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Brendan Dougherty

on 16 November 2013

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Transcript of Cholera

Strain: O1 (cause of most cases) & O139 (confined to Southeast Asia) Other strains are not epidemic

Fecal-oral transmission

Bacteria colonize and attach to small intestine
Cholera toxin secreted after colonization
Toxin stimulates chloride secretion and decreases sodium absorption - this leads to massive fluid and electrolytes loss
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Butterton, J. R., Calderwood, S. B., & Baron, E. L. (2013, february 2013). Pathogenesis of Vibrio cholearae infection Retrieved March 18, 2013, from http://www.uptodate.com/contents/pathogenesis-of-vibrio-cholerae-infection#H1
Durrheim, D. (January 01, 2004). Prevention of cholera. Lancet, 363, 9412, 897-8.
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Mahamud, A. S., Ahmed, J. A., Nyoka, R., Auko, E., Kahi, V., Ndirangu, J., Nguhi, M., Burton, J. W., Muhindo, B. Z., Breiman, R. F., & Eidex, R. B. (2012). Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap. Journal of Infection in Developing Countries, 6(3), 234-241.
Organization, W. H. (2012, July 2012). Cholera. Fact sheet Retrieved March 18, 2013, from http://www.who.int/mediacentre/factsheets/fs107/en/index.html
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Rosewell, A., Addy, B., Komnapi, L., Makanda, F., Ropa, B., Posanai, E., Dutta, S., Mola, G., Man, W. N., Zwi, A., & MacIntyre, C. R. (2012). Cholera risk factors, Papua New Guinea, 2010. BMC Infectious Diseases, 12(1), 287.
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V.Cholerae attach to exoskeleton and gut of crustacean plankton (mainly copepods)
Often symbiotic or commensal
Vibrio cholerae
Environmental Factors Affecting Transmission
Plankton Biomass
Environment and transmission:
social aspects
Developing countries:
water sanitation, sewage
-biosand filters for pumps
-soap, antibacterial
-Health facilities without proper infection control
-Proximity to contaminated water
-Travel, Trade, Population displacement
-Population density
Developed/developing countries
-cook food (esp. seafood) (and treat water used in cooking)
1- Cholera is one of the oldest disease studied

2- 75% of infected people are asymptomatic carriers

3- Cholera causes severe dehydration due to diarrhea

4- Cholera transmission controlled by water conditions (pH, temperature, salinity...) and social factors (hygiene, sewage treatment, food preparation...)

Acute watery diarrhea
dult and children are both susceptible, however mortality rates are mostly children
5% do not develop symptoms but are carriers that can spread the disease
After 3-4 hours of symptoms - become severely dehydrated
Can die within 24 hours if no treatment

Oral re-hydration and IV fluids
Antibiotics can be prescribed to decrease diarrhea
Must regain electrolytes
Group 12
The setting...
You are a great detective, living in London England
The year is 1854, and you are investigating the curious case of an outbreak of vomiting and diarrhea. Ask questions to the people of London (age, occupation, food source, water source) to determine the cause of the illness.
W/out Copepods
With copepods
Bacterial attachment to Copepods increases with increased temperature (Highest at 30 degrees C)
Copepod attachment
Full transcript