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Prof.Dr. Fhim Shaltout
Professor of Meat Hygiene
Faculty of Veterinary Medicne
Benha University, Egypt.
Cholera is an infection in the small intestine caused by
the bacterium Vibrio cholerae. The main symptoms are
profuse, watery diarrhea and vomiting. Transmission
occurs primarily by drinking water or eating food that has
been contaminated by the feces of an infected person,
including one with no apparent symptoms.
The Bacteria that causes Cholera
 Gram-negative rods.
 Curves or Comma shaped.
 Non-spore forming
 Highly motile-single polar flagella
 Associated with salt water
 Oxidase positive
 Tolerate alkaline conditions to pH9.0
 Readily cultivated, Simple nutritional
requirements.
 Facultative anaerobe
 Acute infectious disease
 is often fatal
 characterized by severe
vomiting, diarrhoea, and
collapse
Caused By: Vibrio cholerae
•Indirect transmission
Vehicle borne
•Reaches water through:
Vomiting
Diarrhoea
•Carriers active or passive
•Produces toxins in small intestines
that cause severe diarrhoea and
dehydration

Through:
 Contaminated water
 Contaminated food
 Eating with unwashed hands
Also house flies and other
insects

The primary symptoms of cholera are profuse, painless diarrhea
and vomiting of clear fluid. These symptoms usually start
suddenly, one to five days after ingestion of the bacteria. The
diarrhea is frequently described as "rice water" in nature and
may have a fishy odor.
An untreated person with cholera may produce 10 to 20 liters (3
to 5 US gal) of diarrhea a day with fatal results. For every
symptomatic person, 3 to 100 people get the infection but remain
asymptomatic.
Cholera has been nicknamed the "blue death" due to a patient's
skin turning a bluish-gray hue from extreme loss of fluids.
If the severe diarrhea is not treated with intravenous rehydration,
it can result in life-threatening dehydration and electrolyte
imbalances. The typical symptoms of dehydration include low
blood pressure, poor skin turgor (wrinkled hands), sunken eyes,
and a rapid pulse.
A person with severe
dehydration due to cholera note the sunken eyes and
decreased skin turgor which
produces wrinkled hands
 Host
drinks water
 Bacteria moves through the stomach
 Reach the intestine & produce flagella
 Propel through mucus of the sm.
intestine
 Produce toxin causing diarrhea
 Feces carry new bacteria into drinking
water
Stage 1




Vomiting
Muscle cramps
Sudden onset and watery,
painless diarrhea
Stool has a characteristic “rice
water” appearance (gray,
slightly cloudy with bits of
mucus, and a slightly sweaty
odor)
Stage 2




Dehydration, Thirst and Shock
Cold Skin, sunken Eyes, weak
pulse and feint high-pitched
voice
Reduced urine
Muscle cramps and Muscle
weakness
Stage 3







Start to recover
Mild to severe diarrhoea
Shock and dehydration
Loss of important minerals
and electrolytes
Intense thirst
Reduced urination
Muscle cramps/weakness
 Oral
Rehydration Therapy (ORT)
 Solution of salts and sugars, taken by the mouth
 Also homemade solutions (water, sugar, table
salt, baking soda, and fruit)
 Sometimes intravenous
 Tetracycline
Shortens the course of the disease
 Weaken the symptoms.

1.
2.
3.
4.
Specimens: stool, vomitus.
Stained smear
Culture: alkaline peptone water of agar
plate, and TCBS agar plate.
Quick immunological methods:
immunofluorescent “ball” test; PCR.
 Squatter
camps
 Bad hygiene
 Unsafe preparation of food
 Drinking contaminated water
 To bathe / swim in contaminated water

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Immunization
Boiling water, covering food
Education
Personal and domestic hygiene
Prevention of contamination of water
supplies
Improvement of sewage systems
Access to health care
For shellfish in the shell, either a) boil until the shells
open and continue boiling for 5 more minutes, or b)
steam until the shells open and then continue cooking
for 9 more minutes.
Do not eat those shellfish that do not open during
cooking. Boil shucked oysters at least 3 minutes, or fry
them in oil for at least 10 minutes at 375°F (190°C),
while keeping the pieces well separated.
Although cholera may be life-threatening, prevention of
the disease is normally straightforward if proper
sanitation practices are followed. In developed countries,
due to nearly universal advanced water treatment and
sanitation practices, cholera is no longer a major health
threat.