NURS 2550H Study Guide - Final Guide: Oral Rehydration Therapy, Cholera Toxin, Tachycardia
26 Jun 2018
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Chain of
Infection
Infectious agent: Vibrio Cholerae (V.C.), a gram-negative bacterium
155 known serotypes, only two serotypes (O1 and O139) are
responsible for all epidemic and endemic cholera
produces cholera toxin and enterotoxin, acting on the mucosal
epithelium of the small intestine
The bacteria can be destroyed by stomach acid, the size of the
infectious dose is 100 million
Reservoir: Humans are the primary reservoir (they can be asymptomatic)
V.C. does exist in aquatic reservoirs, can be found on the bilge of boats
Can also be contracted by ingesting raw or undercooked shellfish as
they contain the bacteria
Portal of Exit: Human reservoir is from anus in fecal waste
Aquatic reservoir is in water used for drinking or food preparation
Mode of Transmission: Primary mode of transmission is the ingestion of
water containing V.C or the preparation of food using water containing
V.C.
Usually during an outbreak, there is hand to mouth transmission. This
occurs due to poor hand hygiene and inadequate sanitation of
washrooms (fecal-oral route)
Symptomatic patients begin shedding the bacteria in their stool before
symptoms begin and continue for one to two weeks after
Portal of Entry: Through the mouth with ingestion of contaminated food
and/or water.
Susceptible Hosts: Infants, young children, elderly persons, pregnant
women
Epidemiologica
l Data
Clinical Signs
and Symptoms
The infection can be mild or without symptoms or can develop into severe
cholera.
Profuse diarrhea, referred to as “rice-water stools”, vomiting, rapid heart
rate, loss of skin elasticity, low blood pressure, thirst, muscle cramps, dry
mucous membranes, restlessness, irritability.
Patients with severe cholera can develop acute renal failure, severe
electrolyte imbalances, coma and death.
Diagnostics and
Medical
Management
Identification and isolation of V.C. by culture of a stool specimen is used
for diagnosis.
Commercially available rapid test kits are helpful to use in epidemic
settings but is not the gold standard diagnostic tool.
Cholera vaccines do exist for travelers heading to areas of active cholera
transmission and for the populations of those areas, these vaccines offer
incomplete protection.
Treatment of cholera includes oral rehydration therapy, intravenous (IV)
hydration, antibiotics, and lately zinc supplementation.
Prevention of cholera is dependent on access to clean drinking water and
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Document Summary
155 known serotypes, only two serotypes (o1 and o139) are responsible for all epidemic and endemic cholera. Produces cholera toxin and enterotoxin, acting on the mucosal epithelium of the small intestine. The bacteria can be destroyed by stomach acid, the size of the infectious dose is 100 million. Reservoir: humans are the primary reservoir (they can be asymptomatic) V. c. does exist in aquatic reservoirs, can be found on the bilge of boats. Can also be contracted by ingesting raw or undercooked shellfish as they contain the bacteria. Portal of exit: human reservoir is from anus in fecal waste. Aquatic reservoir is in water used for drinking or food preparation. Mode of transmission: primary mode of transmission is the ingestion of water containing v. c or the preparation of food using water containing. Usually during an outbreak, there is hand to mouth transmission. This occurs due to poor hand hygiene and inadequate sanitation of washrooms (fecal-oral route)
