BY:

Nurul Ain Bt. Rosli

Nur Azimah Bt. Azman

Raja Nur Rahifah Inani Bt. Raja Abdul Rahman

DEFINITION..

• An acute diarrheal illness

• Caused by infection of the intestine

• By bacteria Vibrio cholerae (V. cholerae)

• Through ingestion of food or water contaminated with V. cholerae

• Can be endemic, epidemic, pandemic

Infectious agent : Vibrio cholerae

• A gram-negative bacteria

• Comma-shaped

• 1-3 mm (length), 0.5-0.8 mm (diameter)

• Non-spore forming

• Single, polar flagellum

• Oxidase positive

• Multiply freely in water

• Has 2 major biotypes:

– Classical

– El Tor

EPIDEMIOLOGY: WORLDWIDE

• 7 cholera pandemics since 1817.

• The first 6 (from 1817-1923) - caused by V.cholerae.

• Originated in Asia with subsequent spread to other continents.

• The 7th pandemic:

– Began in Indonesia (1961)

– Affected more countries and continents

– Caused by V.cholerae El Tor

• October 1992:

– Cholera epidemic emerged from Madras, India

– Caused by a new serogroup 0139 (Bengal)

• Then, spread throughout Bangladesh, India, and the neighboring countries in Asia.

• In United States and other developed countries, cholera is not a major threat (rare).

Epidemiology: Malaysia

• 11th May 1996:

– First case of cholera was confirmed

– Caused by Vibrio cholerae biotype El Tor

• Since then, total of 607 cases have been confirmed in the whole country, 476 of them were in Penang

SIGNS & SYMPTOMS

Pathophysiology Of Cholera Disease

TRANSMISSIONSDrinking contaminated water

Eating raw oysters

LABORATORY DIAGNOSIS

Isolation and identification of Vibrio cholerae

• Dark field or phase contrast microscopy.

• Culture of stool specimen on selective thiosulfate-citrate-bile salts-sucrose (TCBS) agar plate.

• Yellow colonies is formed.

PCR- detect genetic material of cholera

Rapid immunochromatographic dipstick testing- areas where cholera is endemic

TREATMENTSOral Rehydration Salt (ORS)

• To replace the fluid loss in the body

• Rehydration

Intravenous Fluid

• For severe cases.

Antibiotics

• Doxycycline

• Azithromycin

CONTROLS

• Set up treatment centers for rapid treatment.

• Food safety and animal health measures.

PREVENTIONS• Drink only safe water!

• Avoid raw meat. Eg : sushi.

• Eat food that's completely cooked and hot.

• Wash hands with soap and water frequently.

• Stick to fruits and vegetables that you can peel yourself.

• Be wary of dairy foods, including ice cream.

• Go get vaccine!

ISLAMIC PERSPECTIVES

“For Allah loves those who turn to Him constantly and He loves those who

keep pure and clean”

(Al-Baqarah 2:222)

Prophet Muhammad PBUH said “purification is half of faith”

(Hadith Muslim)