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Tropical Diseases (part 2 - 12/09) > Cholera > Flashcards

Cholera Flashcards

1
Q

Pathogenic agent name:

Cholera

A

Vibrio cholera

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2
Q

Pathogenic agent description:

Cholera

A
  • Highly motile
  • Curved
  • Gram negative rod/bacilli
  • Facultative organism
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3
Q

Cholera is classified by what?

A

O cell wall that is made up of polysaccharide side chains of LPS

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4
Q

What are the two serogroups that cause cholera? And which is predominant

A
  • O1
  • O139
  • O1 is predominant
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5
Q

Vector:

Cholera

A
  • No known natural host besides humans

Grows in still water associated with copepods and zooplankton

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6
Q

What are the conditions in which cholera likes to grow?

A
  • Low oxygen

- So it grows in still water with zooplankton and copepods

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7
Q

Where is there a current cholera outbreak happening?

A

Haiti

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8
Q

How is cholera transmitted to humans?

A

Ingestion of contaminated food (raw seafood) and water

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9
Q

Why does cholera require a high inoculum?

A

Because gastric acidity

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10
Q

Transmission Mechanism:

Cholera

A
  1. Vibrios pass the stomach and enter the small intestine and adhere to the luminal cells
  2. Produce mucinase to help penetrate mucus
  3. Cholera toxin binds to GM1 receptor and enters cells
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11
Q

Cholera binds to what receptor?

A

GM1 (activated by adenyl cyclase)

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12
Q

Reservoirs:

Cholera

A

No known besides humans

Large cargo ships take in water and contaminate new areas

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13
Q

“Rice water” stool is a symptom of what?

A

Cholera

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14
Q

Clinical Findings:

Cholera

A
  • Diarrhea (mild, severe, death)
  • “Rice water” stool
  • Sunken eyes, dry mouth
  • Lactic acidosis (breakdown of tissue)
  • Renal failure
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15
Q

What is “Rice water stool”

A

Stool that is free of blood and has flecks of mucus with a fishy smell

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16
Q

Diagnosis:

Cholera

A
  • Clinical suspicion

- Isolation of bacteria V. cholerae (easy to grow but needs special media)

17
Q

Treatment (general):

Cholera

A
  1. Aggressive volume replacement (orally or IV)
  2. Antibiotics
  3. Complications treatment
18
Q

Treatment (Drugs):

Cholera

A
  • Tetracycline
  • Doxycycline

(If resistant use fluoroquinolones and macrolides)

19
Q

Prevention:

Cholera

A
  • Safe water
  • Hygiene
  • Vaccines
20
Q

What are the vaccines for cholera? (3)

A
  • Dukoral (combo vaccine)
  • Shanchole
  • VaxChora
21
Q

Describe Third Cholera Outbreak?

A
  • Broad Street Pump in London killed hundreds in a few days

1852-1860
(the first careful epidemiologic experiment that is well documented)

22
Q

Describe Fourth Cholera Outbreak?

A

30K Mecca pilgrims died

1863 - 1879

23
Q

Describe Seventh Cholera Outbreak?

A

New strain called El Tor

Locations: Latin America
Haiti (post earthquake)

(1961- present)

24
Q

If cholera is resistant to tetracycline and docycline what do you use?

A
  • fluoroquinolones

- macrolides)

Tropical Diseases (part 2 - 12/09) (5 decks)

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