Lecture Notes About Cholera

CHOLERA Vibrio gram negative bacilli Curved or comma shoped. CLASSIFIKATION OF VIBRIO SALT REQUIREMENT o Non-halophilic vibrios 1 ob neoded, ex-V.choleme & V. Mimicus • Halophilic vibrioc High salt amc upto 7-10%.. V parahaemghies, Valgundy thus Vul ficus cellulilis Bellus Nevoliy// GARDNER & VENKATRAMAN CLASSIFICATION SERGROUPING somatic O-antiglio -001 serogroup Responsibl for pandemic. agglutinated by 01-Antisera NAG Vibrios serogroup nonngglutinated or NAG ubrio NON-PATHOGENTE, agy with resp antier. 0139 13 tres m India & Ronghe sev o-fred's in -No 01/0139 serogrouy diorthee & ext-manil BIOTYPING classical Ceragrap 157 Tor I classical Biotype Hich) virulent XEl Tor Biotre XELOX Varicants matlab, mozampiqu variante okt's extent PATHOGENESIS OF & Toxin Mediated CHOLERA A Vibrio cholen ODA 0139) capelle of producing Chilere toxin. Mode of Transmission 2 infective dose Ingestion of contaminated water or Extremed Acid Viabile, So food 108 (High in fective dose) is reg. to bypass the gastric Borrier Towing of protective layer of mucus :- Hight active motits secrete (mucinase & other prokaftit efoes secreting Chemagglutinin protease) (cholera lectin Adhesion to mtestinal epithelian facilitated by special type IN fimbria called Toxin-coregulated Pilus (TCP) COLONIZATION Eindry, Binh ganglio side SNIALL INTESTINE CHOLERA TOXIN organiums produce estestixin Heat lobile Toxin of Ecoli receptor Cou're ribosylation of G-Botein TCAMP Incense in cyclic Amp, 5)) cylic Ame inhibits the absorptite sodium transport system) In Villus cells and activate chloride telect (Nell) plein crypt cells; lead to occumulation of sodium chloride in intestinal lumen. water moves passive into bowel lumen to maintain Cosmolalit which leads to ecc. of is ofonic fluid. watery diomher. Loss of FWID & ELECTROLYTES lead to SHOCK (Dehydratia) Aclposts (loss of Bicechonste) CLINICAL MANIFESTATIONS OF CHOLERA 1. Asymptomatic infection (75% (auses) 2. Mild Diarrhole or cholera (20%) 3. Sudden onset of explosive & life threatening diorrher (5.1) Incubation period varils from 24 to 48 hours. * Walter, dixth eyes caden oreet of painless watery diarrhoer that may become voluminous. • RICE WATER STOOL Stool is topically hom-biliou's ligny cloud and watery with mucus flakes and a fishy), notten sive odour. Non-invasive No Blood o pes associated. • PROGRESSION OF CLINICAL FEATURES LABORATORY DIAGNOSIS SPECIMENS WATRY STOOL of Rectal swal before sting the Antointice) (convalesco) TRANSPORT MEDIA: Venkatraman-Ramakrishnan Medium (EUR) Alkaline salt transport Medium •CAMY BLAIR MEDIA (Chia & Salmonelle) • AUTOCLAVER SEA WATER DIRECT MICROSCOPY GRAM NEGATIVE RODS Comma shaped (Fish in stream Appearance) HANGING PROP DARTING MOTILITY CULTORE Enrichment Broth: Alkaline peptone water, Ntonsur's taurocholates tellerite pepbile •Bile salt's ager, TCBS-Selective Media →Macconkey ager producing translucent NLF colonies CULTURE SMEAR & MOTILITY TEST reveals- short curve gram negative Bacilli ✓ Darfing Motilig. IDENTIFICATION → CATALASE & OXIDASE POSITIVE →ICUT test- Indole (+) Citrale Variable Urease→→→ TSI (Tmple suge iron ager test-A/A, gas,₂S STRING TEST POSITIVE (+) →HEMODIGESTION ON BLOOD AGAR AUTOMATED SYSTEM SUCH AS MALDI-TOF & VITER BIOTYPING →Differentiate classical & El TOR SEROGROUPING Diff OGAWA INABA, (HIKOJIMA serotypes of serogroup 01 SEROTYPING Diff 01 & 0139 ANTIGEN DETECTION by Cholera dipstick assay MOLECULAR METHOD → multiple PCR detecting common diorrhveel pathogens. ANTIMICROBIAL SUSCEPTIBILITY TESTING