vibrio #cholerae O1 and O139 serogroup are cause of epidemic cholera
Non-O1 & Non-O139 can cause isolated cases of usually mild gastroenteritis
Secretory diarrhea by #cholera toxin in intestine leas to Cl, Na, and water loss from intestinal epithelial cells
#cholerae has aquatic reservior, particularly brackish estuarine water
Fecal-oral contamination associated with unsafe water & inadequate sanitation 2-3 million cholera cases leads to 100k deaths annually
Vibrio #cholerae Current pandemic O1 El Tor orgainsims, with largest burden in South Asia, sub-saharan Africa, Haiti and Yemen
Rapid antigen tests are available including dipstick stool assay
Confirm by microbiologic culture
#cholera management assessment of dehydration f/b fluid restoration
Severe dehydration >10%fluid loss: needs 100ml/kg fluids within 3-4 hrs
Moderate dehydration 5-10% fluid loss: needs 75-100ml/kg in 3-4hrs. lactate ringer w/5%dextrose +K
#cholera abx play secondary role: usually macrolide or FQ. tetracycline in non-pregnant or >7yrs of age if susceptibility known
Abx decrease duration of diarrhea & limit secondary transmission
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