How can I avoid disease
A disease is an impairment of health or a condition of abnormal functioning which are caused by pathogens. A pathogen is an agent that causes disease which includes viruses, bacteria, fungi, yeast and protozoa. When a pandemic occurs, that means the disease is geographically widespread. When a disease attacks many people in a community simultaneously, that is a epidemic. Endemic is a disease that is constantly present to people of a certain class or living in a particular location.Cholera is an acute infection affecting the intestines caused by bacterium called Vibrio Cholerae found and spread in tropical and overcrowded areas where the water and food supplies are contaminated by this bacterium. This disease is the most dreaded epidemic diarrheal disease because of its severeness. The word ???Cholera??? is derived from a Greek word Khole, which means flow of bile, and the Latin word Cholera
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Means bilious diarrhea. The incubation period is the time between the disease enters the body and the first symptoms appear. Symptoms of Cholera can take from a few hours to five days to appear. The symptoms starts with mild to moderate diarrhea sometimes with vomiting. Several liters of water will be released, leading to hypovolaemic shock. Muscle cramps may occur as loss of water and electrolytes happen. In some cases, the infected person has none or mild symptoms, but sometimes the symptoms can be severe. Some other symptoms of Cholera are specified by abdominal cramps, dehydration, diarrhea with “fishy” odor, dry mouth, dry skin, excessive thirst, leg cramps, low urine output, low blood pressure, nausea, rapid heart rate, sunken eyes, tiredness and unusual sleepiness. In severely infected persons, watery diarrhea causes rapid loss of body fluids which leads to life threatening dehydration, metabolic acidosis, uremia and shock if not treated properly. In severe cholera cases, the death rate can range from 50% or more for patients who do not receive treatment. If treated properly, the fatality rate of the person is less than 1%.If the patient does not die from Cholera, the long term effects are dehydration, salt imbalances,because the body loses water and salt through diarrhea. This results in low blood pressure and kidney damage. People who are infected for a long period are very rare. One case occurred in the Philippines where ???cholera Dolores??? had cholera vibrios in her gall bladder for twelve years since 1962. She had passed away in 1973.Cholera appears in three main epidemiological patterns??”Heavily endemic (such as Zimbabwe and the Indian subcontinent), neo-epidemic, which is newly invaded cholera-receptive areas, and in developed countries with good sanitation, which only occasional limited outbreaks occur. The patterns depend mostly on sanitary and cultural aspects, the immunity status of the people in that area, or the population and the inheritance attributes of the vibrios, for example the resistance to gastric acidity, ability to colonize and toxicity of the genes. In the heavily endemic region, cholera occurs at regular intervals, varying on different years and seasons, partly caused by the amount of rain and flooding. In these places children are more affected than adults. Recent studies have suggested that Cholera vibrios can exist for a period of time in a viable but non-cultural state in shellfish, algae or plankton in coastal regions of infected areas. Transmission of Cholera occurs majorly through water contaminated with human faecal matter, though infection may pass on through households by contaminated foods.In neo-epidemic areas, the spread of cholera depends majorly on the traffic of infected people, although the spread between neighboring communities can occur through contaminated water. In these places, more adults get cholera than children. In 1854, John Snow put a stop to an epidemic in London, England by removing the handle of a contaminated water supply called the Broad Street Pump, and that was before the discovery of the germ theory.
Deaths from cholera in England before John Snow put a stop to this.
http://www.globalsecurity.org/wmd/intro/images/cholera-snow-map.jpgIn developed areas such as Japan, North Europe and North America there are hardly any outbreaks, however Japan has some reported minor cases. In 1978 the United State had an outbreak of roughly 12 cases in Louisiana, when sewage was infected and people ate infected shellfishIn heavily endemic regions, supplies of pure water may reduce the threat of infections. In neo-epidemic cholera receptive and developed areas, rapid identification and treatments for these symptoms, and chlorination of water are the most effective ways of stopping the spread of disease. The treatments for Cholera is to replace what electrolytes the body has lost due to diarrhea (fluids and salts). Recent studies show that almost all cholera patients can be maintained by fluids given orally if the solutions contain energy sources such as glucose. Packets containing NaCl, 3.5 g; KCl,1.5 g; NaHCO3, 2.5 g (or trisodium citrate, 2.9 g); and glucose, 20.0 g called Oral Re-hydrating Salts are given to organizations such as UNICEF and WHO to be given to heavily endemic regions.If the infected person is capable of drinking, Oral Re-hydrating Salts dissolved in water are given to the patient. A former way to cure the infection was to use high-priced sterile intravenous solutions. The patients fluid loss were measured in buckets kept underneath a hole in the patients cot. This was quite unhygienic way to cure the infection. If the diarrhea spilled over and a doctor or nurse came in contact with it, the doctor or nurse would most likely then get infected. Another way to cure cholera is to give antibiotics such as tetracycline, doxycycline and ciprofloxacin to the patient. These antibiotics are commonly used to shorten the period of infection with the cholera vibrios. They help clear the bacteria from the bowel, reducing chances of spreading the disease. A recent oral vaccine provides immunity to cholera, and has less side effects than the previous vaccine. The side effects of these treatments are that antibiotics may cause allergic reactions and an upset stomach. The possibility of creating a pill of pharmacological intervention (a pill that stops choleric diarrhea after it has started) has been considered. Chlorpromazine and nicotine acid have been effective in experimental animals, however the precise chemical mechanism of action is to be defined.Cholera can be cured at home, without any antibiotics or Oral Re-hydration Salts. Home treatments for Cholera includes: Lemon juice, which can kill cholera bacilli in a short time. It can be taken in a sweetened or salted beverage. 30 grams of guava root bark can be used in half a litre of water to make a decoction. The water is boiled down to reduce it by one third. This extraction should be taken twice daily. About 30 grams of onion and seven black peppercorns are pounded finely in a pestle and taken two to three times a day. In the early stages of cholera the fresh juice of bitter gourd is an effective medicine. Two teaspoons of this mixed with the same amount of white onion juice and a teaspoon of lime juice should be taken twice a day. A glass of fresh cucumber leaves juice with an equal quantity of tender coconut water, drank in doses of 30-60 ml each time quenches thirst during cholera. Four grams of cloves should be boiled in three liters of water, until half the water has evaporated. The extract thus prepared should be given to the patient several times a day.
Recent studies establishes that the V parahaemolyticus enteritis prevent multiplication of the organisms of contaminated seafood by doing such measures, for example, refrigerating seafood continuously.When Cholerae vibrios enters the body, the bacterium has to go through certain defences before the person gets the disease. Vibrio are sensitive to acid and mostly die in the stomach. Surviving organisms cling and colonize in the small bowel, where they secrete the potent cholera enterotoxin, also called choleragen. The toxin binds to the plasma membrane of the intestinal epithelial cells and releases enzymatic fractional monetary unit that causes a rise in andenosine 51-monophosphate production.The high intracellular cAMP level causes monumental release of electrolytes and water into the intestinal lumen.Recovering from cholera depends on two factors??”elimination of the vibrios by medicine or the patients immune response, and re-formation of poisoned intestinal epithelial cells. Treatment with a 200mg dose of doxycycline are reccomended by doctors. If the patient recovers, they are stably immune for at least 3 years.Vibrios that are similar to cholera have been reported in Marylands Chesapeake Bay have not been associated with human cases. These vibrios are non-pathogenic nonagglutinable vibrios, which do not contain genes for toxin production, which does not colonize and are unable to produce disease.
To prevent getting cholera, people should practice safe food and water precautions. They should only drink boiled water or water that has been treated with chlorine or iodine, and only eat food that has been cooked well that is still hot when served. They should avoid eating raw food such as seafood and salads. They should only eat fruit they have peeled themselves. People should always wash their hands often and before eating and drinking with soap and warm running water, or alcohol-based hand gel if soap and water are not available. Drink and use ice from purified water that has been boiled or disinfected. Carbonated drinks and commercially bottled water in sealed containers are usually safe. People should avoid eating unpaturized dairy products, and should avoid food from street vendors. They should avoid swimming in polluted or contaminated water. People should brush their teeth with purified or bottled water. People should carry packets of ORS, in case of cholera. When going someplace affected by cholera, check for water purification systems. Vegetables and fruit should be washed with solution of potassium permangate.
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