1. Cholera Dr. Rachel Joshua Thundyil

3. Agent Gram Negative Bacilli Vibrio Cholerae Curved, Actively Motile, Flagellated

7. Narural Host - Humans Transmission – Faeco-oral route Water Food Carriers

8. Clinical Features Incubation Period - few hours to 6 days 3 Phases - Evacuation Phase - Collapse Phase - Recovery Phase

9. Evacuation Phase Abrupt onset Painless Watery diarrhoea “rice-water” without vomitting

12. Collapse Phase Shock – Cold, clammy skin Tachycardia Hypotension Cyanosis  Dehydration – Sunken eyes Hollow Cheek Decreased urine output

14. Recovery Phase Patient gradually recovers

15. Complicaitons Shock Convulsions Renal Failure Aspiration Pneumonia

16. Diagnosis Clinical Rectal swab for C & S

17. Treatment Rehydration Antibiotics

18. Rehydration Mild dehydration Moderate dehydration Severe dehydration

19. Mild Dehydration Use ORS 50 ml/kg in the first 4 hours 100 ml/kg till diarrhoea stops

20. Moderate Dehydration Use ORS 100 ml/kg in the first 4 hours 10 – 15 ml/kg/hour

21. Severe Dehydration Use IV Fluids Ringer – Lactate, followed by ORS

22. Antibiotics Doxycyclin 100 mg stat – for adults EES for 5 days for children

23. Thank you