1. Cholera: How can we control it’s spread? Morgan McAdam http://therevolutionaryindustrialrevolution. blogspot.com/2012/08/cholera.html

2. Background Info. Two lethal serogroup strains that cause epidemic cholera. These serogroups produce enterotoxins. Enterotoxins lead to diarrhea and dehydration.

3. History Believed to have originated 2,500 years ago near Ganges delta in India. 7 recorded cholera pandemics ◦ 1 st in Calcutta in 1817 ◦ 7 th in Latin America in 1991 Haiti in current cholera epidemic.

4. Why did it Spread? Spread by ingesting food or water that contains fecal contamination. Industrial Revolution ◦ Urbanization ◦ Crowded ◦ Poor sanitation These same factors allow the spread of cholera in third world countries today. http://webs.bcp.org/sites/vcleary/ModernWo rldHistoryTextbook/IndustrialRevolution/IRE ffects.html

5. Symptoms Only 5-10% of infected people have severe or life threatening symptoms. Most common is diarrhea. Lead’s to dehydration which can lead to shock and even death. Symptoms appear with 2hrs to 5 days after exposure.

6. Prevention Drink & use clean water when cooking and brushing teeth. Wash hands frequently with soap and water. Use specified bathroom to avoid fecal contamination of water. Cook food, especially seafood, for required amount of time.

7. Current Treatment 99% of people that receive immediate treatment have a quick and full recovery. Intravenous fluid and antibiotics are also used. Most common treatment is oral rehydration salts. ◦ 80% effective. ◦ Mixture of salt, water and glucose.

8. Oral Rehydration Salt Research 3 types of ORS tested ◦ One only glucose ◦ One glucose & amylase-resistant starch (ARS) ◦ One only rice Fecal samples were tested for cholera for 28 days. Rice-ORS lead to a faster recovery.

9. Salovum Egg Yolk Research Antisecretory factor (AF) is a protein found in human organs & reduces fluid loss. Tested to see if increasing AF in chicken egg yolks would increase AF production in cholera patients. End result showed no benefit.

10. Vaccination Oral vaccine, requires 2 doses. Effective for a limited amount of time. 2 vaccines ◦ DuKoral-WHO approved and licensed in 60 countires. ◦ ShanCol-licensed in India.

11. Vaccination Research Widespread vaccination in Bangladesh How effective is mass vaccination? 82% of population received one dose, 72% received both doses. Program cost $461,161 or $3.93 for both doses per person.

12. Conclusion Oral-rehydration salts are the most effective treatment. Preventative measures are not enough. Vaccination is the most time and cost effective measure. Culmination of all three are crucial to control the spread of cholera.

13. Bibliography Alam, N. H., Ashraf, H., Olesen, M., Salam, M. A., Gyr, N., & Meier, R. (2011). Salovum egg yolk containing antisecretory factor as an adjunct therapy in severe cholera in adult males: A pilot study. Journal of Health, Population and Nutrition, 29(4), 297-302. Retrieved from http://search.proquest.com/docview/900729869?accountid=13215 http://search.proquest.com/docview/900729869?accountid=13215 Centers for Disease Control and Prevention. Cholera - Vibrio cholerae infection. Retrieved from http://www.cdc.gov/cholera/illness.html. 19 Nov. 2014. Karlen, Arno. Man and Microbes. 1st ed. New York, NY: G.P. Putnam's Sons, 1995. 130-9. Print. Khan, I.A., Saha, A., Chowdhury, F., Khan, A.L., Uddin, M.J., Begum, Y.A., Riaz, B.K., Islam, S., Ali, M., and Luby, S.P. (2013). Coverage and cost of a large oral cholera vaccination program in a high- risk cholera endemic urban population in dhaka, bangladesh. Vaccine 31(51), 6058-64. Livestrong. How oral rehydration salt works. http://www.livestrong.com/article/312098-how- oral-rehydration-salt-works/. 19 Nov. 2014http://www.livestrong.com/article/312098-how- oral-rehydration-salt-works/ Monira, S., Hoq, M. M., Chowdhury, A. K. A., Suau, A., Magne, F., Endtz, H., and Alam, N. H. (2010). Short-chain fatty acids and commensal microbiota in the feces of severely malnourished children with cholera rehydrated with three different carbohydrates. European Journal of Clinical Nutrition, 64(10), 1116-24. doi:http://dx.doi.org/10.1038/ejcn.2010.123 Wisc-Online. Pathology of cholera. http://www.wisc- online.com/Objects/ViewObject.aspx?ID=MBY1602 24 Nov. 2014.http://www.wisc- online.com/Objects/ViewObject.aspx?ID=MBY1602 World Health Organization. Cholera. http://www.who.int/mediacentre/factsheets/fs107/en/. 19 Nov. 2014.