1. VIBRIO CHOLERAE CHOLERA

2. CHARACTERISTICS GRAM-NEGATIVE, COMMA SHAPED BACILLI MOTILE – POLAR FLAGELLA OXIDASE – POSITIVE CATALASE – POSITIVE ALKALNE PH ( 6.8 – 10.2)  SELECTIVE MEDIA ( TCBS )  ALKALINE PEPTON WATER

5. ANTIGENICITY SOMATIC – O ANTIGE  VIRIO CHOLERAE O-1  NON- O-1 V. CHOLERAE  V. CHOLERAE O-139 ( BENGAL) - 1992 BIOTYPES: 2  CLASSICAL (MORE SEVERE)  EL-TOR SEROTYPES: 3  INABA, OGAWA, HIKOJIMA

6. HABITAT HUMAN  MAIN SOURCE NATURALLY  IN ACQUATIC ENVIRNMENT

7. PATHOGENESIS INGESTION OF CONTAMINATED DRINK WATER, FOOD ID - 10 – 10 MULTIPLY IN SMALL INTESTINE, ILEUM ENTEROTOXIN SIMILAR TO HLET OF E. COLI ACTIVATE ADENYLATE CYCLASE CAMP FLUIDS, EECTROLYTES DIARRHOEA, VOMITING

8. NO INTESTINAL INVASION NO BACTEREMIA NO SEPTICAEMIA LESIONS ARE PATHOPHYSIOLOGICAL

9. CLINICAL PICTURE INCUBATIN PERIOD (IP)  1 – 4 DAYS  ACUTE ONSET EFFORTLESS VOMITING PROFUSE WATERY DIARRHOEA (RICE – WATER ) RAPID DEHYDRATON (10 – 20 L/ DAY) HYPOVOLAEMIC SHOCK - DEATH

10. IMMUNITY VERY SHORT REINFECTIONS(REPEATED ATTACKS) ARE COMMON

11. EPIDEMIOLOGY HUMAN (ONLY HOST ) POOR ENVIROMENTAL SANITATION POOR WATER SUPPLY CONTAMINATED WATER INDIAN SUBCONTINENT,BANGLADESH PANDEMICS - EL-TOR BIOTYPE OUTBREAKS EPIDEMICS ( PILGRIMAGES ) EL- TOR PROLONGED CARRIAG (ENDEMIC INFECTION)

15. LABORATORY DIAGNOSIS SPECIMENS :  STOOLS  RECTAL SWAB MICROSCOPY:  DARTING MOVEMENT CULTURE :  TCBS ( YELLOW COLONIES)  ALKALINE PEPTONE WATER(6 – 8 h) SEROLOGICAL IDENTIFICATION  SLID AGGLUTINATION FOR SEROTYPES

18. TREATMENT REHYDRATION  REPLACEMENT : FLUID, ELECTROLYTES ANTIBIOTIC  TETRACYCLINE

19. PREVENTION CONTROL PATIENTS  ISOLATION, TREATMENT CONTACTS  PROPHYLAXIS (TETRACYCLINE) WATER  PURE SUPPLY, PROPER TREATMENT SEWAGE  PROPER DISPOSAL HEALTH EDUCATION

20. VACCIN NO EFFECTIVE VACCINE AVAILABLE  KILLED (INJECTION)  LIVE ATTENUATED (ORAL) REACTOGENIC SHORT IMMUNITY

21. V.PARAHAEMOLYTICUS FOOD POISONING SEA FOODS (RAW, UNDERCOOKED) HALOPHILIC (NACL) GROWS ON TCBS AGAR  (GREEN COLONIES) TREATMENT :  REHYDRATION

22. CAMPYLOBACTER GRAM – NEGATIVE BACILLI S- SHAPED (SPIRAL) ACTIVELY MOTILE OXIDASE POSITIVE CATALASE POSITIVE MICROAEROPHILIC ( 5 – 10% CO ) NON CAPSULATED

24. SPECIES C.JEJUNI  MOST COMMON  THERMOPHILIC (42C – NOT 25C )  HIPPURATE HYDROLYSIS +  SELECTIVE MEDIA (SKIRROW’S ) C. COLI C. FETUS  GROW AT 25 C

25. DISEASES ENTERITIS  80 – 90% ( C. JEJUNI )  C. COLI SEPTICAEMIA, MENINGITIS,ENDOCAR.  C. FETUS  IMMUNOCOMPROMISED  EXTREME OF AGE

26. SOURCE INTESTINE OF BIRDS ( CHIKEN ) DOMESTIC ANIMALS, CATTELE(BEEF) UNPASTEURISED MILK CONTAMINATED WATER

27. CHARACTERISTICS GRAM NEGATIVE SPIRAL SHAPED BACILLI MICROAEROPHILIC OXIDASE POSIIVE UREASE POSITIVE

28. PATHOGENESIS INVASIVE DISEASE ( COLON ) – ID:100 DYSENTERIC LIKE ILLNESS  BLLODY DIARROEA  FEVER  ABDOMINAL PAIN WATERY DIARROEA (ENTERTOXIN)  ILEUM SEPTICAEMIA (IMMUNOCOMPROMISED)

29. TREATMENT REHYDRATION  ELECTROLYTES  FLUIDS ANTIBIOTIC :  ERYTHROMYCIN  CIPROFLOXACIN  GENTAMICIN ( SEPTICAEMIA )

30. HALICOBACTER PYLORI

31. HABITAT GASTRIC MUCOSA ( MUCUS LAYER )

32. TREATMENT AMOXACILLIN METRONIDAZOLE + BISMUTH SUBCITRATE FOR 1 - 2 WEEK OR CLARITHROMYCIN + AMOXACILLIN + OMEPRAZOLE FOR 1 WEEK

33. DISEASES CHRONIC ACTIVE GASTRITIS PEPTIC ULCER ASSOCIATED WITH GASTRIC CARCINOMA LYMPHOMA ( MALT )