Cholera is an infection of the small intestine by some of the bacterial strains Vibrio cholerae . Symptoms can range from none, to mild, to severe. The classic symptom is a large amount of watery diarrhea lasting several days. Vomiting and muscle cramps can also occur. Diarrhea can be so severe as to cause working hours to severe dehydration and electrolyte imbalances. It can cause sunken eyes, cold skin, decreased skin elasticity, and wrinkles on the hands and feet. Dehydration can cause skin to bluish. Symptoms begin two hours to five days after exposure.
Cholera is caused by a number of types of Vibrio cholerae , with some species producing more severe disease than others. These are scattered mostly by unsafe water and unsafe food that has been contaminated with human waste containing bacteria. Half-cooked seafood is a common source. Humans are the only animals affected. Risk factors for this disease include poor sanitation, inadequate clean drinking water, and poverty. There is concern that rising sea levels will increase disease rates. Cholera can be diagnosed with a stool test. The dipstick test is quickly available but not accurate.
Cholera prevention methods include improved sanitation and access to clean water. Cholera vaccine given by mouth provides reasonable protection for about six months. They have the added benefit of protecting against other types of diarrhea caused by E. coli . The main treatment is oral rehydration therapy - fluid replacement with a slightly sweet and salty solution. Rice-based solutions are preferred. Zinc supplementation is useful in children. In severe cases, intravenous fluids, such as Ringer's lactate, may be necessary, and antibiotics may be beneficial. Testing to see which antibiotics are susceptible to cholera can help guide choice.
Cholera affects about 3-5 million people worldwide and causes 28,800-130,000 deaths per year. Although classified as a pandemic in 2010, it is rare in developed countries. Children are mostly affected. Cholera occurs both as an outbreak and is chronic in certain areas. Areas with ongoing disease risk include Africa and Southeast Asia. The risk of death among those affected is usually less than 5% but may be as high as 50%. There is no access to treatment that results in higher mortality. The description of cholera was discovered at the beginning of the 5th century BC in Sanskrit. The study of cholera in England by John Snow between 1849 and 1854 led to significant progress in the epidemiological field.
Video Cholera
Signs and symptoms
The main symptoms of cholera are excessive diarrhea and vomiting clear fluids. These symptoms usually start suddenly, half a day to five days after ingestion of bacteria. Diarrhea is often described as "rice water" in nature and may have a fishy smell. People who are not treated with cholera can cause 10 to 20 liters (3 to 5 days) of diarrhea a day. Cholera is heavy, without treatment, killing about half of the affected individuals. If severe diarrhea is untreated, it can lead to life-threatening dehydration and electrolyte imbalances. Estimates of asymptomatic ratios for symptomatic infections range from 3 to 100. Cholera is dubbed "blue death" because a person's skin may turn into a bluish gray due to excessive loss of fluid.
Fever is rare and should raise suspicions of secondary infection. Patients may become lethargic, and may have sunken eyes, dry mouth, cold sweaty skin, or wrinkled hands and feet. Respiratory kussmaul, deep and working respiratory patterns, may occur due to acidosis of the stools losing bicarbonate and lactic acidosis associated with poor perfusion. Blood pressure decreases due to dehydration, rapid and weak peripheral pulses, and urine output decreases with time. Muscle cramps and weakness, altered consciousness, seizures, or even coma because electrolyte imbalances are common, especially in children.
Maps Cholera
Cause
Transmission
Cholera has been found in two animal populations: shells and plankton.
Transmission is usually through the fecal-oral route of contaminated food or water caused by poor sanitation. Most cases of cholera in developed countries are the result of foodborne transmission, while in developing countries more water is common. Food transmission can occur when people harvest seafood like oysters in infected waters of waste, such as Vibrio cholerae accumulated in planktonic crustaceans and oysters feeding on zooplankton.
People who are infected with cholera often experience diarrhea, and disease transmission can occur if these very liquid stools, daily referred to as "rice water", contaminate water used by others. Single diarrhea events can cause a one-million-fold increase in the number of V. cholerae in the environment. The source of contamination is usually other cholera sufferers when their untreated diarrheal fluid is allowed into the drains, ground water supply or drinking water. Drinking contaminated water and eating washed foods in water, as well as shellfish that live in affected waters, can cause a person to get infected. Cholera rarely spreads from person to person.
V. cholerae also exists outside the human body in natural water sources either by itself or through interacting with phytoplankton, zooplankton, or biotic and abiotic detritus. Drinking such water can also cause illness, even without prior contamination through feces. However, selective pressure exists in an aquatic environment that can reduce virulence V. cholerae . In particular, animal models suggest that pathogenic transcription profiles change when preparing to enter the aquatic environment. This transcriptional change results in the loss of the ability of V. cholerae to be cultivated on standard media, a phenotype called 'viable but non-culturable' (VBNC) or more conservative 'active but non-culturable' (ABNC). One study showed that culture V. cholerae fell 90% within 24 hours of entering water, and furthermore, the loss of culture ability was associated with loss of virulence.
Both toxic and non-toxic strains exist. Non-toxic strains can obtain toxicity through temperate bacteriophages.
Vulnerability
About 100 million bacteria usually have to be swallowed to cause cholera in normal healthy adults. These doses, however, are less in those with lower gastric acidity (eg those using proton pump inhibitors). Children are also more vulnerable, with children two to four years old having the highest infection rates. Individual susceptibility to cholera is also affected by their blood type, with those with blood type O being the most vulnerable. People with low immunity, such as people with AIDS or malnourished children, are more likely to experience severe cases if they become infected. Every individual, even a healthy adult in middle age, may experience severe cases, and each person's case should be measured with fluid loss, should consult a professional health care provider.
The genetic mutation of cystic fibrosis known as delta-F508 in humans has been said to retain selective heterozygotes of advantage: the mutant heterozygote carrier (which is unaffected by cystic fibrosis) is more resistant to V. cholerae infection. In this model, a genetic deficiency in transmembrane cystic fibrosis conduction of regulatory channel proteins interferes with bacteria that bind the intestinal epithelium, thus reducing the effects of infection.
Mechanism
When consumed, most bacteria do not survive the human stomach acid conditions. Bacteria that survive save less energy and nutrients stored during the trip through the stomach by shutting off protein production. When the live bacteria come out of the stomach and reach the small intestine, they must push themselves through the thick mucus that lines the small intestine to reach the intestinal wall where they can stick and grow.
Once the cholera bacteria reach the intestinal wall, they no longer need flagella to move. Bacteria stop producing protein flagellins to save energy and nutrients by altering the protein mixture they express in response to changes in the chemical environment. Upon reaching the intestinal wall, V. cholerae starts producing toxic proteins that give people infected with watery diarrhea. This brings a new generation of bacteria out into the drinking water from the next host if proper sanitary measures are not in place.
Cholera toxin (CTX or CT) is an oligomeric complex consisting of six protein subunits: one copy of subunit A (part A), and five copies of subunit B (part B), connected by a disulfide bond. The five B subunits form a five membered ring that binds the GM1 ganglioside to the surface of the gut epithelial cell. Part A of subunit A is an enzyme that is a protein ADP-ribosylate G, whereas the A2 chain fits into the central pore of the B subunit ring. After binding, the complex is brought to the cell via a receptor-mediated endocytosis. Once inside the cell, the disulfide bond is reduced, and the A1 subunit is released to bind with a human partner protein called ADP-ribosylation factor 6 (Arf6). Binding exposes its active site, allowing it to permanently perform ribosilate in the alpha Gs subunit of the heterotrimeric G protein. This results in the production of cAMP constitutive, which in turn causes the secretion of water, sodium, potassium, and bicarbonate into the intestinal lumen and rapid dehydration. The gene encoding cholera toxin is inserted into V. cholerae with horizontal gene transfer. The virulent strain of V. cholerae carries a variant of a temperate bacteriophage called CTX.
Microbiologists have studied the genetic mechanism by which the bacteria kill bacteria and produce other proteins because they respond to a series of chemical environments they encounter, passing through the stomach, through the lining of the small intestine, and into the walls intestines. What is interesting is the genetic mechanism by which the cholera bacteria activate the production of proteins from toxins that interact with the stem cell mechanism to pump chloride ions into the small intestine, creating an ionic pressure that prevents sodium ions from entering the cell. Chloride and sodium ions create a saltwater environment in the small intestine, which through osmosis can attract up to six liters of water per day through the intestinal cells, creating large amounts of diarrhea. The host can become rapidly dehydrated unless the right mixture of dilute water and sugar is taken to replace the blood and salt water lost in the diarrhea.
By incorporating separate and separate parts of V. cholerae DNA into other bacterial DNA, such as E. coli which naturally will not produce protein toxins, researchers have investigated the mechanism by which < i> V. cholerae responds to changes in the chemical environment of the stomach, mucosal lining, and intestinal wall. Researchers have found an elaborate cascade of regulating proteins that control the expression of V. cholerae the determinants of virulence. In response to the chemical environment of the intestinal wall, bacteria produce bacteria TcpP/TcpH, which, together with the ToxR/ToxS protein, activates the expression of the ToxT regulatory protein. ToxT then directly activates the expression of virulence genes that produce toxins, causing diarrhea in infected people and allowing bacteria to colonize the intestines. The current study aims to find "a signal that makes the cholera bacteria stop swimming and begin colonizing (ie, obeying the cells) of the small intestine."
Genetic structure
Amplification of long fragments of fingerprint polymorphisms from pandemic isolates V. cholerae has revealed variations in the genetic structure. Two groups have been identified: Cluster I and Cluster II. For the most part, Cluster I consists of strains from the 1960s and 1970s, while Cluster II mostly contains strains from the 1980s and 1990s, based on changes in clone structure. This grouping of strains is best seen in strains of the African continent.
Antibiotic resistance
In many areas of the world, antibiotic resistance increases in cholera bacteria. In Bangladesh, for example, most cases are resistant to tetracycline, trimethoprim-sulfamethoxazole, and erythromycin. Rapid diagnostic test methods are available for the identification of drug-resistant cases. New-generation antimicrobials have been found to be effective against cholera bacteria in in vitro studies .
Diagnosis
A rapid dipstick test is available to determine the presence of V. cholerae . In a positive sample, further testing should be performed to determine antibiotic resistance. In an epidemic situation, a clinical diagnosis can be done by taking a patient history and performing a brief examination. Treatment usually begins without or before confirmation by laboratory analysis.
Stool samples and samples collected at the acute stage of the disease, before antibiotics are given, are the most useful specimens for laboratory diagnosis. If a cholera epidemic is suspected, the most common causative agent is V. cholerae O1. If V. cholerae serogrup O1 is not isolated, the laboratory should test for V. cholerae O139. However, if none of these organisms is isolated, it is necessary to send the stool specimen to the referral laboratory.
Infection with V. cholerae O139 should be reported and treated in the same way as is caused by V. cholerae O1. The associated diarrheal diseases should be referred to as cholera and should be reported in the United States.
Prevention
The World Health Organization (WHO) recommends focusing on prevention, preparedness and response to combat the spread of cholera. They also stressed the importance of an effective oversight system. Governments can play a role in all these areas.
Although cholera can be life-threatening, disease prevention is usually immediate if good sanitation practices are followed. In developed countries, because almost universal drinking and sanitation practices are present there, cholera is rare. For example, the last major outbreak of cholera in the United States occurred in 1910-1911. Cholera is primarily a risk in developing countries.
An effective sanitation practice, if instituted and adhered to in time, is usually enough to stop the epidemic. There are several points along the cholera transmission line where the spread can be stopped:
- Sterilization: Proper disposal and treatment of all materials that may have come into contact with the cholera victims' feces (eg, clothing, sleeping mats, etc.) is essential. It should be cleaned by washing it in hot water, using chlorine bleach if possible. Hand touching cholera patients or clothing, bedding, etc., Should be thoroughly cleaned and disinfected with water containing chlorine or other effective antimicrobial ingredients.
- Waste and faecal management: In areas affected by cholera, fecal waste and mud needs to be carefully managed and managed to stop the spread of the disease through human waste. The provision of sanitation and hygiene is an important precautionary measure. Lethal disposal, untreated waste disposal, or disposal of sludge from septic or septic tanks into the environment should be prevented. In many zones affected by cholera, there is a low level of sewage treatment. Therefore, the application of dry toilets that do not contribute to water pollution, as they do not flush with water, may be an attractive alternative to flush toilets.
- Source: Warnings about the possibility of cholera contamination should be installed around contaminated water sources with instructions on how to decontaminate water (boiling, efficacious etc.) for possible use.
- Water purification: All water used for drinking, washing, or cooking should be sterilized by boiling, chlorination, ozone water treatment, ultraviolet ray sterilization (eg, by solar water disinfection), or antimicrobial screening in any area where cholera may be present. Chlorination and boiling are often the cheapest and most effective ways to stop transmission. Fabric filters or filtration, though very basic, have significantly reduced the occurrence of cholera when used in poor villages in Bangladesh that depend on untreated surface waters. Better antimicrobial filters, such as those in the advanced individual water treatment hiking kits, are most effective. Public health education and adherence to proper sanitation practices are the most important to help prevent and control the transmission of cholera and other diseases.
Washing hands with soap or ashes after using the toilet and before handling food or eating is also recommended for cholera prevention by WHO Africa.
Supervision
Supervision and rapid reporting make it possible to contain cholera epidemics quickly. Cholera exists as a seasonal disease in many endemic countries, occurring every year mostly during the wet season. The surveillance system can provide early warning for outbreaks, leading to a coordinated response and help prepare preparedness plans. An efficient surveillance system can also increase risk assessments for possible outbreaks of cholera. Understanding the season and location of the outbreak provides guidance for improving cholera control activities for the most vulnerable. For prevention to be effective, it is important that cases be reported to national health authorities.
Vaccines
A number of safe and effective oral vaccines for cholera are available. The World Health Organization has three prequalified oral cholera vaccines (OCVs): Dukoral, Sanchol, and Euvichol. Ducoral, intact orally activated whole-cell vaccine, has an overall efficacy of about 52% during the first year after being given and 62% in the second year, with minimal side effects. It is available in over 60 countries. However, it is not currently recommended by the Centers for Disease Control and Prevention (CDC) for most people traveling from the United States to endemic countries. The FDA-recommended vaccine, Vaxchora, is an attenuated oral live vaccine, which is effective as a single dose.
One injectable vaccine was found to be effective for two to three years. The protective properties are 28% lower in children less than 5 years. However, in 2010, its availability is limited. Work is underway to investigate the role of mass vaccination. The World Health Organization (WHO) recommends immunization of high-risk groups, such as children and people with HIV, in countries where the disease is endemic. If people are immunized widely, the immune flock results, with a decrease in the amount of contamination in the environment.
Filter Sari
An effective and relatively inexpensive method of preventing cholera transmission is the use of folded folds (long garment clothing) to filter out drinking water. In Bangladesh, this practice was found to lower cholera by nearly half. This involves folding sari four to eight times. Between using the cloth should be rinsed with clean water and dried in the sun to kill the bacteria on it. Nylon fabric seems to work as well but not reachable.
Treatment
Eating continues to speed up normal bowel function recovery. The World Health Organization recommends this in general for diarrhea cases no matter what the cause. A special CDC training guide for cholera states: "Keep feeding your baby if the baby has watery diarrhea, even when traveling for treatment. Adults and older children should continue to eat frequently."
Fluid
The most common mistake in treating patients with cholera is to underestimate the speed and volume of fluids required. In most cases, cholera can be successfully treated with oral rehydration therapy (ORT), which is highly effective, safe, and manageable. Rice-based solutions are preferred for glucose-based ones because of greater efficiency. In severe cases with significant dehydration, intravenous rehydration may be necessary. Ringer's lactate is the preferred solution, often with the addition of potassium. Large volumes and subsequent replacement until diarrhea has subsided may be necessary. Ten percent of a person's body weight in a liquid may need to be given in the first two to four hours. This method was first tried on a mass scale during the Bangladesh Liberation War, and was found to have much success. Despite widespread belief, commercial fruit juices and sparkling drinks such as cola, are not ideal for rehydration of people with serious intestinal infections, and their excessive sugar content can even damage the taking of water.
If commercially produced oral rehydration solutions are too expensive or difficult to obtain, solutions can be made. One such recipe requires 1 liter of boiled water, 1/2 teaspoon of salt, 6 teaspoons of sugar, and added mashed bananas for potassium and for enhancing flavor.
Electrolytes
Because of the frequent initial acidosis, potassium levels may be normal, despite great loss. When dehydration is corrected, potassium levels may drop rapidly, and therefore need to be replaced. This can be done by eating foods high in potassium, such as bananas or coconut water.
Antibiotics
Treatment of antibiotics for one to three days shortens the course of the disease and reduces the severity of the symptoms. The use of antibiotics also reduces the need for fluids. People will recover without them, however, if sufficient hydration is maintained. The World Health Organization only recommends antibiotics in those with severe dehydration.
Doxycycline is usually used first line, although some strains V. cholerae have shown resistance. Testing endurance during an outbreak can help determine the right future choices. Other antibiotics that are proven effective include cotrimoxazole, erythromycin, tetracycline, chloramphenicol, and furazolidone. Fluoroquinolones, such as ciprofloxacin, may also be used, but resistance has been reported.
Antibiotics improve results in those who are very severe and do not get severe dehydration. Azithromycin and tetracycline may work better than doxycycline or ciprofloxacin.
Zinc supplements
Zinc supplements in Bangladesh reduce the duration and severity of diarrhea in children with cholera when administered with antibiotics and rehydration therapy as needed. This reduces the disease length by eight hours and the amount of diarrhea droppings by 10%. Supplementation seems also effective in treating and preventing diarrhea due to other causes among children in developing countries.
Prognosis
If people with cholera are treated promptly and promptly, the mortality rate is less than 1%; However, with untreated cholera, the mortality rate increases to 50-60%.
For certain genetic strains of cholera, such as those present during the 2010 epidemic in Haiti and the 2004 outbreak in India, deaths can occur within two hours of falling ill.
Epidemiology
Cholera affects around 3-5 million people worldwide, and causes 58,000-130,000 deaths per year in 2010. This occurs mainly in developing countries. In the early 1980s, the death toll was believed to be more than three million a year. It is difficult to calculate the exact number of cases, as many are not reported because of fears that the outbreak may have a negative impact on a country's tourism. Cholera remains an epidemic and endemic in many areas of the world. In October 2016, a cholera outbreak began in war-torn Yemen. WHO called it "the world's worst cholera outbreak".
Although much is known about the mechanism behind the spread of cholera, this does not lead to a full understanding of what makes cholera outbreaks occur in some places and not others. Lack of human fecal treatments and lack of drinking water treatments are helpful in spreading, but water bodies can serve as reservoirs, and long-haul seafood can spread the disease. Cholera was not known in America for much of the 20th century, but reappeared towards the end of the century.
History
The word cholera comes from Greek: ?????? kholera from ???? khol? "bile". Cholera probably originates from the Indian subcontinent as evidenced by its prevalence in the region over the centuries. Early outbreaks in the Indian subcontinent are believed to be the result of poor living conditions and the presence of puddles, both of which provide ideal conditions for cholera to thrive. The disease first spread through trade routes (land and sea) to Russia in 1817, then throughout Europe, and from Europe to North America and around the world. Seven cholera pandemics have occurred in the last 200 years, with the seventh pandemic coming from Indonesia in 1961.
The first cholera pandemic occurred in the Indian Bengal region, near Calcutta from 1817 to 1824. The disease spread from India to Southeast Asia, the Middle East, Europe, and East Africa through trade routes. The second pandemic lasted from 1829 to 1851 and mainly affected North America and Europe as a result of advances in global transport and trade, and increased human migration, including the army. The third pandemic erupted in 1852, lasting until 1860, extending into North Africa, and reaching South America, for the first time in particular affecting Brazil. The fourth pandemic lasted from 1863 to 1875 spread from India to Naples and Spain. The fifth pandemic was from 1881-1896 and started in India and spread to Europe, Asia, and South America. The sixth pandemic began from 1899 to 1923. This epidemic is less fatal because of a greater understanding of cholera bacteria. Egypt, the Arabian Peninsula, Persia, India and the Philippines were most severely hit during the epidemic, while other areas, such as Germany in 1892 and Naples from 1910-1911, also experienced severe outbreaks. The seventh pandemic originated in 1961 in Indonesia and is characterized by the emergence of a new strain, dubbed El Tor , which is still ongoing (in 2018) in developing countries.
Since it was widespread in the 19th century, cholera has killed tens of millions of people. In Russia alone, between 1847 and 1851, more than a million people died from the disease. It killed 150,000 Americans during the second pandemic. Between 1900 and 1920, perhaps eight million people died of cholera in India. Cholera becomes the first disease that can be reported in the United States because of its significant health effects. John Snow, in England, was the first to identify the importance of contaminated water as a cause in 1854. Cholera is now no longer considered a pressing health threat in Europe and North America due to filtering and chlorination of water supplies, but still greatly affecting populations in developing countries.
In the past, ships were flying yellow quarantine flags if there were crew members or passengers suffering from cholera. No one on the ship flying a yellow flag will be allowed to land for long periods, usually 30 to 40 days. In the modern set of international maritime signal flags, yellow and black quarantine flags.
Historically many different claimed drugs have existed in folklore. Many older treatments are based on the theory of miasma. Some believe that a cold belly makes people more vulnerable and flannel and cholera belts routine in military equipment. In 1854-1855 an outbreak in Naples, homeopathy camphor was used according to Hahnemann. The book "Mother's Remedies" by T. J. Ritter lists tomato syrup as home-based medicine from North America. Elecampane is recommended in the UK according to William Thomas Fernie.
Cholera cases are much less frequent in developed countries where governments have helped to build water sanitation practices and effective medical care. The United States, for example, used to have severe cholera problems similar to those in some developing countries. There were three major cholera outbreaks in the 1800s, which could be associated with Vibrio cholerae spreading through interior waterways such as the Erie Canal and the route along the East Coast. Manhattan Island in New York City touches the Atlantic Ocean, where cholera is gathered offshore. At this time, New York City does not have such an effective sanitation system now, so cholera can spread.
Cholera morbus is a historical term used to refer specifically to gastroenteritis rather than cholera.
Research
The bacteria were isolated in 1854 by Italian anatomist Filippo Pacini, but their exact nature and results were not widely known.
Spanish physician Jaume Ferran Clua developed cholera inoculation in 1885, the first to immunize humans against bacterial disease.
Russian-Jewish bacteriologist Waldemar Haffkine developed the first cholera vaccine in July 1892.
One of the major contributions to combating cholera was made by the pioneering doctor and medical scientist John Snow (1813-1858), who in 1854 found an association between cholera and contaminated drinking water. Dr. Snow proposed the origin of microbes for cholera epidemics in 1849. In a "sophisticated" study in 1855, he proposed a model that was substantially complete and appropriate for the cause of the disease. In two pioneering epidemiologic field studies, he was able to show contamination of human waste was the most probable disease vector in two major epidemics in London in 1854. His model was not immediately accepted, but seems to be more plausible, as medical microbiologists developed over the next 30 years or more.
Cities in developed countries invested heavily in clean water supply and sewage treatment infrastructure separated between the mid-1850s and 1900s. This eliminates the threat of cholera epidemics from the world's major developing cities. In 1883, Robert Koch identified V. cholerae with a microscope such as bacillus that caused the disease.
Robert Allan Phillips, who worked at the US Naval Medical Research Unit, Two in Southeast Asia, evaluated the pathophysiology of the disease using modern laboratory chemistry techniques and developed a protocol for rehydration. His research led the Lasker Foundation to award him a prize in 1967.
More recently, in 2002, Nature, et al. , studying stool samples from patients at the International Center for Diarrheal Disease in Dhaka, Bangladesh. From the various experiments they performed, the researchers found a correlation between the V. cholerae section through the human digestive system and increased status of infectivity. Furthermore, the researchers found the bacteria create a hyperinfected state in which genes that control the biosynthesis of amino acids, the iron absorption system, and the formation of periplasmic nitrate reductase complex are induced just before the bowel movements. These induced characteristics allow cholera vibrios to survive in stools of "rice water", environments with limited oxygen and iron, patients with cholera infection.
Society and culture
Health policy
In many developing countries, cholera still reaches its victims through contaminated water sources, and countries without proper sanitation techniques have a greater incidence of disease. The government can play a role in this. In 2008, for example, the Zimbabwean cholera outbreak was in part due to the government's role, according to a report from the James Baker Institute. The inability of the Haitian government to provide safe drinking water after the 2010 earthquake caused an increase in cases of cholera as well.
Similarly, the cholera outbreak in South Africa is exacerbated by government policies to privatize water programs. The wealthy elite in the country are able to buy safe water while others have to use water from a river infected with cholera.
According to Rita R. Colwell of the James Baker Institute, if cholera begins to spread, government readiness is essential. The government's ability to control the disease before it extends to other areas can prevent high casualties and the development of epidemics or even a pandemic. Effective disease control can ensure that cholera outbreaks are acknowledged as soon as practicable and handled appropriately. Often, this will allow public health programs to determine and control the cause of the case, whether it is unhealthy water or seafood that has collected many specimens of Vibrio cholerae . Having an effective surveillance program contributes to the government's ability to prevent cholera from spreading. In 2000 in India's Kerala state, Kottayam district was determined to be "Cholera-affected"; this statement led to a task force concentrating on educating citizens with 13,670 information sessions on human health. The task force promotes boiling water for safe water, and provides chlorine salts and oral rehydration salts. Ultimately, it helps control the spread of the disease to other areas and minimizes death. On the other hand, researchers have shown that the majority of infected people during the 1991 cholera outbreak in Bangladesh live in rural areas, and are not recognized by government oversight programs. This inhibits the ability of doctors to detect cases of cholera early.
According to Colwell, the quality and inclusiveness of a country's health care system affect the control of cholera, as happened in the Zimbabwean cholera epidemic. Although sanitation practices are important, when the government responds quickly and vaccines are available, the country will have less victims of cholera death. The affordability of a vaccine can be a problem; if the government does not give vaccinations, only the rich can afford it and there will be more victims to the poor in the country. The speed of government leaders responding to cholera outbreaks is important.
In addition to contributing to an effective or declining public health care system and water sanitation treatments, governments can have an indirect effect on cholera control and effectiveness of response to cholera. A country's government can influence its ability to prevent disease and control its spread. Rapid government response is supported by a fully functioning health care system and financial resources can prevent the spread of cholera. This limits the ability of cholera to cause death, or at least a decrease in education, as children are banned from school to minimize the risk of infection.
Important case
- Tchaikovsky's death has traditionally been linked to cholera, most likely contracting through drinking contaminated water a few days earlier. Mother Tchaikovsky died of cholera, and her father became ill with cholera at this point but made a full recovery. However, some scholars, including British music experts and Tchaikovsky authority David Brown and biographer Anthony Holden, theorized that his death was suicide.
- 2010 Haiti cholera outbreak. Ten months after the 2010 earthquake, the plague struck Haiti, traced to the UN peacekeeping headquarters of Nepal. This marks the worst cholera epidemic in recent history, as well as the best documented cholera outbreak in modern public health.
- Sadi Carnot, Physicist, founder of thermodynamics (1832)
- Charles X, King of France (d 1836)
- James K. Polk, eleventh president of the United States (died 1849)
- Carl von Clausewitz, Prussian Warrior and German military theorist (died 1831)
- Elliot Bovill, Chief Judge of the Strait Settlement (1893)
References
External links
- Prevention and control of cholera outbreaks: WHO policy and recommendations
- Cholera - World Health Organization
- Cholera - Vibrio cholerae infection - Centers for Disease Control and Prevention
- Ã, "Cholera". EncyclopÃÆ'Â|dia Britannica . 6 (issue 11). 1911. pp.Ã, 262-267
Source of the article : Wikipedia
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