Cholera

Cholera is an acute infectious disease characterized by epidemic spread in the summer-autumn period and development of heavy diarrhea in severe cases with rapid loss of fluid and salts leading to dehydration of the body.
It is a particularly dangerous infection.
Cause. The disease is caused by cholera vibrios - curved sticks with flagella, which causes their pronounced mobility. For a very long time they survive in open reservoirs into which drainage water flows and when water warms up more than 17 ° C. Resistant to low temperatures, they can overwinter in frozen water sources. On food products vibrios survive 2-5 days, tomatoes and watermelons in sunlight - 8 hours. They quickly die under the influence of various disinfectants, instantly die by boiling. Very sensitive to acids, which is used for disinfection of drinking water.
The source of cholera vibrios is only a person, a sick or a vibrio carrier, who came from a dysfunctional region in cholera.
Transmission of infection occurs by fecal-oral route. Most epidemics are associated with the use of contaminated water, but in the home, direct contamination of food by infected feces and vomit contributes to the spread of the disease, which, with cholera, does not smell and color, resulting in natural disgust and the desire to quickly clean contaminated objects. It is possible to infect through fish, crayfish caught in contaminated water bodies and not subjected to proper heat treatment, because in them vibrios can for a long time not only survive, but also multiply.
The susceptibility of people to cholera is high. Infection is facilitated by a decreased acidity of the gastric contents, which occurs with a plentiful drink.
Cholera is typical for South and South-East Asia (India, Indonesia, Thailand, etc.). In the 1970s, she left the region and gained widespread popularity. In 1970 there was an epidemic of cholera in Astrakhan, in 1994 in Dagestan 2321 people were captured, in 1995, to a considerable extent, struck Ukraine with the excrement in other regions. It spreads with greater ease than other intestinal infections.
The process of development of the disease. Gates of infection is the digestive tract. Once in the stomach, cholera vibrios often die due to the presence of hydrochloric acid there. The disease develops only when cholera vibrios overcome the stomach and reach the small intestine. There, they multiply intensively and produce a toxin that causes intense secretion of tissue fluid into the lumen of the small intestine, reaching 1 liter for an hour. As a result, there is a thickening of blood and dehydration of body tissues.
Resistant immunity after the transferred illness does not develop, repeated diseases are possible.
Signs. The incubation period lasts from several hours to 5 days.
The disease begins acutely. The first sign of cholera is the sudden onset of painless diarrhea. In most cases, stools are watery from the very beginning. They are a cloudy white liquid with floating flakes, do not have a smell and resemble a rice decoction in appearance. In severe cases, the initial stool volume may exceed 1 liter. In the next few hours from the onset of the disease, fluid loss can be several liters, which quickly leads to a serious condition of the patient. Vomiting appears after diarrhea suddenly, is not accompanied by any tension and sensation of nausea, very quickly becomes watery and also similar in appearance to rice broth. Soon there are strong muscle cramps, more often in the calf area.
The facial features are sharpened, eyes fall, the skin feels cold, it is easy to gather into folds and slowly straightens. The voice becomes hoarse and disappears, there is shortness of breath, body temperature drops below normal.
Along with severe cases of the disease, there are lungs, flowing with moderate losses of fluid, and asymptomatic, in which the infected remains healthy, but with feces secrete cholera vibrios.
Recognition of the disease. The diagnosis of the first cases of cholera in the area where it was not previously, is necessarily confirmed by laboratory tests. For the study, take stool and vomit. The material is collected in individual, washed from the disinfectant solutions of the vessel, to the bottom of which is placed a smaller, disinfected by boiling, a vessel or sheets of parchment paper.
Urgent care. The paramount task with any diarrhea is compensation of loss of fluid and salts in accordance with the degree of dehydration. To this end, it is recommended to drink, but not any liquid, and a solution - 1 teaspoon of table salt, 4 teaspoons of sugar per 1 liter of drinking water. The solution is taken in a slightly cooled form for 100-150 ml every 20-30 minutes with a total volume of 1.5 times the loss of fluid with vomit and feces.
All patients with cholera and vibrio carriers are subject to mandatory hospitalization in hospitals with a special regime.
Examination. Those who have been ill for 1 year are under medical supervision. Mandatory examination of feces to exclude vibrio carrying.
Prevention of disease. In order to prevent importation of the causative agent of cholera from abroad, sanitary inspection of vehicles arriving from there is carried out, bacteriological examination of the citizens ill with acute intestinal infections is carried out within 5 days after arrival from the countries unfavorable for cholera.
A study of the water of surface water bodies for the presence of cholera vibrios is conducted.
After hospitalization of the patient or vibrio-carrier in the apartment disinfection is carried out.
Persons who interact closely with a sick or vibrio-bearer and suffer from diseases of the gastrointestinal tract are hospitalized. They are discharged after a 5-day medical observation and examination for cholera vibrios.