SITI NUR BAITI BINTI SHAIK

KHAMARUDIN
012013100196
1

MODE OF TRANSMISSION
Cholera is spread by contaminated
water and food rather than direct personto-person spread.
Ingestion of food or water contaminated
with feces or vomitus of cases or carrier/
Consumption of raw or improperly
cooked seafood.
Other foods harvested from estuarine
water or seawater.

INCUBATION PERIOD

The incubation period ranged from few hours to 5

days, usually 2-3 days.

PERIOD OF COMMUNICABILITY
For

the duration of the stool-positive

stage, usually until 2-3 days after
recovery, however, carrier state may
persist for months.
Appropriate antibiotics can shorten the
period of communicability, but are not
recommended for treatment.

HOST SUSCEPTIBILTY AND

RESISTANCE
1) Poor sanitation
Cholera is seen in communities with
poor sanitation.
Contaminated water plays a role.
Cholera outbreaks happen after natural
disasters - earthquake in Haiti in 2010.

2) Blood group
Cholera occurs more often in person with
blood type O.
The mechanisms are not clearly understood.
Those people are twice as likely to develop
cholera as are people with other blood types.

3) Level of gastric acid

Cholera bacteria cannot survive in an
acidic environment normal level of
gastric acid serves as first line defense.
People with low stomach acid level
children, older adults and people who
take antacids, H-2 blockers or proton
pump inhibitors.
Lack of protection.

WHO ARE RESISTANT?

Breastfed

infants are at reduced risk of

cholera.
People who acquire antibodies by early
adulthood.
However, previous exposure does not
confer immunity against future
infection.

TREATMENT
Intravenous

fluids

Oral rehydration during epidemic

Severely dehydrated patients may need IV
fluids.
Antibiotics

Not necessary but may reduce amount &

duration of cholera-related diarrhoea.
Only to severe dehydrated patient.
A single dose doxycycline ( Adoxa, Monodox) or
azithromycin (Zithromax, Zmax).

10

PREVENTION STRATEGIES
Traveller education
consult with a travel clinic regarding
occurrence of cholera & vaccination
recommendation.
avoid eating raw oysters & undercooked
shellfish and fish.

11

Vaccination
Two types of oral vaccines:
WC-rBS (Dukoral) - killed whole cells of V.
cholerae O1 plus additional recombinant
Cholera Toxin B subunit (CTB).
BivWC (Shanchol & mORCVAX) killed whole
cells V. cholerae O139 without CTB.
Both are given in 2 doses, 1-6 weeks apart.
Only 2 years protection.

12

REFERENCES

Murray, Rosenthal, Pfaller. Medical Microbiology.

7th edition (2013). Elsevier Saunders.
Mayo Clinic
http://
www.mayoclinic.org/diseases- conditions/chole
ra/basics/risk-factors/con-20031469?p=1
Lecture notes
Ontario Ministry of Health and long-term care
http://
www.health.gov.on.ca/en/pro/programs/publichea
lth/oph_standards/docs/cholera_chapter.pdf
#_ga=1.4170608.1700645002.1434292685
Manitoba Health: Public Health
http://
www.gov.mb.ca/health/publichealth/cdc/protocol
/cholera.pdf