L12: Cholera & Acute Food Poisoning Flashcards
1
Q
Def of Cholera
A
- Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae.
Cholera remains a global threat to public health & an indicator of inequity and lack of social development.
2
Q
- Estimated that each year there are ……. cases of cholera & …….. deaths worldwide due to cholera .
- Most of those infected will have no or mild symptoms and can be successfully treated with oral rehydration solution .
A
- 1.3 to 4.0 million
- 21,000 to 143,000
3
Q
A global strategy on cholera control, Ending Cholera
(2017): a global roadmap to 2030 ,targeted to reduce cholera deaths by 90%.
A
..
4
Q
Cholera can occur in …….
A
epidemics or pandemics
5
Q
Global Epidemeology of Cholera
A
6
Q
National Epidemeology of Cholera
A
Last epidemic in Egypt: 1947. and eliminated in 1948
No cases for 20 years.
7
Q
Epidemic Threshold of Cholera
A
at least 1 confirmed case of cholera with evidence of local transmission in an area where there is not usually choler
8
Q
Suspected Case of Cholera
A
- Any person 2 yrs old or more suffering from acute watery diarrhea (3 times or more within 24 hs) with severe dehydration. Or death due to acute watery diarrhea .
9
Q
Probable Case of Cholera
A
None
10
Q
Confirmed Case of Cholera
A
Suspected case confirmed by V.Cholerae O1 or O139 confirmed by stool culture or PCR
11
Q
Causative Agent of Cholera
A
12
Q
Compare between Classical vibrio & ElTor Vibrio in terms of
- Virulence
- Severity
- Infectivity
- Resistance
A
13
Q
Reservoir of Cholera
A
- Man is the only source of infection either cases or carriers
- Cases Ranging from inapparent, subclinical, or clinical infection
- Carrier
❶ Incubatory
❷ Contact (the most serious)
❸ Convalescent (temporary)
The carriers are usually temporary but in El Tor biotype tend to be more chronic.
14
Q
These characters of El-Tor biotype illustrate why the 7th pandemic occurred in about 100 countries and remain endemic in most of these countries.
A
..
15
Q
MOT of Cholera
A
❶ Ingestion of contaminated food or water
❷ Hand-to-mouth infection: (freshly contaminated hands with human excreta due to contact with cases or carriers)
❸ Indirect infection through contaminated eating& drinking tools
16
Q
IP of Cholera
A
From few hours to 5 days,
internationally: 5 days
17
Q
Infectivity Period of Cholera
A
7-10 days
- Carrier state may persists for several months
- Effective antibiotics shorten period of infectivity
18
Q
Susceptibility of Cholera
A
19
Q
General Prevention of Cholera
A
Refer to general preventive measures of food borne diseases
20
Q
Specific prevention of Cholera
A
21
Q
Active Vx of Cholera
A
22
Q
Compare between oral Vxs for Cholera
A
23
Q
Indications of chemoprophylaxis in Cholera
A
24
Q
Drugs used in chemoprophylaxis in Cholera
A
25
Case Control Measures in **Cholera**
26
Contact Control Measures in **Cholera**
27
Epidemic Measures of **Cholera**
❶ Notify WHO
❷ Trace the source and channel of infection
❸ A single case of cholera in a person with a history of no overseas travel is considered an outbreak
❹ Adopt emergency measures to assure a safe water supply
❺ Ensure careful supervision of food and drink preparation.
28
International Measures in **Cholera**
29
International Measures for travellers in **Cholera**
30
Def of **Acute Food Poisoning**
- The presence of 2 or more cases with gastrointestinal symptoms with a history of ingestion of a common food or sharing the same place of food ingestion (time or place link).
- However, one case of botulism or chemical substance intake can be considered food poisoning.
30
Global Epi of **Acute Food Poisoning**
common, worldwide distribution .
31
National Epi of **Acute Food Poisoning**
**Common in Egypt**
32
Suspected Case of **Acute Food Poisoning**
- Any person suffers from two or more of the principal symptoms (colic – vomiting – nausea – fatigue – fever – diarrhea)
- Usually more than one person with time or place link.
32
Epidemic Threshold of **Acute Food Poisoning**
2 or more cases with epidemiological link
33
Probable Case of **Acute Food Poisoning**
not present
34
Confirmed Case of **Acute Food Poisoning**
Suspected case confirmed by lab
35
Compare between Cholera & AFP in terms of:
- 2ry CAses
- IP
- Vomiting
- Abdominal Tenderness
- Tenesmus
- Dehydration
- Muscle Cramps
- temperature
- Urine
36
Causative organsims of **Acute Food Poisoning**
37
Causative Organism of **Salmonella Food Poisoning**
38
Reservoir of **Salmonella Food Poisoning**
- Human: Cases (clinical –subclinical), Carrier (convalescent)
- Animals (mainly):
❶ Rodents: excreta of infected rats & mice (diseased or carriers).
❷ Cattle: excreta (contaminated milk) & tissues .
❸ Swine.
❹ Poultry especially turkey & ducks: eggs & tissues of infected birds.
39
Infectivity Period of **Salmonella Food Poisoning**
- Throughout course of infection
- continues for months in carrier state
40
MOT of **Salmonella Food Poisoning**
41
IP of **Salmonella Food Poisoning**
12 – 36 hours
42
Susepctibility of **Salmonella Food Poisoning**
43
General Prevention of **Salmonella Food Poisoning**
refer to prevention of food borne disease
44
Specific Prevention of **Salmonella Food Poisoning**
No specific prevention measures against salmonella
45
Ten Golden Rules for Safe food preparartion
46
Case Control Measures in **Salmonella Food Poisoning**
47
Contact Control Measures in **Salmonella Food Poisoning**
❶ Enlistment of contacts.
❷ Surveillance of persons who shared food and drink
❸ Stool examination, to detect mild cases and carriers .
48
Epidemic Measures in **Salmonella Food Poisoning**
Epidemiologic investigation to trace source & channels of infection .
49
Suspected Case of **Staph Food Poisoning**
50
Confirmed Case oof **Staph Food Poisoning**
Depends on epidemiological data & Isolation of S. aureus or detection of enterotoxin from suspected food items or vomitus and stool
51
Probable Case of **Staph Food Poisoning**
None
52
Causative Organism of **Staph Food Poisoning**
(Toxic agent) Enterotoxin of Staphylococcus aureus
53
Reservoir of **Staph Food Poisoning**
❶ Human: Nasal & throat carriers or persons with purulent discharge of infected finger or eye, abscess & acneiform facial eruption
❷ Animals: Cows with infected udders
54
MOT of **Staph Food Poisoning**
55
General Prevention of **Staph Food Poisoning**
refer to prevention of food borne disease .
55
Infectivity period of **Staph Food Poisoning**
As long as enterotoxins are stable & active or organisms are viable.
56
IP of **Staph Food Poisoning**
From ½ hour to 8 hours (average 2-4 hrs)
57
Specific Prevention of **Staph Food Poisoning**
No specific prevention measures against Staphylococcal food poisoning
58
Outbreak Measures in **Staph Food Poisoning**
Complete investigation to determine:
❶ Time and place of exposure
❷ Incremented food: origin, preparation, storage and serving.
❸ Population at risk.
59
Food Borne Botulism
60
Infant Botulism
61
Wound Botulism
62
Threpeutic Botulism
63
Inhalation Botulism
64
Def of **Food-Borne Botulism**
- Food borne botulism is an infectious food poisoning characterized by nervous manifestations rather than gastro-intestinal manifestations.
- It is a severe intoxication resulting from ingestion of pre-formed toxins present n contaminated food
- Less common forms (inhalation, wound, therapeutic and infant botulism may occur)
65
Global Epi of **Food-Borne Botulism**
- Worldwide distribution: sporadic cases, family & general outbreaks may occur.
66
National epi of **Food-Borne Botulism**
- Cases were reported in Egypt after consumption packed salted fish (Fesekh).
- Last epidemic occurred during 1991: 91 cases after ingestion of salted fish (Fesekh).
67
Epidemic threshold of **Food-Borne Botulism**
One confirmed case
68
Suspected Case of **Food-Borne Botulism**
69
Probable Case of **Food-Borne Botulism**
None
70
Confirmed Case of **Food-Borne Botulism**
suspected case confirmed by laboratory test
71
Causative Organism of **Food-Borne Botulism**
- Exotoxins produced by clostridium botulinum, a spore forming obligatory anaerobic bacillus .
- These exotoxins have a great affinity to the nerves resulting in muscle paralysis.
72
Reservoir of **Food-Borne Botulism**
73
Infectivity Period of **Food-Borne Botulism**
- As long as the microbe is excreted in stool of cases with no secondary cases
**No person to person transmission**
74
MOT of **Food-Borne Botulism**
75
IP of **Food-Borne Botulism**
- 12 –36 hours
- sometimes several days after eating contaminated food
76
Susceptibility of **Food-Borne Botulism**
General, but higher among patients with intestinal health problems and infants below 6 years due to Decreased immunity.
77
General Prevention of **Food-Borne Botulism**
Refer to prevention of food borne disease
78
Specific Prevention of **Food-Borne Botulism**
79
Case Control Measures of **Food-Borne Botulism**
80
Contact Control Measures of **Food-Borne Botulism**
❶ Person sharing same food: gastric lavage & high enema, kept under close observation
❷ Polyvalent antitoxin may be given .
81
Epidemic Measures of **Food-Borne Botulism**
Trace source of intoxication & eradicate it.
82
International Measures in **Food-Borne Botulism**
Proper checking of suspected food according to international health regulation
83
DDx between salmonella FP, Staph FP & Botulism FP
84
Done
,,
