Travelers beware of CHOLERA

Cholera is caused by a member of the species Vibrio cholerae, which is a species of bacteria with many serotypes. The non-O1 and non-O139 serotypes have a natural reservoir in sea and coastal waters

For centuries, cholera has devastated many countries all over the world including several African countries, Cuba, Dominican Republic, Haiti, Mexico and parts of Asia. Cholera is life-threatening: 3-5 million people around the world are infected with cholera and 100,000- 120,000 people die from the infectious disease.

Cholera is most times transmitted by a contaminated water source or rarely, may be from contaminated foods, especially raw shellfish.

Cholera is characterized by watery diarrhea, vomiting, dehydration, which can lead to hypovolemic shock (low blood pressure, rapid heart rate, poor skin turgor, dry mucous membrane, cardiac arrhythmias due to loss of electrolytes, change in mental status, decreased urinary output), and if left untreated, can lead to death.

Goal of treatment is REHYDRATION: Oral Rehydration Solution (ORS) Intravenous Fluids : Lactated Ringers Normal Saline Oral or IV antibiotics may be necessary in the cases of severe cholera.

Tips for Travelers Frequent hand washing is important: Before and after you eat Before preparing foods After using the bathroom Buy and drink bottled water Wash fruits and vegetables thoroughly before preparing Avoid buying foods from roadside vendors

References Center of Disease Control and Prevention (2014). Global Water, Sanitation & Hygiene (WASH). Retrieved from http://www.cdc.gov/healthywater/global/ Center of Disease Control and Prevention (2015). Cholera – Vibrio cholerae infection. Retrieved from http://www.cdc.gov/cholera/index.html City of Westminister (2015). Cholera and the Thames: Origins of Cholera. Retrieved from http://www.choleraandthethames.co.uk/cholera-in-london/origins-of-cholera/ Finkelstein, R.A. (n.d.). Chapter 24: Cholera, Vibrio cholerae O1 and O139, and Other Pathogenic Vibrios. Medical Microbiology (4th ed.). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK8407/#_A1383_ World Health Organization (2015). Areas affected by cholera epidemics. Retrieved from http://www.who.int/gho/epidemic_diseases/cholera/epidemics_text/en/

Sources of Pictures http://images.medicinenet.com/images/article-promo/vaccines-and-preventing-diseases-abroad-ss- promo.jpg http://papahealth.com/wp-content/uploads/2013/08/Cholera.jpg http://www.cdc.gov/cholera/images/cholera-world-map-resized3.png https://encrypted- tbn0.gstatic.com/images?q=tbn:ANd9GcT18tgX2ydwPBiOAKMQ0Nr5XvA6yIs3YRDrPMTJwg4eCyi6ZQSU http://www.skinsight.com/images/dx/webAtlas/cholera_26149_lg.jpg https://encrypted-tbn1.gstatic.com/images?q=tbn:ANd9GcRWXfKNy4Yvh7Lvll- pnyIe_3KpJkui8RR8IypCoWDYokYmbb-J https://encrypted- tbn3.gstatic.com/images?q=tbn:ANd9GcTaCKZDgbfBj9umHVBNkUqBOTXl86_VkCAcihP2OCrL9qOyN0vrFg http://www.cnhsa.com/Data/Sites/1/skins/style_three/images/hand_washing.jpg

Directed by: sheryl doctor-mendoza Grand Canyon University HLT 555: Environmental Health July 1, 2015