cholera
Cholera is a particularly dangerous infectious disease characterized by damage to the small intestine, accompanied by the loss of a large amount of fluid and salt, diarrhea and vomiting. Cholera causes epidemics.
ETIOLOGY
Currently, more than 150 types of vibrions are known, differing in serological properties and signs. They are divided into two large groups: A and B. In turn, cholera is caused by vibrions of group A.
The source of cholera vibrio can be a sick person or a carrier of infection. The carriers are flies. The mechanism of infection is fecal-oral, ways: food, water, contact and household.
Cholera is caused by cholera vibrio. This is a gram negative wand, extremely stable in the external environment. In open reservoirs, it retains its viability for up to several months, is well inactivated by boiling, UV, in a 3% solution of chloramine. Cholera vibrio produces a thermostable endotoxin, as well as cholerogen.
The incubation period of the disease is from 12 hours to 5 days. During recovery, a stable immunity develops.
SYMPTOMS OF CHOLERA
Cholera is characterized by an acute onset, the absence of any abdominal pain, no fever, on the contrary, the temperature may be slightly reduced
The symptoms of cholera depend on the degree of dehydration:
1 degree – loss of fluid up to 1-3%. The patient has weakness, thirst. Loose stools up to 10 times a day, vomiting up to 2 times a day.
Degree 2 – loss of fluid 4-6%. The patient faints. The skin is pale, cyanosis of the lips. Blood pressure is reduced, convulsions. Diarrhea up to 20 times a day, feces in the form of “rice broth” – cloudy white due to the exfoliated epithelium. Vomiting reaches 10 times a day. Kidney function is sharply reduced, oliguria.
Grade 3 – loss of fluid 7-9%. The patient is adynamic, the facial features are pointed, around the eyes is a “symptom of dark glasses”. Skin turgor is reduced, the skin is cyanotic, acrocyanosis. Blood pressure is sharply reduced, prolonged convulsions, tachycardia of 120 beats / min is observed. Copious continuous vomiting and diarrhea more than 20 times a day. Kidney function is impaired up to anuria.
Grade 4 – fluid loss of more than 10%. The symptoms are the same as in stage 3. A characteristic symptom is “washerwoman’s hands”, “cholera algid” – pronounced diffuse cyanosis, thready pulse, temperature 34-35 degrees.
COMPLICATIONS
Acute cerebrovascular accident
Heart attack
Pneumonia, abscesses
Phlegmons
diagnostics
Cholera is a particularly dangerous infection. If cholera infection is suspected, the patient is transported to a cholera box. All tests are collected strictly in an anti-plague suit. The diagnosis of cholera is made on the basis of bakposev, microscopic method, serological blood analysis. Materials are urgently delivered to the laboratory within 2 hours.
treatment
The fundamental principle of cholera treatment is rehydration therapy. The patient is named Regidron, Oralit. The composition of the oral includes: 1 liter of boiled water, 3.5g of sodium chloride, 2.5g of sodium bicarbonate, 1.5 g of potassium chloride, 20 g of glucose, the temperature of the solution is 38-40 degrees. This solution is drunk out – adults 1 tbsp. l per minute, children 1 tsp.l. until vomiting stops. All solutions administered intravenously are heated to 38 degrees. Patients are located on the Philips coke. Every two hours it is necessary to do a bowel movement control. Along with these measures, antibacterial therapy with tetracycline drugs (Tetracycline, Levomycetin) is carried out.
Cholera patients are discharged only after the disappearance of clinical symptoms, as well as 3 negative crops after 24 hours after the withdrawal of antibiotics.
