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Views: 0 Author: Diffei Medical Publish Time: 2023-08-21 Origin: 迪飞医学
Cholera is an acute intestinal infectious disease caused by the pathogenic bacterium Vibrio cholerae. It is characterized by acute onset, rapid spread, and wide spread.Cholera is one of the international quarantine infectious diseases stipulated in the International Health Regulations and one of the Class A infectious diseases stipulated in the Law of the People's Republic of China on the Prevention and Control of Infectious Diseases.
Recently, the Wuhan Municipal Health Commission issued a notice on the handling of a cholera case at Wuhan University:
Report on the handling of a cholera case in Wuhan University
Vibrio cholerae is a gram-negative bacterium and is divided into 139 serogroups, among which group O1 and group O139 can cause cholera.Under natural circumstances, humans are the only susceptible species to V. cholerae.Transmission occurs through ingestion of contaminated water or food and is mainly found in areas lacking adequate hygiene and clean drinking water. Direct person-to-person transmission is uncommon.After being infected with Vibrio cholerae, cholerae enterin can be produced, which acts on mucosal epithelial cells and intestinal glands to cause excessive secretion of intestinal juice. The feces is 'rice swill-like' and contains a large amount of Vibrio.Clinical manifestations include severe vomiting, diarrhea, water loss, and high mortality.
Infection with Vibrio cholerae group O1 can cause diarrhea ranging from asymptomatic or mild to severe and fatal diarrhea.Severe diarrhea and vomiting usually occur 2-3 days after ingesting the bacteria. Without treatment, the mortality rate is as high as 60%.The infection rate of Vibrio cholerae group O139 is higher than that of group O1, which is characterized by severe dehydration and high mortality!Each year, there are an estimated 3 million to 5 million cholera cases, with another 100,000 to 120,000 deaths.The disease peaks in summer and can cause diarrhea, dehydration and even death within a few hours.
microbiological examination
Cholera is a highly infectious disease. The etiological diagnosis of the first patient should be rapid and accurate, and the epidemic report should be made in a timely manner.The National Health Commission of my country pointed out in the 2004 'National Cholera Surveillance Plan (Trial)' that all localities must conduct inspections whenever suspected, and feces and/or vomit specimens must be collected for laboratory testing from every suspected cholera case.Metagenomic sequencing (mNGS) has the characteristics of fast speed and wide coverage. It can detect more than 20,000 pathogens and determine the pathogenic bacteria in a short time, which can well assist the diagnosis and treatment of clinical cholera.
Prevention and control principles
Improving the community environment, strengthening the management of water sources, feces and garbage, cultivating good personal hygiene habits, and not eating raw shellfish and seafood are important measures to prevent Vibrio cholerae infection and epidemics.
The key strategies for treating cholera are rapid and massive replacement of fluids with electrolytes and antimicrobial therapy.The use of antibiotics accelerates the clearance of bacteria and reduces persistent diarrhea and the production of exotoxins. Antibacterial drugs used to treat cholera include tetracycline, cidocycline, furazolidone, etc.However, it should be noted that the number of strains with multi-drug resistance is increasing, and the O139 group is more resistant than the O1 group, which will bring certain difficulties to treatment.If resistance genes such as floR, sul2, and catB are detected in the sample, it indicates that Vibrio cholerae may be resistant to florfenicol, chloramphenicol, sulfisoxazole tablets, erythromycin, and azithromycin.
