Cholera is an acute infectious disease. It is characterized by damage to the small intestine, impaired water-salt metabolism, varying degrees of dehydration due to loss of fluid with watery stools and vomit. Refers to the number of quarantine infections. The causative agent is Vibrio cholerae in the form of a curved stick (comma). When boiled, it dies after 1 minute. Some biotypes are stored for a long time and multiply in iodine, in silt, in the organisms of the inhabitants of water bodies. The source of infection is a person (patient and bacillus carrier). Vibrios are excreted in faeces, vomit. Epidemics of cholera are water, food, contact-household and mixed. Susceptibility to cholera is high.

The symptoms and course of cholera are very diverse – from asymptomatic carriage to the most severe conditions with severe dehydration and death.

The incubation period of cholera lasts 1-6 days. The onset of the disease is acute. The first manifestations include sudden diarrhea, mainly at night or in the morning. The stool is initially watery, later it takes on the form of “rice water” without smell, an admixture of blood is possible. Then profuse vomiting joins, appearing suddenly, often erupting in a fountain. Diarrhea and vomiting are usually not accompanied by abdominal pain.

With a large loss of fluid, the symptoms of damage to the gastrointestinal tract recede into the background. The leading ones are violations of the activity of the main body systems, the severity of which is determined by the degree of dehydration:

  • I degree : dehydration is expressed non-cardinally;
  • II degree : a decrease in body weight by 4-6%, a decrease in the number of red blood cells and a drop in hemoglobin levels, an acceleration of ESR. Patients complain of severe weakness, dizziness, dry mouth, thirst. Lips and fingers turn blue, hoarseness of voice appears, convulsive twitches of the calf muscles, fingers, chewing muscles are possible;
  • III degree : weight loss of 7-9%, while all of the listed symptoms of dehydration increase. With a drop in blood pressure, collapse is possible, body temperature drops to 35.5-36C, urine output may completely stop. The blood thickens from dehydration, the concentration of potassium and chlorine in it decreases;
  • IV degree : fluid loss exceeds more than 10% of body weight. Facial features are sharpened, “dark glasses” are found within the eyes. The skin is cold, clammy to the touch, cyanotic, prolonged tonic convulsions are frequent. Patients are in a state of prostration, shock develops. Heart sounds are sharply muffled, blood pressure drops sharply. The temperature drops to 34.5C. Frequent deaths.

Complications of cholera: pneumonia, abscesses, phlegmon, erysipelas, phlebitis.

Recognition of cholera. Characteristic epidemiological anamnesis, clinical picture. Bacteriological examination of feces, vomit, gastric contents, laboratory physical and chemical blood tests, serological reactions.

cholera treatment. Hospitalization of all patients. The leading role is given to the fight against dehydration and the restoration of water-salt balance. Solutions containing sodium chloride, potassium chloride, sodium bicarbonate, glucose are recommended. In severe dehydration – jet injection of fluid until the pulse returns to normal, after which the solution is continued to be injected drip. Foods containing a large amount of potassium salts (dried apricots, tomatoes, potatoes) should be included in the diet. Antibiotic therapy is carried out only in patients with III-IV degree of dehydration, tetracycline or chloramphenicol are used in average daily dosages. Discharge from the hospital after complete recovery in the presence of negative bacteriological tests. The prognosis for timely and adequate treatment is favorable.

Prevention of cholera. Protection and disinfection of drinking water. Active observation by a doctor of persons who have been in contact with patients for 5 days. For the purpose of specific prophylaxis, according to indications, corpuscular cholera vaccine and cholerogen toxoid are used.

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