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12 Cards in this Set

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Vibrio cholerae
grahm
morphology
motility
-can be seen
-growth (special approach)
-Specimens for recovery include
-Stool is characterized
1. Short slightly curved Gram-negative rod
2. Single polar flagellum
Characteristic darting motility
Can be seen on Darkfield
3. Grows rapidly on many media, but special approach needed: grows on alkaline media that inhibit other organisms
4. stool, rectal swabs. as "rice water"
Transport with minimal delay, susceptible to dehydration.
Can be semi-solid transport media (Carey-Blair), or wet blotter paper with fluid stool and put in air tight bag
Vibrio cholerae epidemiology

-parallels the recognition of its transmission... and devp of

-this strain emerged as prevalent organism in the late 1960's has caused pandemic disease in Africa, Asia, and the Middle East.

Strains associated with epidemic cholera are

-us cases
-Endemic cases now occur on
-Threat exists for
-preventions
-Recent Epidemic in
-A disease of the
-route of spread
-inoculation #s
-% of exposed that contract
-could be maintained in
1. The epidemiology of cholera closely parallels the recognition of its transmission in water and the development of sanitary water systems.
2. Vibrio cholera El for biotype emerged as prevalent organism in the late 1960's has caused pandemic disease in Africa, Asia, and the Middle East. Strains associated with epidemic cholera are serogroup 0:1.
3. In the U.S.:
Three cases from 1911-1978, 2 were lab workers
Endemic cases now occur on Gulf Coast
Threat exists for rapid transit of people from one place to another
Proper water control and active programs are important
4. Recent Epidemic in Central/South America
5. A disease of the poor
6. Fecal-oral route of spread
7. Requires 106 organisms with neutralized gastric acidity and 1012- organisms with

normal acidity to cause disease. Large numbers of organisms required in normal hosts
8. Only 1-5% of exposed individuals may contract disease
9. Maybe maintained in marine and fresh water crust-oceans
pathogenesis 4
1. An enterotoxin is produced which is responsible for the action on the bowel wall
2. Non-invasive
3. Very little intestinal mucosal change
4. Profound fluid loss
clinical disease 4
-Ratio of asymptomatic to symptomatic
Incubation
Several hours to 5 days
-Host factors important
about 4.1
onset is

-8 symptoms
sudden

-(a) profound watery diarrhea
(b) initially, stool brown with fecal matter
(c) soon becomes pale gray with little solid material
(d) inoffensive, slightly fishy odor
(e) mucus in stool imparts "RICE WATER" appearance
(f) tenesmus is absent--often a decrease in irritability, as enormous amounts of fluid passed effortlessly
(g) vomiting a common occurrence
(h) rapid, faint heart beat
(i) skin is cold, clammy, wrinkled
j)oliguria eventually occurs
(k) may have painful muscle cramps and CNS abnormalities
(1) loss of fluid continues 1-7 days and dehydration may be profound
(m) may have profound complications depending on fluid therapy
TX
1. Fluid therapy (EMERGENCY) W.H.O. oral rehydration regimen with water, electrolytes, glucose
2. Physiologic recovery prompt
3. Tetracycline drug of choice, could use ampicillin, chloramphenicoi, or sulfa-trimethoprim
(a) Decreases duration and volume of diarrhea
(b) Helps eradicate organisms
prognosis/mortality with and without therapy
1. As high as 60% mortality if untreated
2. 1-2% with good therapy even in severe disease
prevention
1. Vaccine
(a) 50% protection for 3-6 months
(b) two doses, one week to one month apart
(c) continued work on new vaccines using recombinant techniques
2. Good hygiene
3. World-wide surveillance
HALOPHILIC (SEA WATER) VIBRIOS

2 kinds

1. causes .. after eating... found in...

tx
Vibrio parahemolyticus

-causes acute gastroenteritis after ingestion of contaminated sea food such as raw fish or shell fish
2. coastal areas (or air transport of fresh fish)
3. self limited disease, may require rehydration
2nd halophilic vibrio

causes... from...
-can progress to
-major illness occurs in people with
-areas that are contaminated
-vibrio vulnificus

1.skin lesions from abraded skin and sea water contact
2. systemic disease, septicemia and death. Major illness occurs in individuals with chronic liver disease who have excess iron storage
3. coastal areas of Gulf of Mexico
HALOPHILIC (SEA WATER) VIBRIOS

2 kinds

1. causes .. after eating... found in...

tx
Vibrio parahemolyticus

-causes acute gastroenteritis after ingestion of contaminated sea food such as raw fish or shell fish
2. coastal areas (or air transport of fresh fish)
3. self limited disease, may require rehydration
2nd halophilic vibrio

causes... from...
-can progress to
-major illness occurs in people with
-areas that are contaminated
-vibrio vulnificus

1.skin lesions from abraded skin and sea water contact
2. systemic disease, septicemia and death. Major illness occurs in individuals with chronic liver disease who have excess iron storage
3. coastal areas of Gulf of Mexico