Chapter 8: King Cholera

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Published on 28 Mar 2011
School
UTSC
Department
Health Studies
Course
HLTB21H3
Chapter 8: King Cholera
Cholera: as known as ‘King Cholerain England
Water or food borne disease, sewage disease
·History: described as the history of pandemics
-7 pandemics:
1) 1816-1821: originated in India (River Ganges) and spread mainly by British troops, headquarters in Bengal
2) 1829-1851: reaching Europe, Canada, and the US
1831: mortality of 13% in Cairo, Egypt
1832: known as ‘King Cholerain England
1849: Americas greatest scourge
3) 1852-1859: scientific advances in understanding Cholera
4) 1863-1873
5) 1881-1896: hygienic measures stopped its spread to North America
6) 1899-1923: stopped for the most part of western hemisphere
7) 1961-ongoing: in its dying phase, series of outbreak below
·Etiology:
-Bacteria: Vibrio Cholerae (due to its vibrating wiggles), gram negative, comma-shaped bacillus (Koch saw the bacteria
in feces during 5th epidemic 1883)
-has two viruses within it, one that codes for cholera toxin (1929), the other codes for the receptor which allow the toxin
coding virus to enter bacterium
-bacteria can go dormant and enter spore-like cell when reproduction is not favourable, next epidemic boom may come
from phytoplankton triggered by global warming
-Incubation period: few hours to 5 days
·Transmission
-indirect transmission: fecal—oral route of transmission (water)
-bacteria can survive on food for up to 5 days at ambient temperatures, and up to 10 days at 5-10 c
-often found in the aquatic environment, can live in dirty water
-stomach gastric juice is lethal to V. cholerae
-low stomach acidity implies high susceptibility to cholera because the bacteria can survive on those environment
-people with O type blood are more susceptible
-infected individual can excrete a trillion viruses per day
-bacteria may become dormant in between epidemics, can only happen to humans
·Symptoms:
-severe diarrhea (producing ‘rice waterstools), vomiting, convulsions, muscle cramps
-but little abdominal pain, leads to loss of water and electrolytes but not protein, radical dehydration, ruptured capillaries
causing them to be black and blue.
-Death: severe dehydration in less than 10% of ill persons, sometimes within hours
·Diagnosis and Treatment:
-Dark-field or phase-contrast microscope
-1832: rehydration therapy
-Food-based ORT: using starches and proteins instead of glucose, antibiotics to reduce severity
-ORT(oral rehydration salts): glucose, NaCl, K and lactate
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Document Summary

Cholera: as known as king cholera" in england. 7 pandemics: 1816-1821: originated in india (river ganges) and spread mainly by british troops, headquarters in bengal, 1829-1851: reaching europe, canada, and the us. 1849: america"s greatest scourge: 1852-1859: scientific advances in understanding cholera, 1863-1873, 1881-1896: hygienic measures stopped its spread to north america, 1899-1923: stopped for the most part of western hemisphere, 1961-ongoing: in its dying phase, series of outbreak below. Bacteria: vibrio cholerae (due to its vibrating wiggles), gram negative, comma-shaped bacillus (koch saw the bacteria in feces during 5th epidemic 1883) Has two viruses within it, one that codes for cholera toxin (1929), the other codes for the receptor which allow the toxin coding virus to enter bacterium. Bacteria can go dormant and enter spore-like cell when reproduction is not favourable, next epidemic boom may come from phytoplankton triggered by global warming. Incubation period: few hours to 5 days. Indirect transmission: fecal oral route of transmission (water)