Cholera

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Clinical Description

• Bacterial infection caused by Vibrio cholerae
• Causes severe watery, “rice water” diarrhoea and may lead to death

Clinical Features

SINGS AND SYMPTOMS

• Severe watery diarrhea (usually painless, rice water like)
• Vomiting

INVESTIGATIONS

• Usually clinical diagnosis
• Cholera Ag rapid test (stool sample)

Treatment 

NON-PHARMACOLOGICAL

• Isolate the patient
• Ensure hygienic precautions by all in contact with patient
• Investigate source of contamination, inform environmental health authorities
• Trace close contacts and give antibiotics as below

PHARMACOLOGICAL

• Rehydration is mainstay of treatment
• Type of resuscitation fluid is less important than quantity of fluid replaced may need 1L/hour initially
  • if available, IV Ringer’s Lactate is the preferred fluid of choice   
  • maintenance fluids after resuscitation: IV fluids and oral rehydration solution (ORS)

Antibiotics can shorten duration of diarrhoea 

Adults:

• Doxycycline 300 mg STAT OR Azithromycin 1g STAT