Cholera
exp date isn't null, but text field is
Introduction
- An acute severe diarrhoeal illness of worldwide importance
- It is caused by Vibrio cholerae bacilli (classical and El Tor species)
Clinical features
- Diarrhoea (Rice water stool)
- Vomiting
Complications
- Hydropaenia/Hypovolaemic shock with multiple end-organ failure leading to death
- Dyselectrolytetaemia
- Hypokalaemia
Investigations
- Stool microscopy, culture and sensitivity
- Urea, Electrolytes and Creatinine
- Complete Blood Count
Treatment goals
- Hydration
- Eradicate organism
- Prevent spread
Drug treatment
- Intravenous
- Electrolyte
- Oral Rehydration Therapy
- Antibiotic therapy:
- Tetracycline:
- Adult: 500 mg orally every 6 hours for 5 days
Or:
- Doxycycline:
- Adult: 200 mg orally once daily for 5 days
- Child: 12 - 18 years, 200 mg on first day, then 100 mg daily
- Severe infections, 200 mg orally daily
- Erythromycin:
- Adult and child over 8 years: 250 - 500 mg orally every 6 hours for 5 days or 500 mg - 1 g every 12 hours
- Child:
- Up to 2 years: 125 mg every 6 hours
- 2 - 8 years: 250 mg every 6 hours
- Doses doubled in severe infection
Or:
- Co-trimoxazole
- Adult: 960 mg orally every 12 hours for 5 days
- Child:
- 6 weeks - 12 years: 24 mg/kg every 12 hours
- 6 weeks - 6 months: 120 mg every 12 hours
- 6 months - 6 years: 240 mg every 12 hours
- 6 years - 12 years: 480 mg every 12 hours
- 12 years - 18 years: 960 mg every 12 hours
Supportive measures
- Monitor fluid intake and output (vomitus, urine and stool)
Prevention
- Personal and communal hygiene
- Potable water, sanitary disposal of faeces
- Cholera vaccine