidly and dramatically. Because of loss of liquid trace elements appear muscle cramps, often — from the calf muscles.

The facial features are sharpened, eyes sink, turn blue lips and ears. The skin is cold (cholera — One of the few infections that are accompanied by low or normal body temperature). The skin loses its elasticity, easy-going in the folds and cracks down very long back, and the feet and the skin becomes wrinkled hands — the so-called "hands laundress." Shortness of breath, severe weakness.

In the absence of treatment with modern means half of the patients die within the first day.

Diagnostics

Diagnosis of cholera during an outbreak is not difficult and is based, for the most part, in the clinical manifestations. The diagnosis of the first cases require bacteriological confirmation — the release of the pathogen in the vomit or stool. The main thing in the effort to curb the outbreak — isolation of cases and disinfection of sources spread of pathogens.

Treatment

Treatment is carried out in a hospital infection, although because of the rarity of disease transmission directly from an infected person to a healthy WHO experts believe it possible to place such patients in the conventional therapy wards. It should be noted that in recent years to 90% cholera are mild.

The mainstay of treatment — replenishing fluid loss and mikroelemetov, maintenance water and electrolyte andAcid-base balance in the body. Antibiotics — a further treatment facility, Vibrio still sensitive to tetracycline normal. Thanks to the treatment of deaths from cholera in the present does not exceed 1%.

Prophylaxis

Moved infection does not leave behind a persistent immunity and re-infection with cholera is possible at any time of life, and attempts to create an effective vaccine yet fruitless. The effectiveness of vaccination is currently being evaluated in25-50% If the duration of 3-6months, although there have been reports and the creation of a more effective vaccine.

Basic preventive measures when visiting unfavorable for cholera areas — wash your hands before eating or preparing food and after using the toilet. Drink only boiled water, fruits and vegetables after washing with running water necessarily coddle; exclude purchases of products from unsuspecting people, swim only in approved areas.

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