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.

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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
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3
Q

A global strategy on cholera control, Ending Cholera
(2017): a global roadmap to 2030 ,targeted to reduce cholera deaths by 90%.

A

..

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4
Q

Cholera can occur in …….

A

epidemics or pandemics

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5
Q

Global Epidemeology of Cholera

A
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6
Q

National Epidemeology of Cholera

A

Last epidemic in Egypt: 1947. and eliminated in 1948
No cases for 20 years.

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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

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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 .
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9
Q

Probable Case of Cholera

A

None

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10
Q

Confirmed Case of Cholera

A

Suspected case confirmed by V.Cholerae O1 or O139 confirmed by stool culture or PCR

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11
Q

Causative Agent of Cholera

A
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12
Q

Compare between Classical vibrio & ElTor Vibrio in terms of

  • Virulence
  • Severity
  • Infectivity
  • Resistance
A
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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.

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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

..

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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

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16
Q

IP of Cholera

A

From few hours to 5 days,

internationally: 5 days

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17
Q

Infectivity Period of Cholera

A

7-10 days
- Carrier state may persists for several months
- Effective antibiotics shorten period of infectivity

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18
Q

Susceptibility of Cholera

A
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19
Q

General Prevention of Cholera

A

Refer to general preventive measures of food borne diseases

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20
Q

Specific prevention of Cholera

A
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21
Q

Active Vx of Cholera

A
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22
Q

Compare between oral Vxs for Cholera

A
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23
Q

Indications of chemoprophylaxis in Cholera

A
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24
Q

Drugs used in chemoprophylaxis in Cholera

A
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25
Q

Case Control Measures in Cholera

A
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26
Q

Contact Control Measures in Cholera

A
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27
Q

Epidemic Measures of Cholera

A

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.

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28
Q

International Measures in Cholera

A
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29
Q

International Measures for travellers in Cholera

A
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30
Q

Def of Acute Food Poisoning

A
  • 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.
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30
Q

Global Epi of Acute Food Poisoning

A

common, worldwide distribution .

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31
Q

National Epi of Acute Food Poisoning

A

Common in Egypt

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32
Q

Suspected Case of Acute Food Poisoning

A
  • 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.
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32
Q

Epidemic Threshold of Acute Food Poisoning

A

2 or more cases with epidemiological link

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33
Q

Probable Case of Acute Food Poisoning

A

not present

34
Q

Confirmed Case of Acute Food Poisoning

A

Suspected case confirmed by lab

35
Q

Compare between Cholera & AFP in terms of:

  • 2ry CAses
  • IP
  • Vomiting
  • Abdominal Tenderness
  • Tenesmus
  • Dehydration
  • Muscle Cramps
  • temperature
  • Urine
A
36
Q

Causative organsims of Acute Food Poisoning

A
37
Q

Causative Organism of Salmonella Food Poisoning

A
38
Q

Reservoir of Salmonella Food Poisoning

A
  • 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
Q

Infectivity Period of Salmonella Food Poisoning

A
  • Throughout course of infection
  • continues for months in carrier state
40
Q

MOT of Salmonella Food Poisoning

A
41
Q

IP of Salmonella Food Poisoning

A

12 – 36 hours

42
Q

Susepctibility of Salmonella Food Poisoning

A
43
Q

General Prevention of Salmonella Food Poisoning

A

refer to prevention of food borne disease

44
Q

Specific Prevention of Salmonella Food Poisoning

A

No specific prevention measures against salmonella

45
Q

Ten Golden Rules for Safe food preparartion

A
46
Q

Case Control Measures in Salmonella Food Poisoning

A
47
Q

Contact Control Measures in Salmonella Food Poisoning

A

❶ Enlistment of contacts.

❷ Surveillance of persons who shared food and drink

❸ Stool examination, to detect mild cases and carriers .

48
Q

Epidemic Measures in Salmonella Food Poisoning

A

Epidemiologic investigation to trace source & channels of infection .

49
Q

Suspected Case of Staph Food Poisoning

A
50
Q

Confirmed Case oof Staph Food Poisoning

A

Depends on epidemiological data & Isolation of S. aureus or detection of enterotoxin from suspected food items or vomitus and stool

51
Q

Probable Case of Staph Food Poisoning

A

None

52
Q

Causative Organism of Staph Food Poisoning

A

(Toxic agent) Enterotoxin of Staphylococcus aureus

53
Q

Reservoir of Staph Food Poisoning

A

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
Q

MOT of Staph Food Poisoning

A
55
Q

General Prevention of Staph Food Poisoning

A

refer to prevention of food borne disease .

55
Q

Infectivity period of Staph Food Poisoning

A

As long as enterotoxins are stable & active or organisms are viable.

56
Q

IP of Staph Food Poisoning

A

From ½ hour to 8 hours (average 2-4 hrs)

57
Q

Specific Prevention of Staph Food Poisoning

A

No specific prevention measures against Staphylococcal food poisoning

58
Q

Outbreak Measures in Staph Food Poisoning

A

Complete investigation to determine:

❶ Time and place of exposure

❷ Incremented food: origin, preparation, storage and serving.

❸ Population at risk.

59
Q

Food Borne Botulism

A
60
Q

Infant Botulism

A
61
Q

Wound Botulism

A
62
Q

Threpeutic Botulism

A
63
Q

Inhalation Botulism

A
64
Q

Def of Food-Borne Botulism

A
  • 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
Q

Global Epi of Food-Borne Botulism

A
  • Worldwide distribution: sporadic cases, family & general outbreaks may occur.
66
Q

National epi of Food-Borne Botulism

A
  • 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
Q

Epidemic threshold of Food-Borne Botulism

A

One confirmed case

68
Q

Suspected Case of Food-Borne Botulism

A
69
Q

Probable Case of Food-Borne Botulism

A

None

70
Q

Confirmed Case of Food-Borne Botulism

A

suspected case confirmed by laboratory test

71
Q

Causative Organism of Food-Borne Botulism

A
  • 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
Q

Reservoir of Food-Borne Botulism

A
73
Q

Infectivity Period of Food-Borne Botulism

A
  • As long as the microbe is excreted in stool of cases with no secondary cases

No person to person transmission

74
Q

MOT of Food-Borne Botulism

A
75
Q

IP of Food-Borne Botulism

A
  • 12 –36 hours
  • sometimes several days after eating contaminated food
76
Q

Susceptibility of Food-Borne Botulism

A

General, but higher among patients with intestinal health problems and infants below 6 years due to Decreased immunity.

77
Q

General Prevention of Food-Borne Botulism

A

Refer to prevention of food borne disease

78
Q

Specific Prevention of Food-Borne Botulism

A
79
Q

Case Control Measures of Food-Borne Botulism

A
80
Q

Contact Control Measures of Food-Borne Botulism

A

❶ Person sharing same food: gastric lavage & high enema, kept under close observation

❷ Polyvalent antitoxin may be given .

81
Q

Epidemic Measures of Food-Borne Botulism

A

Trace source of intoxication & eradicate it.

82
Q

International Measures in Food-Borne Botulism

A

Proper checking of suspected food according to international health regulation

83
Q

DDx between salmonella FP, Staph FP & Botulism FP

A
84
Q

Done

A

,,