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Cholera


Acute infectious disease. It is characterized by lesions of the small intestine, impaired water-salt metabolism, varying degrees of dehydration due to loss of fluid with watery stools and vomit. It belongs to the number of quarantine infections. The causative agent is a cholera vibrio in the form of a bent stick (comma). When boiling dies after 1 minute. Some biotypes persist for a long time and multiply in iodine, silt, organisms of inhabitants of water bodies. The source of infection is a person (sick and bacilli carrier). Vibrios are excreted in faeces, emetic masses. Epidemics of cholera are water, food, contact-household and mixed. Susceptibility to cholera is high.
Symptoms and course:
Very diverse - from asymptomatic carriers of severe conditions with severe dehydration and death.
The incubation period lasts 1-6 days. The onset of the disease is acute. The first manifestations include suddenly appeared diarrhea, mainly in the night or morning. The chair is initially watery, later acquires the form of a "rice-free" odorless, blood may be admixed. Then, abundant vomiting appears, appearing suddenly, often erupting a fountain. Diarrhea and vomiting are usually not accompanied by abdominal pain. With a large loss of fluid, the symptoms of gastrointestinal damage recede into the background. Leading are violations of the main body systems, the severity of which is determined by the degree of dehydration. Degree 1: dehydration is expressed slightly. Grade 2: weight loss of 4-6%, a decrease in the number of red blood cells and a drop in hemoglobin level, accelerated ESR. Patients complain of severe weakness, dizziness, dry mouth, thirst. Lips and fingers turn blue, hoarseness appears, convulsive twitching of the calf muscles, fingers, masticatory muscles are possible. Grade 3: weight loss of 7–9%, with all of these symptoms of dehydration exacerbated. With a drop in blood pressure, a collapse is possible, the body temperature drops to 35.5-36 ± C, and the release of urine can completely stop. Blood from dehydration thickens, decreases the concentration of potassium and chlorine in it. 4 degree: loss of fluid is more than 10% of body weight. Sharpen facial features, appear "dark glasses" around the eyes. The skin is cold, sticky to the touch, bluish, frequent prolonged tonic convulsions. Patients in a state of prostration, shock develops. Heart sounds are sharply muffled, blood pressure drops sharply. The temperature drops to 34.5 ± C. Frequent deaths.
Complications: pneumonia, abscesses, phlegmon, erysipelas, phlebitis.
Recognition:
Characteristic epidamniasis, clinical "" arthina. Bacteriological examination of feces, emetic masses, gastric contents, laboratory physical and chemical blood tests, serological reactions.
Treatment:
Hospitalization of all patients. The leading role is assigned to the fight against dehydration and restoration of water-salt balance.
Solutions containing sodium chloride, potassium chloride, sodium bicarbonate, glucose are recommended. In severe dehydration - jet injection of the liquid to normalize the pulse, after which the solution continues to enter drip. The diet should include foods containing large amounts of potassium salts (dried apricots, tomatoes, potatoes). Antibiotic therapy is carried out only in patients with 3-4 degrees of dehydration, tetracycline or chloramphenicol is used in average daily dosages. Discharge from the hospital after full recovery in the presence of negative bacteriological tests. The prognosis for timely and adequate treatment is favorable.
Prevention:
Protection and disinfection of drinking water. Active observation by a doctor of persons who were in contact with patients for 5 days. For the purpose of specific prophylaxis, according to the indications, corpuscular cholera vaccine and cholerogen-toxoid are used.