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MB4030 > Cholera > Flashcards

Cholera Flashcards

1
Q

Two serogroups

A

O1
O139

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2
Q

Which serogroup causes majority of outbreaks

A

O1

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3
Q

Type of bacteria

A
  • gram -ve
  • motile
  • comma shaped curved rod
  • single polar flagellum
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4
Q

How many serogroups are there

A

200

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5
Q

How can serogroup 01 be subdivided

A

Classical
El Tor

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6
Q

Features of clinical strains of serogroups 01 El Tor

A

Haemolytic
Polymyxin B resistant

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7
Q

How does cholera exist

A

As natural flora in aquatic ecosystems

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8
Q

Transmission route

A

Oral route
- contaminated water

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9
Q

Two isolates with a close relationship

A

Haitian El Tor01 and Bangladesh

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10
Q

Vehicle for transmission

A

Diarrhea

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11
Q

Incubation period

A

1 to 3 days

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12
Q

Symptoms

A

Vomiting
Muscle cramps
Watery diarrhea

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13
Q

Consequences of severe diarrhea

A

dehydration
electrolyte imbalance

*loss of 20L water/day

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14
Q

Serious symptoms

A

circulatory collaps -> HF

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15
Q

Survival of acute disease leads to

A

recovery with immunity
(some potential to carry and shed the pathogen)

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16
Q

Treatments

A
  • oral/ IV hydration
  • prompt restoration of lost fluids and salts
  • in conjunction with hydration, treatment with Abs
  • doxycycline - adults
17
Q

Mechanism of action of Doxycycline

A

Inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit

18
Q

Composition of cholera hexameric enterotoxin

A

1 A chain and 5 B chain

19
Q

Toxic component

A

A chain

20
Q

What receptor does cholera toxin bind to?

A

GM1 ganglioside receptor

*located on surface of intestinal epi cells

21
Q

MOA of cholera toxin

A

Binds to GM1 receptor, retrograde endocytosis, Gsa binds to Ac, acticates cAMP, Cl ions efflux via CFTR

*Na, H30- and H20 alss efflux into lumen -> watery diarrhea

22
Q

Innate Immune response to V.C

A
  • v.c disrupts mucosal barrier which widens intracellular spaces, disrupting apical junction
  • influx of NFs, macrophages, APCs and lymphocytes into lamina propia
  • production of effector molecules at mucousal surface (lactoferrin, defensins, oxidases)
  • increase in expression of ROS proteins (DUOX2) (iNOS)
  • activation of NLRP3 inflammasome and type I IFN
  • APCS produce cytokines (IL1B, IL6, IL17)
23
Q

Adaptive Immune Response to V.c

A
  • long-lasting immunity
  • protection by specific IgA Abs
24
Q

Primary virulence factor of V.c

A

enterotoxin

25
Q

How much v.c required to produce symptoms

A

5 ug

26
Q

Most abundant Ab

A

IgA (70%)

27
Q

Previous vaccine against V.c

A
  • vaccine consisted of phenol-killed whole cells of v.c
  • provided poor immunity
  • no longer recommended
  • limited efficacy
  • short duration of protection
28
Q

Live attenuated vaccine

A

the inactivated hexameric enterotoxin not effective as a vaccine

*the generation of v.c vaccine strain that does not produce A subunit of toxin is required

MB4030 (11 decks)

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