1. SERVICE-BASED LEARNING Mary Ann Mueller Graduate Student Walden University May 4, 2012 Electron micrograph of Vibrio cholerae Source: Boyd and Wirtz, authors of General Microbiology

2. CHOLERA RISK, INFECTION and PREVENTION Source: healthystate.org

3. Todays slides are focused on Cholera and will cover the following: CHOLERA RISK, INFECTION and PREVENTION Risk Factors Statistics Disease Infection Research Symptoms Prevention Helpful Tips

4. 1.What are some FYI Statistics? 2.What are Waterborne Disease and Cholera? 3.What are the Symptoms for Cholera? 4.What can I do to Prevent Infection? 5.What are the Risk Factors? 6.When should I seek Medical Help? CHOLERA RISK, INFECTION and PREVENTION

5. Quote: “Even when people have been treated, the risk of re-infection remains high…Cholera can be treated quickly and people can get better quickly but the challenge is ensuring they don’t get re-infected and clean drinking water needs to be available.” Paul Garwood, WHO CHOLERA RISK, INFECTION and PREVENTION

6. CHOLERA Epidemics of Cholera Source: http://www.who.int/gho/epidemic_diseases/cholera/en/index.htmlhttp://www.who.int/gho/epidemic_diseases/cholera/en/index.html

7. CHOLERA Source: The Cholera Model; based on research by Rita Colwell and others. http://blokesch-lab.epfl.ch/page-10508-en.html RESERCHRESERCH

8. CHOLERA Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae (CDC, 2011) It is considered any disease that can spread through contaminated water (LMASDHD, 2012; RD, 2012)

9. CHOLERA O1 & O139 Cause Outbreaks Two Serogroups of V. cholerae VIBRIO CHOLERAE STRAINS Source: http:// www.cdc.gov/cholera/non-01-0139-infections.htmlhttp:// www.cdc.gov/cholera/non-01-0139-infections.html

10. CHOLERA LATEST NEWS BREAK!!! Recently, new variant strains have been detected in several parts of Asia and Africa. (WHO, 2012)

11. ANYONE can get “CHOLERA” through Contaminated Food and Drink Containing Cholera Bacterium. CHOLERA The Centers for Disease Control and Prevention (2011)

12. CHOLERA (WHO, 2012) CHOLERA is an Extremely Virulent Disease. It affects both children and adults and can kill within hours.

13. CHOLERA (WHO, 2012) Prevention, Preparedness, Response, and Surveillance System Are keys for mitigating cholera outbreaks, controlling cholera in endemic areas and reducing deaths. MULTIDISCIPLINARY APPROACH:

14. Drinking Water Food Hand Washing Bathing & Sports CHOLERA Source: http:// www.who.int/mediacentre/factsheets/fs107/en/index.htmlhttp:// www.who.int/mediacentre/factsheets/fs107/en/index.html

15. CHOLERA Poor Sanitary Conditions. Reduced or Nonexistent Stomach Acid.. Household Exposure. Raw or Undercooked Shellfish. (Mayo Clinic, 2011)

16. Cholera remains a global threat to public health and a key indicator of lack of social development. CHOLERA (WHO, 2012) Epidemics have never arisen from dead bodies

17. CHOLERA IMMEDIATELY Dehydration can be rapid so fluid replacement is essential.

18. 1.Cholera is an Acute Diarrhoeal Disease! 2.Cholera can be Orally Treated Successfully! 3.Cholera Prevention, Preparedness and Response … Works! 4.Safe Water and Sanitation are Critical! 5.Remember … Conventional Control Measures! CHOLERA (WHO: Media Centre, 2012)

19. CHOLERA Source: http://www.who.int/immunization/Cholera_PP_Accomp_letter__Mar_10_2010.pdfhttp://www.who.int/immunization/Cholera_PP_Accomp_letter__Mar_10_2010.pdf ORAL CHOLERA VACCINES: (CDC, 2012) 1.Dukoral (manufactured by SBL Vaccines) 2.ShanChol (manufactured by Shantha Biotec in India)

20. No Country Requires Proof of Cholera Vaccination! Individual Travelers are Responsible for cholera Infected Food Imports Quarantine Measures and Embargoes of People and Goods are Unnecessary HELPFUL INFORMATION (WHO, 2012)

21. WHO Global Task Force on CHOLERA Control WORKS TO 1.Provide technical advice, support for cholera control and prevention at country levels! 2.Train health professionals at national, regional, international levels in prevention, preparedness and response of diarrhoeal disease outbreaks! 3.Disseminate information. guidelines on cholera, and other epidemic-prone enteric diseases to health professionals and the general public! World Health Organization, 2012 HELPFUL INFORMATION Continued

22. HELPFUL WEBSITES CDC—Cholera: Resources and Publications http://www.cdc.gov/cholera/publications.html Department of Environmental Quality—Drinking Water http://www.michigan.gov/deq/0,1607,7-135-3313_3675---,00.html Michigan State University Extension—Searchable Database and Other Resources http://www.msue.msu.edu/portal/ World Health Organization---Cholera: Media Centre http://www.who.int/mediacentre/factsheets/fs107/en/index.html

23. REFERENCES Busari, S. (2008). WHO: 60,000 at risk of cholera in Zimbabwe. [CNN/Garwood]. Retrieved from http://articles.cnn.com/2008-12- 09/world/zimbabwe.epidemic.cholera_1_cholera-outbreak-zimbabwe-president- robert-mugabe?_s=PM:WORLDhttp://articles.cnn.com/2008-12- 09/world/zimbabwe.epidemic.cholera_1_cholera-outbreak-zimbabwe-president- robert-mugabe?_s=PM:WORLD Centers for Disease Control and Prevention. (2011). Cholera. Epidemiology and risk factors. Retrieved from http://www.cdc.gov/cholera/epi.htmlhttp://www.cdc.gov/cholera/epi.html Centers for Disease Control and Prevention. (2011). Cholera. Non-O1 and Non-O139 Vibrio cholerae Infections. Retrieved from http://www.cdc.gov/cholera/non-01-0139- infections.htmlhttp://www.cdc.gov/cholera/non-01-0139- infections.html Children’s Hospital of Philadelphia. (2012). Cholera: General information. [CHOP]. Retrieved from http://www.chop.edu/service/parents-possessing-accessing- communicating-knowledge-about-vaccines/vaccine-preventable- diseases/cholera.htmlhttp://www.chop.edu/service/parents-possessing-accessing- communicating-knowledge-about-vaccines/vaccine-preventable- diseases/cholera.html

24. École polytechnique fédérale de Lausanne (EPFL; 2011). Research. BLOKESCH Lab - Laboratory of Molecular Microbiology UPBLO. Retrieved from http://blokesch- lab.epfl.ch/page-10508-en.htmlhttp://blokesch- lab.epfl.ch/page-10508-en.html LMAS District Health Department. (2012). Waterborne and Vector-borne diseases. What you should know. Retrieved from http://lmasdhd.org/uploads/PDF/Water_VectorFS08.pdf http://lmasdhd.org/uploads/PDF/Water_VectorFS08.pdf Mayo Clinic. (2011). Cholera. Risk factors. Retrieved from http://www.mayoclinic.com/health/cholera/ds00579/dsection=risk-factors http://www.mayoclinic.com/health/cholera/ds00579/dsection=risk-factors Moeller, D. W. (2005). Environmental health (3 rd ed.). Cambridge, MA. Harvard University Press. Right Diagnosis. (2012). Cholera. Waterborne diseases. Retrieved from http://www.rightdiagnosis.com/w/waterborne_diseases/intro.htm REFERENCES: Continued 2

25. Sack, D.A., Sack, R.B., Nair, G.B., Siddique, A.K. (2004). Cholera. The Lancet Journals. 363(9404)223–33. doi:10.1016/S0140-6736(03)15328-7 World Health Organization. (2010). Cholera vaccines. The WHO position paper on cholera vaccines. [Brief Summary]. Retrieved from www.who.int/entity/immunization/Cholera_PP_Accomp_letter__Mar_10_2010.pdf www.who.int/entity/immunization/Cholera_PP_Accomp_letter__Mar_10_2010.pdf World Health Organization. (2012). Cholera. Global Health Observatory (GHO). Retrieved from http://www.who.int/gho/epidemic_diseases/cholera/en/index.html World Health Organization. (2012). Cholera. Media centre. Retrieved from http://www.who.int/mediacentre/factsheets/fs107/en/index.html http://www.who.int/mediacentre/factsheets/fs107/en/index.html REFERENCES REFERENCES: Continued 3