Sujit Dey B.Sc, MTU.S. Embassy-DhakaBangladesh

One of the Youngest VictimsOne of the Youngest Victims

CauseCause*Bacterium Vibrio

cholerae*This bacteria

produces enterotoxin

known as cholera toxin

Biochemical PropertiesBiochemical Properties

• Gram –negative bacteria• Straight or curved rods• Fermentative and oxidative in

metabolism• Oxidase positive

PathogenesisPathogenesisTransmitted by the fecal-oral route(Specially Contaminated Water)

Adheres and colonizes to the small bowel

Secretes the cholerae enterotoxin (CT)

SymptomsSymptoms

• Massive Watery Diarrhea • Muscle and Stomach Cramp• Vomiting• FeverLater Stage Symptom:* Rice Water Stool

DiagnosisDiagnosis• Rice Water Stool (Severe watery

diarrhea)

• Dehydration

• Shock

• Loss of urine production

A wet mount of liquid stool can be examined microscopically using “Dark Field Condenser”

Cholera Bacteria will look like shooting stars

Laboratory DiagnosisLaboratory Diagnosis

““Dark Field Condenser”Dark Field Condenser”

Stool CultureStool CultureUsed TTGA (Taurocholate Tellurite

Gelatin Agar) plates for growth of Vibrio

A MacConkey and SS plate is used for the growth of other organism-if present

Dept. of MicrobiologyDept. of Microbiology

When TTGA PositiveWhen TTGA Positive

Confirmed by testing with

Cholera Antisera

Cholera Cholera SerotypesSerotypes

Ogawa InabaHikozima(Not found

in Bangladesh)

Ogawa biotype

EltorClassical

(Not found inBangladesh)

SensitivitySensitivityNotice the DifferenceNotice the Difference

Ogawa: Tetracycline ResistantOgawa: Tetracycline Resistant Inaba: Tetracycline Sensitive Inaba: Tetracycline Sensitive

(Sensitivity or resistance is not 100%, there is some (Sensitivity or resistance is not 100%, there is some variations)variations)

Global ScaleGlobal Scale

TreatmentTreatment• Essentially

replacing the lost fluid and electrolytes

• Antibiotics

ICDDR,B TreatmentICDDR,B Treatment

TreatmentTreatment

PreventionPrevention• Ensuring personal

Hygiene• Treated Water

(Boiling and other treatment)

• Hand Washing is important

PreventionPrevention

• Vaccination if available

Thank YouThank You