Vibrio cholerae

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Vibrio cholerae

• Asiatic or Epidemic Cholera
• Page 360

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Readings Question 1

• Describe the Vibrio cholerae bacterium. Where is
  it found?

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Outbreaks

• no major outbreaks in U.S. since 1911
• sporadic 1973-1991
• 1991 South America Peru
• 1,099,882 cases and 10,453 deaths (1991-95)
• 1992 new strain Bangladesh and India
• 1 case in U.S.
• 2010 Haiti (confirmed 10/21/10)

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Symptoms of Cholera

• rice-water stools (Color Plate 54)
• viscous blood
• sudden onset, incubation 6 hrs- 5 days
• violent vomiting
• No fever
• abdominal cramps, nausea, dehydration, shock
• 1 million organisms

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Progression of Disease
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Diagnosis

• isolated from feces
• recovered from foods
• pathogenic and non-pathogenic forms exist
• test for presence of cholera enterotoxin

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Treatment of Cholera

• water and electrolyte replacement
• oral rehydration therapy
• sodium chloride, sodium bicarbonate, potassium
  chloride and dextrose
• intravenous rehydration
• tetracycline
• untreated 50 mortality rate
• death occurs from dehydration and loss of
  essential electrolytes

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Bacillus anthracis

• Page 361 note embalming implications
• 1877 isolated by Robert Koch
• Readings question 2
• List 5 characteristics of the Bacillus anthracis
  bacterium.

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People at Risk

• handle animals, hides, wool, and other animal
  products
• goat hair and handicrafts containing animal hides
  from the Middle East
• infection initiated by endospores
• 2 exotoxins edema toxin and lethal toxin
• capsule does not stimulate a protective response

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Readings Question 3

• What are the 3 forms of anthrax that affect
  humans?

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Treatment of Anthrax

• antibiotics
• ciprofloxacin and doxycycline
• preventive doses of antibiotics (60 days)
• vaccination of livestock
• live attenuated
• human vaccine inactivated form
• 6 injections over 18 months
• Annual boosters

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Biological Weapons

• the use of living pathogens for hostile
  purposes
• 14th century 1346 Tartar army catapulted
  plague-ridden bodies over the walls of Kaffa
  (Ukraine)
• - Kaffa fell and survivors escaping
  introduced the plague to Europe
• (began the plague pandemic from 1348 1350)

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U.S. Epidemic Intelligence Service

• formed in 1951 (after start of Korean War)
• served as early warning system
• important role in combating epidemics and
  tracking outbreaks of disease
• 1940s-1960s research on biological weapons
• develop vaccines or treatments

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Biological Weapons

• 2001 U.S. Postal Service
• Bacillus anthracis
• gave rise to a new termbioterrorism
• new vaccines being developed existing vaccines
  stockpiled for use when needed
• military personnel and first-responders are
  vaccinated if biological agents are a risk

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Bordetella(Page 362)

• Whooping Cough (Pertussis)
• 2 basic toxins 1) tracheal cytotoxin
• - damages ciliated cells
• 2) pertussis toxin
• - systemic symptoms
• small children violence of coughing can break
  ribs
• infants irreversible damage to the brain
  occasionally occurs
• adults misdiagnosed as bronchitis

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Diagnosis of Pertussis

• clinical signs and symptoms
• throat swab culture
• culture on special media
• rapid tests available

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Treatment of Pertussis

• Erythromycin
• Antibiotics render the patient noninfectious.
• Immunity following recovery is good.
• DTap Vaccine 1996, minimal side effects
• - lowered annual cases
• - fewer than 10 deaths/year
• - effectiveness wanes after 12 years of age
• - elderly and infants