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Cholera

Cholera. By: Kelsey Duncan. http:// fieldnotes.unicefusa.org /photos/. Cholera was discovered by Filippo Pacini . . Vibrio Cholerae. Filippo Pacini , 1854. Robert Koch, 1883. Rosenberg, Charles E. (1987). The cholera years: the United States in 1832, 1849 and 1866.

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Cholera

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  1. Cholera By: Kelsey Duncan http://fieldnotes.unicefusa.org/photos/

  2. Cholera was discovered by FilippoPacini. Vibrio Cholerae FilippoPacini, 1854 Robert Koch, 1883 Rosenberg, Charles E. (1987). The cholera years: the United States in 1832, 1849 and 1866.

  3. Vibrio Cholerae is the causative agent. http://en.wikipedia.org/wiki/Cholera

  4. Reports of cholera probably barely scratch the surface. WHO, http://www.phac-aspc.gc.ca/tmp-pmv/info/cholera-eng.php

  5. Around the world, an estimated 3-5 million cases and over 100,000 deaths occur each year. WHO, 2012

  6. Cholera can have different hosts! Humans (intestines) Marine Life (shellfish, oysters)

  7. The main connection is water.

  8. Ingested bacteria travel to the upper small intestine, where they replicate.

  9. Cholera expresses a toxin that leads to severe symptoms, and if not treated, death. A, B: cholera toxin subunits GM1: ganglioside receptor AC: adenylatecyclase G: G protein cAMP: cyclic AMP CFTR: cystic fibrosis transmembrane conductance regulator Trends Pharmacol Sci. 26, J. R. Thiagarajah and A. S. Verkman, New Drug Targets for Cholera Toxin.

  10. Cholera toxin is released from bacteria in infected intestine

  11. Toxin binds through interaction of the B subunit of the toxin with the GM1 ganglioside receptor. Triggers endocytosis of toxin

  12. Toxin undergoes cleavage for A1 subunit to become active enzyme Inside cell: A1 fragment of toxin subunit enters cytosol and activates G protein

  13. Action stimulates adenlatecyclase to produce cAMP

  14. High levels of cAMP activate the CFTR causing a dramatic efflux of ions and water from infected endothelial cells, leading to watery diarrhea

  15. The main symptom is rapid and major fluid loss. Sudden onset and large amounts of watery diarrhea Major Fluid Loss Emed, http://diarrhea.emedtv.com/cholera/cholera-symptoms.html

  16. The most effective treatment for cholera is oral rehydration therapy. Mayo Clinic, 2011

  17. Two oral vaccines exist to increase immunity. Dukoral Mutacol Ryan, 2006, “Live Oral Cholera Vaccines”

  18. To prevent cholera while traveling follow these suggestions. • Drink only water that you have boiled • Make sure all vegetables are cooked • Avoid undercooked or raw fish or shellfish • Avoid foods and beverages from street vendors • Do not bring perishable food back to the United States Emed, 2012, http://diarrhea.emedtv.com/cholera/prevention-of-cholera-p2.html

  19. Cholera outbreak officially announced in Haiti on October 22, 2010.

  20. Paul Farmer, PIH, 2011

  21. Many organizations, including Partners in Health, are supplying aid.

  22. Public health prevention in Haiti and all developing countries is crucial to eradicate cholera.

  23. References • General information on vibrio cholera, cholera toxin, etc. • www.wikipedia.org • Cholera Toxin Pathway • http://www.ebi.ac.uk/interpro/potm/2005_9/Page2.htm • Effects on Health • http://diarrhea.emedtv.com/cholera/cholera-symptoms.html • Treatment • WHO/CDS/CSR/ISR/2000.1 WHO Report on Global Surveillance of Epidemic-prone Infectious Diseases- http://www.who.int/csr/resources/publications/surveillance/en/cholera.pdf • Incidence Reports • WHO, 2008, http://www.who.int/topics/cholera/surveillance/en/index.html • Prevention • http://diarrhea.emedtv.com/cholera/prevention-of-cholera-p2.html • Epidemiology Report: Cholera in Haiti • Paul Farmer, Partners in Health, 2011, http://www.cdc.gov/haiticholera/haiti_cholera.htm

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