Cholera Cholera is an acute diarrhoea disease caused by Vibrio cholera Vibrio cholera : 'Gram-negative bacterium' that produces cholera toxin (enterotoxin), which act on C-AMP system of mucosal cells of epithelium lining of the small intestine (to cause massive diarrhoea) Classic biotype El Tor biotype (serotypes: Ogawa , Inaba and Hikojima) Incubation period : 1-2 days (Few hours - 5 days) Reservoir : Human beings only Rice-water diarrhoea Essentials for treatment of cholera : Water and electrolyte replacement (ORS) Guidelines for Cholera control Verification of diagnosis Identifying Vibrio cholerae 01 in stools OF FEW PATIENTS is sufficient. It is not necessary to culture stools of all cases or contacts Notification Cholera is a notifiable disease locally, nationally and internationally Under international Health Regulations, cholera is notifiable to WHO by national Govt Within 24 HOURS (no. Of cases & deaths to be repoed daily and weekly) An area is declared free of cholera when TWICE the OP had elapsed since last case Early case finding: Through aggressive case search Establishment of treatment centres Rehydration therapy : through ORS Adjuncts to therapy : Only antibiotics may be used when vomiting stops Group Antibiotic of choice Treatment Adults Doxycycline Children Azithromycin Pregnancy Azithromycin Chemoprophylaxis Tetracycline Epidemiological investigations : General sanitation measures, epidemiological studies Sanitation measures : Water control, excreta disposal, food sanitation, disinfection Chemoprophylaxis :. Mass chemo prophylaxis I'd not advised for total community ; is only advisable for house hold contacts or a closed community Drug of choice for chemoprophylaxis : Tetracycline. To prevent one case of cholera, 10000 persons need to be given chemoprophylaxis Vaccination Health education Most effective prophylactic measures Ref: park 25th edition Pgno : 247-256