•Group 15•

CholeraSiti Nur Farhana Binti Mohd Asri 126627

Siti Nur Fatihah Binti Zoo 126728

Siti Nur Syahadah Binti Shamsuddin 125624

Siti Rodziah Binti Bashsh 126701

Siti Solehah Binti Mohd Noh 125625

Soh Shi Ting 125626

Suad Binti Sa’aban 125627

Subhashini A/P Thirsuchelvan 125654

Sufial Amir Bin Rahim 122152

Suraya Adlina Binti Hashim 123155

Suzila Binti Mat Dani 125628

Syahida Aini Binti Said 100038

Syarifah Nurul Athira Binti Syed Ahmad 122153

Introduction

Cholera is a severe gastrointestinal disease caused by bacteria which involve severe diarrhoea and vomiting.

Cholera usually spread through contaminated water.

Left untreated, it can be fatal in a matter of hours, even in previously healthy people.

Introduction (cont.)

Every year, there are an estimated 3–5 million cholera cases and 100 000 –120 000 deaths due to cholera. The short incubation period of two hours to five days, enhances the potentially explosive pattern of outbreaks.

Agent of cholera : Vibro cholerae•Gram-negative

–Lipopolysaccharide coat which provides protection against hydrophobic compounds

–Provides a surface for immune recognition

•0.5-0.8μm width and 1.4-2.6μm length

•Comma-shaped bacterium

•Single polar flagellum for movement (motile)

•Optimal growth 20-30 degrees

•Facultative anaerobic organism

–An organism that makes ATP by aerobic respiration if oxygen is present but is capable of switching to fermentation or anaerobic respiration if oxygen is absent

Ecology of Vibro cholerae

Thrives in a water ecology, particularly surface of water

The primary connection between human and pathogenic strains is through water

Particularly in economically reduced areas that having poor sanitation and inadequate hygiene

History of CholeraDuring the 19th century, cholera spread across the world from its original reservoir in the Ganges delta in India.

Six subsequent pandemics killed millions of people across all continents.

The current (seventh) pandemic started in South Asia in 1961, and reached Africa in 1971 and the Americas in 1991. Cholera is now endemic in many countries.

Vibro cholerae was first isolated as the cause of cholera by Filippo Pacini in 1854, but his discovery was not widely known.

until Robert Koch (who also discovered the cause of tuberculosis), working independently 30 years later, publicized the knowledge and the means of fighting the disease.

How cholera spread

The bacteria vibro cholerae release exotoxin into the small intestine that causes massive flow of water and electrolytes like sodium, chloride and bicarbonate, into the intestine where the fluid and electrolytes are excreted as diarrheal fluid. It colonizes the small intestine

Particularly its localization along the villous axisRegionspecific colonization factor that is critical

for colonization of the proximal but not the distal of small intestine

Risk factors

 Inadequate environmental managementat-risk areas include peri-urban slums, where

basic infrastructure is not available, as well as camps for refugees, where minimum requirements of clean water and sanitation are not met.

Risk factors (cont.)

Increasing size of vulnerable populations living in unsanitary conditions.

Risk factors (cont.)

The consequences of a disaster disruption of water and sanitation systems or the

displacement of populations to inadequate and overcrowded camps

Syria Malaysia

Causes

Drinking water contaminated with human feces

Using and drinking from tap water supplies

Do not have good water purification systems

Causes (cont.)

Foods and drinks sold by street vendors (not covered)

Vegetables grown with water containing human wastes

Causes (cont.)

Raw or undercooked fish and seafood caught in waters polluted with sewage

Symptoms•Rapid onset of copious, smelly and watery diarrhoea with severe dehydration. - This can lead to death if untreated.

Symptoms (cont.)

•Dehydration : •- Rapid heart rate

•- Loss of skin elasticity (the ability to return to original position quickly if pinched)

•- Dry mucous membranes, including the inside of the mouth, throat, nose, and eyelids

•- Low blood pressure

•- Thirst

•- Muscle cramps

Symptoms (cont.)

Rice Water Stool

Vomiting

People with low immunity such as malnourished children or people living with HIV are at a greater risk of death if infected

WORLD STATISTIC CHOLERA

MALAYSIA MINISTRY OF HEALTH

TreatmentRehydration – Fluid and electrolyte supplements

Treatment

Intravenous administration of fluids

Treatment

Antibiotics : - to diminish the duration of diarrhoea- reduce the volume of rehydration fluids needed- shorten the duration of Vibro cholera excretion.

PreventionVaccination

have sustained protection of over 50% lasting for two years in endemic settings

Prevention

Cook food well (especially seafood), keep it covered, eat it hot, and peel fruits and vegetables

Be sure to cook shellfish (like crabs) until they are very hot all the way through

Prevention

•Drink and use safe water :

–Use safe water to brush your teeth, wash and prepare food and to make ice.

–Clean food preparation areas and kitchenware with soap and safe water and let it dry completely before reuse.

–All water should be bottled and boiled for 1 minute or treated with chlorine

Prevention (cont.)

•Use toilet or bury your feces (poop); do not defecate in any body of water expanded

–Use toilet or other sanitation systems, like chemical toilets, to dispose of feces.

Prevention (cont.)

•Practice good personal hygiene

–Wash hands with soap and safe water after defecating.

How To Educate Public About Cholera

Promote safe water handling practicesfor example, organise mass campaigns for the

cleaning of water source

How To Educate Public About Cholera (cont.)

Continue routine analysis of water quality at source

especially household levels.

How To Educate Public About Cholera (cont.)

Mobilise the camp community to maintain these facilities

there may be a case for paying male and female toilet attendants during the outbreak period to ensure cleanliness.

How To Educate Public About Cholera (cont.)

Ensure that handwashing stations are located next to communal toilet.

How To Educate Public About Cholera (cont.)

Undertake heightened community education to ensure that communities are informed about and engaged in preventing an outbreak of cholera.

The education must be rapid and should employ all possible approaches to ensure the widest coverage.

Thank you