Communicable disease is an infectious disease caused by microorganisms that may be transmitted from a person, animal or the environment to susceptible persons, either directly or indirectly.
Infectious diseases results from multiplication of microorganisms in the body.
The infectious process / chain of infection
- Causative organism
- Portal of exit
- Mode of entering in susceptible host
- Susceptible host
The cycle includes;
Causative organism – reservoir – portal of exit – mode of transmission – mode of entry susceptible most
Bacteria are present in most environment. The variety of micro – organisms known as Normal Flora. The normal flora may cause disease if it gets to access to another area of the body.
E.g. the skin host staphylococci but if it gets into a surgical wound, it may cause infection Escherichia coli in the anus may cause urinary Tract Infection (UTI) if it enters the bladder.
Diarrheal is an accelerated movement of the content through the intestine with the decrees in the organism’s mixing and absorptive process, resulting in frequent liquid or unformed stool. Cholera is an acute notifiable infectious enteritis and the causative organism is: Vi brio cholera.
Vi brio cholera does not form spore and the virus can be killed by heating at 55° at 15° minutes spores forming organism does not die at 100° but so it is sterilized in an autoclave at 120°
Reservoir / mode of transmission of cholera
Reservoir: Focal contamination of water and food supply
- Shell fish
Mode of Transmission: Focal – oral
Signs and symptoms of cholera
- Rapid on set of diarrhoea (1 L of fluid can lose in I hour)
- Muscle cramps
- Hypovolaemia (a reduction in the circulating blood volume due to external loss of body fluids or to loss from the blood into the tissue, as a shock)
Hypovolaemia will lead to hypotension and will lead to impaired consciousness.
- Renal failure may occur
- Hypoglycaemia occurs in children
Management of cholera – DRUGS
Tetracycline, Ciprofloxacin, Doxycycline, Azithromycin in children, Zinc table + ORS in children
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Management of mild Dehydration signs and symptoms
Management: give 50mls of ORS per 1 kg over 4 hours
Signs and symptoms
Sunken eyes, dry mouth and increases thirst.
Management: give 100mls of ORS per 1 kg over 4hrs
- Due to vomiting which is associated to diarrhoea, set fluid in bit and at frequent interval
- Monitor intake and output of fluids
- Maintain adequate caloric intake (caloric are from refined carbohydrate / sugar) to prevent hypoglycaemia. Serve food rich in starch and simple sugar, e.g. Rice water, white porridge mashed agidi, coconut water
N/B Electrolyte lost leads to hypokalaemia and hyponatraemia
DIAGNOSIS OF CHOLERA
- WHO, clinic case definition is a cute watery diarrhoea in a patient 5 years of age or older with or without vomiting in an area where cholera is likely to occur
- Stool CS (culture and sensitivity) and stool R E (Routine Examination)
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