583 results on '"Cholera therapy"'
Search Results
252. The role of an anaesthetist in a field hospital during the cholera epidemic among Rwandan refugees in Goma.
- Author
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Ginosar Y and Shapira SC
- Subjects
- Anesthesia methods, Cholera epidemiology, Democratic Republic of the Congo epidemiology, Fluid Therapy methods, Humans, Rwanda ethnology, Triage, Ambulatory Care Facilities, Anesthesiology, Cholera therapy, Disease Outbreaks, Physician's Role, Refugees
- Abstract
In 1849 John Snow, already the leading anaesthetic practitioner and innovator of his day, made a historic contribution to the epidemiology of infectious disease by his famous study of the distribution of cholera around the area of Broad Street in London. We report on our experience as anaesthetists in a field hospital, dispatched as part of the international rescue effort to Goma, Zaire, to help combat the effects of cholera among the Rwandan refugees.
- Published
- 1995
- Full Text
- View/download PDF
253. Correct case management of childhood diarrhea: a survey of nine state capitals in northeast Brazil.
- Author
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Ribeiro Júnior Hda C and Drasbek CJ
- Subjects
- Brazil epidemiology, Child, Preschool, Cholera mortality, Cholera therapy, Diarrhea, Infantile diagnosis, Diarrhea, Infantile mortality, Diarrhea, Infantile prevention & control, Guidelines as Topic, Humans, Infant, Infant, Newborn, Risk Factors, Case Management standards, Child Health Services standards, Diarrhea, Infantile therapy, Quality of Health Care
- Abstract
The National Program for Maternal and Child Health (COSMI) of the Ministry of Health (MOH) of Brazil conducted a survey in nine state capitals from 29 March to 30 April 1993 to assess how well health facilities were managing diarrhea cases in patients under 5 years of age. One of seven PAHO/WHO health facility surveys performed in Latin America and the Caribbean in 1992-1993, the Brazilian survey took place in the Northeast Region where most diarrheal morbidity and mortality occur. Like the other six surveys, it used a new PAHO/WHO methodology designed to collect data on certain principal indicators through observation, interviews, and review of clinical records. Overall, 475 cases of patients with diarrhea were observed in 192 facilities, and 463 health workers and 474 caretakers were interviewed. The results indicated that few diarrhea patients received care that strictly followed the PAHO/WHO/Ministry of Health treatment guidelines. In terms of these guidelines, the correct procedure was used to assess the patient's hydration status only 8% of the time, and only 1% of the health workers provided correct advice to the caretaker on prevention and home care aspects of diarrheal diseases. The procedure used to rehydrate patients with oral rehydration salts (ORS) was correct in only 6% of the cases. Of those patients with bloody stools, 24% were treated appropriately with antibiotics. Besides collecting information on correct case management, the survey provided a basis for developing two-year operational plans of action in each of the nine participating states to strengthen efforts directed at controlling and preventing diarrheal diseases, including cholera.
- Published
- 1995
254. Failure of treatment centres to prevent cholera deaths in Goma.
- Author
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Siddique AK
- Subjects
- Ambulatory Care Facilities, Cholera mortality, Clinical Competence, Democratic Republic of the Congo, Fluid Therapy, Humans, International Agencies, Relief Work standards, Cholera therapy, Disasters, Refugees
- Published
- 1995
- Full Text
- View/download PDF
255. Do refugees belong in camps? Experiences from Goma and Guinea.
- Author
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Van Damme W
- Subjects
- Africa South of the Sahara, Cholera epidemiology, Cholera therapy, Disease Outbreaks, Housing, Humans, Public Policy, Relief Work, Rwanda epidemiology, Violence, Disasters, Health Policy, Refugees
- Published
- 1995
- Full Text
- View/download PDF
256. Septicemia due to Vibrio cholerae 0139 Bengal.
- Author
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Khan AM, Albert MJ, Sarker SA, Bhattacharya MK, and Azad AK
- Subjects
- Bacteremia complications, Bacteremia therapy, Bangladesh, Cholera complications, Cholera therapy, Dysentery, Bacillary complications, Dysentery, Bacillary therapy, Humans, Infant, Male, Nutrition Disorders complications, Bacteremia diagnosis, Cholera diagnosis, Dysentery, Bacillary diagnosis, Shigella boydii isolation & purification, Vibrio cholerae isolation & purification
- Abstract
We describe septicemia due to Vibrio cholerae 0139 Bengal, the newly described causative agent of cholera, in a child who also had simultaneous intestinal infection with Shigella boydii. Because V. cholerae 0139 is capsulated, its propensity to cause extraintestinal infection is stressed.
- Published
- 1995
- Full Text
- View/download PDF
257. Clinical profile of cholera in young children--a hospital based report.
- Author
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Amin V, Patwari AK, Kumar G, Anand VK, Diwan N, and Peshin S
- Subjects
- Age Distribution, Cholera complications, Cholera epidemiology, Cholera therapy, Humans, Incidence, India epidemiology, Infant, Predictive Value of Tests, Prospective Studies, Seasons, Severity of Illness Index, Cholera diagnosis
- Abstract
Clinical profile of cholera was studied in children attending Diarrhea Training and Treatment Unit from January-December 1993. Out of a total 8714 cases of acute watery diarrhea, 64 children (0.7%) were suspected to have cholera on the basis of acute onset loose water/rice watery stools, high purge rate with or without excessive vomiting and/or severe dehydration. Stool culture was positive for cholera in 33 cases (51.6%). All the isolates were V. cholerae 01 biotype El Tor serotype Ogawa. Sixty four per cent of stool culture positive cases were below 5 years of age. The results assume importance because out of 28 children < 2 years with clinical suspicion of cholera, 11 cases (39.3%) were culture positive for V. cholerae, youngest child being 3 months old. Comparison of various parameters revealed that presence of vomiting > 4 episodes/ day (p < 0.005), frequency of stools >12/24 hours (p <0.002), rice watery stools (p < 0.01) and presence of severe dehydration (p < 0.01) were significant parameters associated with positive stool culture. Beside examination of stool sample by hanging drop method was an excellent diagnostic tool (p < 0.001) with a sensitivity of 51.5%, specificity 100% and positive predictive value of 100%. The isolates of V. cholerae were susceptible to furazolidone, cephelexin, nalidixic acid, norfloxacin and gentamicin. Our observations indicate that cholera is not uncommon in infants and young children. Like children in the older age group, acute onset diarrhea with watery/rice watery stools and high purge rate with or without excessive vomiting and/or rapid development of severe dehydration should arouse suspicion of cholera in younger children also. They should be investigated for cholera even in non-endemic areas and in the absence of cholera outbreaks.
- Published
- 1995
258. Cholera gravis caused by Vibrio cholerae O139, a novel, imported pathogen.
- Author
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Sharma TK, Snyder MB, Eisenberg BM, and Cutler AF
- Subjects
- Aged, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Cholera therapy, Feces microbiology, Fluid Therapy, Humans, Male, Microbial Sensitivity Tests, Thailand, Travel, Vibrio cholerae classification, Vibrio cholerae drug effects, Cholera etiology, Vibrio cholerae isolation & purification
- Published
- 1995
- Full Text
- View/download PDF
259. Vibrio cholerae O139 in Denmark.
- Author
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Dalsgaard A, Nielsen GL, Echeverria P, Larsen JL, and Schønheyder HC
- Subjects
- Cholera microbiology, Cholera therapy, Denmark, Female, Fluid Therapy, Humans, Middle Aged, Tetracycline therapeutic use, Vibrio cholerae classification, Vibrio cholerae isolation & purification, Vietnam, Cholera diagnosis
- Published
- 1995
- Full Text
- View/download PDF
260. Cholera treatment in Goma.
- Author
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Anand JK
- Subjects
- Acids administration & dosage, Beverages, Cholera mortality, Democratic Republic of the Congo, Diet, Humans, India, Water Supply standards, Cholera therapy, Disasters, Disease Outbreaks, Refugees
- Published
- 1995
261. Cholera treatment in Goma.
- Author
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Pelly MD and Besse C
- Subjects
- Ambulatory Care Facilities, Cholera therapy, Democratic Republic of the Congo, Diarrhea therapy, Disaster Planning, Disease Outbreaks, Fluid Therapy, Humans, International Agencies, Relief Work, Cholera mortality, Disasters, Refugees
- Published
- 1995
262. Cholera treatment in Goma.
- Author
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Burns DA and Wood CB
- Subjects
- Cholera mortality, Democratic Republic of the Congo, Diarrhea mortality, Diarrhea, Infantile therapy, Female, Fluid Therapy methods, Humans, Infant, Cholera therapy, Diarrhea therapy, Disasters, Refugees
- Published
- 1995
263. Oral rehydration therapy.
- Author
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Greenough WB 3rd
- Subjects
- Disasters, Humans, India, Pakistan, Refugees, Rehydration Solutions chemistry, Cholera therapy, Diarrhea therapy, Fluid Therapy methods
- Published
- 1995
264. Cholera treatment in Goma.
- Author
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Boelaert M, Suetens C, van Soest M, Henkens M, Rigal J, and de Graaf P
- Subjects
- Ambulatory Care Facilities, Cholera mortality, Democratic Republic of the Congo, Diarrhea therapy, Disease Outbreaks, Fluid Therapy, Humans, International Agencies, Relief Work, Cholera therapy, Disasters, Refugees
- Published
- 1995
265. A method to screen T lymphocyte epitopes after oral immunisation of humans: application to cholera toxin B subunit.
- Author
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Castello-Branco LR, Griffin GE, Dougan G, and Lewis DJ
- Subjects
- Administration, Oral, Cell Division immunology, Cholera immunology, Cholera therapy, Cholera Toxin administration & dosage, Cholera Toxin therapeutic use, Humans, T-Lymphocytes cytology, Cholera Toxin immunology, Immunodominant Epitopes immunology, T-Lymphocytes immunology
- Abstract
The response to oral immunisation of humans with classical biotype cholera toxin B subunit was studied to identify immunodominant T lymphocyte determinants. The in vitro proliferative response to pools of 12-mer peptides and larger peptides used individually was analysed by a novel statistical approach, and identified an immunodominant region in residues 70-79 in immunised subjects, when either pools or individual peptides were employed. In contrast, a patient infected with El Tor biotype had a dominant response to residues 40-60. The statistical software employed in this study may enable efficient screening of antigens for immunodominant T lymphocyte determinants when blood precursor frequencies are low following immunisation, and may therefore be of special relevance to mucosal vaccines.
- Published
- 1995
- Full Text
- View/download PDF
266. Cholera outbreaks: role of oral rehydration therapy.
- Author
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Bhattacharya SK
- Subjects
- Child, Child, Preschool, Cholera epidemiology, Cholera transmission, Humans, India epidemiology, Cholera therapy, Disease Outbreaks, Fluid Therapy methods
- Published
- 1995
267. [Cholera in Mexico. Current epidemiologic status].
- Author
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Jiménez-Corona A, Gutiérrez-Cogio L, López-Moreno S, and Tapia-Conyer R
- Subjects
- Cholera diagnosis, Cholera microbiology, Cholera therapy, Humans, Mexico epidemiology, Morbidity, Cholera epidemiology
- Published
- 1995
268. Cholera in the United States.
- Author
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Hellinger WC and Alvarez S
- Subjects
- Cholera physiopathology, Cholera therapy, Diarrhea microbiology, Humans, Latin America epidemiology, United States epidemiology, Vibrio cholerae, Cholera epidemiology, Disease Outbreaks
- Abstract
Cholera remains a threat to human health in many parts of the world, including the United States. The epidemiology of cholera is reviewed to prepare for identification and prevention of the disease in appropriate clinical settings. The clinical manifestations of cholera and the pathophysiology of the toxin-induced diarrhea are reviewed to introduce and to clarify appropriate therapeutic and preventive interventions.
- Published
- 1995
- Full Text
- View/download PDF
269. [A case of the importation onto the territory of Russia of cholera caused by a new serovar].
- Author
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Lomov IuM, Mazrukho BL, Mishan'kin BN, Avrorov VP, Vlasov VP, Kudriakova TA, Kondratenko TA, and Shvager MI
- Subjects
- Acute Disease, Cholera diagnosis, Cholera microbiology, Cholera therapy, Combined Modality Therapy, Female, Humans, India, Male, Russia, Serotyping, Travel, Vibrio cholerae isolation & purification, Cholera etiology, Vibrio cholerae classification
- Abstract
Materials on the import of rarely occurring Vibrio cholerae, not belonging to group O1 of serovar O139, to the territory of Russia are presented. The clinical picture of a cholera case is described and the biological properties of V. cholerae, serovar O139, are presented. A suggestion has been made concerning the appearance of a new V. cholerae serovar, capable of ousting V. cholerae eltor, the cause of the seventh pandemic.
- Published
- 1995
270. [A novel treatment of cholera by a Mexican physician in the 19th century].
- Author
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Rodríguez-de-Romo AC
- Subjects
- Cholera therapy, History, 19th Century, Mexico, Cholera history, Disease Outbreaks history
- Abstract
Doctor Felipe Castillo, head of the Hospital de San Pablo during the cholera epidemic of 1850, used "Salty water" as treatment for the patients who attended the hospital. The etiology and pathogenesis of this sickness were unknown in those days, so Castillo's conduct was surprising. This study is based on an unpublished report, classified as anonymous, that Castillo gave to the Governor of Mexico City during the cholera epidemic.
- Published
- 1995
271. The presence of bicarbonate in oral rehydration solution does not influence fluid absorption in cholera.
- Author
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Sarker SA and Mahalanabis D
- Subjects
- Administration, Oral, Adult, Cholera metabolism, Double-Blind Method, Humans, Intestinal Absorption physiology, Cholera therapy, Fluid Therapy, Intestinal Absorption drug effects, Rehydration Solutions chemistry, Sodium Bicarbonate pharmacology
- Abstract
Background: On the basis of human perfusion studies it has been speculated that bicarbonate ions in oral rehydration salt solutions (ORS) to treat diarrhoea are more efficiently absorbed from the small bowel. We evaluated the role of bicarbonate in ORS by using a reduced purging rate in cholera as a proxy indicator for absorption efficiency in cholera-like severe diarrhoea., Methods: In a double-blind randomized trial 60 patients received standard ORS containing bicarbonate or an identical solution except that sodium bicarbonate was replaced by an equimolar amount of sodium chloride (sodium, 90 mmol/l; potassium, 20 mmol/l; chloride, 80 mmol/l; bicarbonate, 30 mmol/l; glucose, 111 mmol/l; and osmolality, 331 mmol/l) after initial intravenous rehydration to correct initial dehydration and shock and until diarrhoea ceased., Results: Five patients receiving standard ORS and eight receiving bicarbonate-free ORS required unscheduled intravenous therapy for recurrence of severe dehydration in spite of receiving ORS solution. ORS intake and purging rate, in ml/kg body weight/day, both including and excluding stool output during unscheduled intravenous therapy are closely similar in the two treatment groups., Conclusion: The results indicate that bicarbonate-containing ORS solution does not have any clinically significant effect on the absorption efficiency of ORS, either beneficial or adverse, and its use is relevant only for correction of metabolic acidosis of diarrhoeal dehydration.
- Published
- 1995
- Full Text
- View/download PDF
272. Why treatment centres failed to prevent cholera deaths among Rwandan refugees in Goma, Zaire.
- Author
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Siddique AK, Salam A, Islam MS, Akram K, Majumdar RN, Zaman K, Fronczak N, and Laston S
- Subjects
- Cholera therapy, Clinical Competence, Democratic Republic of the Congo epidemiology, Doxycycline pharmacology, Drug Resistance, Microbial, Fluid Therapy standards, Health Personnel standards, Humans, International Agencies, Relief Work, Rwanda ethnology, Tetracycline pharmacology, Vibrio cholerae drug effects, Ambulatory Care Facilities, Cholera mortality, Disasters, Refugees
- Abstract
In July, 1994, in one of the worst cholera outbreaks in recent times, an estimated 12,000 Rwandan refugees died in Goma in eastern Zaire. The Vibrio cholerae strains were resistant to tetracycline and doxycycline, the commonly used drugs for cholera treatment. Despite the efforts of international organisations, which provided medical relief by establishing treatment centres in Goma, mortality from the disease was much higher than expected. In the area of Muganga camp, which had the largest concentration of refugees and where most of the medical aid organisations were active, the highest reported case-fatality ratio for a single day was 48%. The slow rate of rehydration, inadequate use of oral rehydration therapy, use of inappropriate intravenous fluids, and inadequate experience of health workers in management of severe cholera are thought to be some of the factors associated with the failure to prevent so many deaths during the epidemic. In one of the temporary treatment centres with the worst case-fatality record, our team showed that improvement of these factors could increase the odds of survival of cholera patients even in a disaster setting.
- Published
- 1995
- Full Text
- View/download PDF
273. Fighting the good fight. Lessons from Texas physicians.
- Author
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Myers C
- Subjects
- Acquired Immunodeficiency Syndrome history, Acquired Immunodeficiency Syndrome therapy, Cholera history, Cholera therapy, History, 19th Century, History, 20th Century, Smallpox history, Smallpox therapy, Texas epidemiology, Yellow Fever history, Yellow Fever therapy, Disease Outbreaks history, Physician's Role
- Published
- 1995
274. Simultaneous outbreak due to Vibrio cholerae and Shigella dysenteriae in Kenya.
- Author
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Iijima Y, Oundo JO, Taga K, Saidi SM, and Honda T
- Subjects
- Cholera complications, Cholera therapy, Drug Resistance, Microbial, Dysentery, Bacillary complications, Dysentery, Bacillary therapy, Health Education, Humans, Hygiene, Kenya epidemiology, Microbial Sensitivity Tests, Refugees, Cholera epidemiology, Disease Outbreaks, Dysentery, Bacillary epidemiology, Shigella dysenteriae, Shigella sonnei
- Published
- 1995
275. [Emergency intra-osseous rehydration in children during a cholera epidemic].
- Author
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Robert M, Flocard F, Adam JC, Prigent D, and Imbert P
- Subjects
- Child, Preschool, Disease Outbreaks, Emergencies, Female, Humans, Infant, Male, Cholera therapy, Fluid Therapy methods, Infusions, Intraosseous methods
- Published
- 1995
276. [The history of the study of the pathogenesis and the search for agents for the treatment of cholera (based on data from the first 3 pandemics of 1817-1862)].
- Author
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Stochik AM and Zatravkin SN
- Subjects
- Cholera etiology, Cholera therapy, Global Health, History, 19th Century, Humans, Cholera history, Disease Outbreaks history, Fluid Therapy history
- Published
- 1995
277. Toward an improvement of life optimizing resource use.
- Author
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Rafanelli M, Ferri F, and Maceratini R
- Subjects
- Algorithms, Cholera epidemiology, Cholera therapy, Cost-Benefit Analysis, Decision Trees, Disease Outbreaks prevention & control, Epidemiologic Methods, Geography, Humans, Infant, Newborn, Italy, Models, Biological, Population Dynamics, User-Computer Interface, Decision Support Systems, Management, Health Care Rationing organization & administration, Health Resources statistics & numerical data
- Abstract
In this paper an object-oriented system for the storing and the managing of epidemiological data in order to decrease the incidence of a given groups of diseases by means of health care strategy application and of the relative health care resource allocation is described. The system starts from the present epidemiological situation of the territory examined and from the real distribution on this territory of human and material health care resources. The health care manager inputs the available budget, some information regarding the population living on this area, other geographical and climatic informations, the values of certain epidemiological parameters of the diseases considered--the system has stored the mathematical and departmental models of these diseases--and the system allocates (using own allocation algorithms) human and material health care resources, optimizing the cost-benefit rate.
- Published
- 1995
278. Use of rice-based oral rehydration solution in a large diarrhoea treatment centre in Bangladesh: in-house production, use and relative cost.
- Author
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Islam MA, Mahalanabis D, and Majid N
- Subjects
- Bangladesh, Citrates, Citric Acid, Costs and Cost Analysis, Flour, Humans, Potassium Chloride, Quality Control, Rehydration Solutions standards, Sodium Bicarbonate, Sodium Chloride, Cholera therapy, Diarrhea therapy, Fluid Therapy, Oryza, Rehydration Solutions economics
- Abstract
Glucose-based oral rehydration salt (ORS) is an appropriate and cost-effective tool to treat diarrhoeal dehydration. In patients with a high purging rate, particularly due to cholera, rice-based ORS has been shown to substantially reduce stool output compared to glucose ORS. However, it is not used in the hospitals or diarrhoea treatment centres largely because of the non-availability of a ready-to-use inexpensive packaged product and because of the problem of cooking. In a large diarrhoea treatment centre in Bangladesh (with an annual ORS consumption of approximately 140,000 litres), we have maintained in-house production of rice ORS and used it routinely for more than 600,000 patients over the last nine years. Semi-literate health workers cook rice ORS and supervise mothers in its use. Rice ORS is less costly (US $0.15 per patient treated compared with US $0.37 for glucose ORS) and is well accepted. It is an attractive alternative to glucose ORS in many fixed facility treatment centres in countries where rice is a staple and cholera is endemic. The process of its in-house preparation and use is described in this report which may assist hospitals wishing to use rice ORS in treating diarrhoea patients. Availability of a low cost ready-to-use rice ORS packet (which needs no cooking) with adequate shelf-life will increase its use at fixed facilities.
- Published
- 1994
279. Diagnosis and treatment of cholera in the United States. Are we prepared?
- Author
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Besser RE, Feikin DR, Eberhart-Phillips JE, Mascola L, and Griffin PM
- Subjects
- Cholera epidemiology, Disease Outbreaks prevention & control, Fluid Therapy statistics & numerical data, Humans, Rehydration Solutions supply & distribution, Travel, United States epidemiology, Cholera diagnosis, Cholera therapy
- Abstract
Objective: To assess cholera recognition and treatment by US health care workers in the largest cholera outbreak in the United States this century., Design: We reviewed the medical records of passengers from a flight on which a cholera outbreak occurred. To determine the availability of oral rehydration solutions, we surveyed treatment facilities and referral pharmacies., Setting: On February 14, 1992, more than 100 passengers on a flight from South America to Los Angeles, Calif, were infected with toxigenic Vibrio cholerae O1., Subjects: Fifty-four of 67 passengers who sought care in California and Nevada., Results: We reviewed the records of 54 passengers, including 39 with diarrhea and 15 without symptoms. All 17 persons who sought treatment before the outbreak was widely reported by the media had diarrhea. For 12 of these persons, recent travel to South America was noted, but only those four whose records listed cholera as a possible diagnosis were immediately hospitalized. Seven sought care again within 3 days; three were dehydrated, two of these three were hospitalized, and one of these two died. None of the 26 patients suspected to have cholera received appropriate fluids; severely dehydrated patients did not receive Ringer's lactate solution and those not severely dehydrated did not receive an oral rehydration solution. None of the facilities and pharmacies involved stocked World Health Organization oral rehydration salts solution, the preferred solution for treating cholera and other diarrheal diseases., Conclusions: Treatment of cholera in the United States was suboptimal. Oral fluids appropriate for the treatment of cholera and other diarrheal diseases were generally unavailable. Widespread cholera in the developing world means that US physicians should be prepared to treat "imported" cases. Physicians evaluating patients with diarrhea should obtain a travel history, should consider cholera in patients returning from countries with endemic or epidemic cholera, and should instruct patients in appropriate use of World Health Organization oral rehydration salts solution or other oral rehydration solutions containing 75 to 90 mmol/L of sodium. Pharmacies and medical facilities should stock these solutions.
- Published
- 1994
280. Cholera treatment.
- Author
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Pierce NF, Robinson D, Rigal J, and Dualeh M
- Subjects
- Administration, Oral, Cholera epidemiology, Cholera prevention & control, Cholera Vaccines administration & dosage, Humans, Refugees, Rehydration Solutions therapeutic use, Rwanda epidemiology, Vaccination, Cholera therapy, Disease Outbreaks
- Published
- 1994
281. Cholera treatment.
- Author
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Blok L and Sondorp E
- Subjects
- Administration, Oral, Cholera epidemiology, Cholera prevention & control, Humans, Rwanda epidemiology, Vaccination, Cholera therapy, Cholera Vaccines administration & dosage, Disease Outbreaks, Rehydration Solutions
- Published
- 1994
282. Magic bullet: the history of oral rehydration therapy.
- Author
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Ruxin JN
- Subjects
- Cholera history, Cholera therapy, Clinical Protocols, Diarrhea therapy, Fluid Therapy methods, Global Health, History, 20th Century, Humans, Developing Countries, Diarrhea history, Fluid Therapy history
- Published
- 1994
- Full Text
- View/download PDF
283. Cholera control.
- Author
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Sack DA
- Subjects
- Administration, Oral, Cholera therapy, Humans, Vaccination, Cholera prevention & control, Cholera Vaccines administration & dosage
- Published
- 1994
- Full Text
- View/download PDF
284. Severe life-threatening cholera associated with blood group O in Peru: implications for the Latin American epidemic.
- Author
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Swerdlow DL, Mintz ED, Rodriguez M, Tejada E, Ocampo C, Espejo L, Barrett TJ, Petzelt J, Bean NH, and Seminario L
- Subjects
- Adolescent, Adult, Age Factors, Aged, Child, Child, Preschool, Cholera epidemiology, Cholera therapy, Female, Fluid Therapy, Humans, Infant, Male, Middle Aged, Peru epidemiology, Severity of Illness Index, ABO Blood-Group System, Cholera blood
- Abstract
A household survey in 1991, at the onset of the Latin American cholera epidemic, investigated high attack rates in Trujillo, Peru, and determined the association between blood group O and severe cholera. Of 463 persons in 69 households, 173 (37%) reported diarrhea, 21% required rehydration therapy, and 4% were hospitalized; these treatment requirements greatly exceeded estimates based on other populations. Elevated vibriocidal or antitoxic antibody titers were present in 52% of 321 from whom serum was obtained; 73% were blood group O. Blood group O was strongly associated with severe cholera: Infected persons had more diarrheal stools per day than persons of other blood groups, were more likely to report vomiting and muscle cramps, and were almost eight times more likely to require hospital treatment. Since prevalence of blood group O in Latin America may be the world's highest, estimates of treatment requirements should be increased to prevent unnecessary deaths.
- Published
- 1994
- Full Text
- View/download PDF
285. [Cholera threatens again].
- Author
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Lukas D and Beus A
- Subjects
- Humans, Cholera diagnosis, Cholera epidemiology, Cholera physiopathology, Cholera therapy
- Abstract
The etiology, epidemiology, pathogenesis, clinical manifestations and treatment procedures of cholera with the point to new experience are presented. This work was motivated by the intensifying interest for this old disease which has reappeared in Europe in epidemic form.
- Published
- 1994
286. [Complications and treatment of cholera during pregnancy].
- Author
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Figueroa Damian R, Villagrana Zesati R, and Kasis Ariceaga D
- Subjects
- Adult, Cholera complications, Cholera therapy, Female, Humans, Infant, Newborn, Mexico epidemiology, Obstetric Labor, Premature etiology, Parity, Pregnancy, Pregnancy Trimester, Third, Tetracycline therapeutic use, Cholera epidemiology, Pregnancy Complications, Infectious therapy
- Abstract
Since 1961 cholera has spread in many countries reaching a pandemic form. Since 1991 Mexico has been involved in this pandemia. Near 20% of all cases of cholera in our country happen in fertile women, so the possibility of the association between cholera and pregnancy is high. We present the case of a pregnant woman, who during her third trimester presented a episode of cholera, developing premature labor. Furthermore is revised the medical literature about the general principles of the management of cholera, and the association between pregnancy and the intestinal infection.
- Published
- 1994
287. [Imported cholera infection caused by a new nonagglutinating cholera agent].
- Author
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Emeis M, Liesenfeld O, Stephan R, Panzer-Heinig S, and Stück B
- Subjects
- Adolescent, Agglutination Tests, Cholera complications, Cholera therapy, Dehydration etiology, Dehydration therapy, Feces microbiology, Female, Fluid Therapy, Germany, Humans, Klebsiella Infections complications, Klebsiella Infections drug therapy, Klebsiella pneumoniae, Pakistan, Serotyping, Shock etiology, Shock therapy, Tetracycline therapeutic use, Trimethoprim, Sulfamethoxazole Drug Combination therapeutic use, Urinary Tract Infections complications, Urinary Tract Infections drug therapy, Vibrio cholerae isolation & purification, Cholera microbiology, Travel, Vibrio cholerae classification
- Abstract
Within 24 hours of returning from a five-week holiday in Pakistan a 15-year-old girl developed vomiting and massive diarrhoea leading to severe dehydration with hypovolaemic shock. The diastolic blood pressure was no longer measurable and prerenal renal failure occurred with a serum creatinine of 4.4 mg/dl and metabolic acidosis (pH 7.21, base excess-16.9 mmol). Initially treatment consisted of rehydration (day 1: 9280 ml, day 2: 4850 ml). The patient's condition rapidly improved and she had voluminous stools. A concurrent urinary infection due to Klebsiella pneumoniae was first treated with cotrimoxazole. As a new strain of Vibrio cholerae, serogroup O 139, was isolated from stool, treatment was changed to tetracycline (50 mg/kg daily). Regaining a good general state she was transferred to an isolation ward on the 6th hospital day. The isolated cholera organism belongs to a nonagglutinating serogroup which is indistinguishable clinically and epidemiologically from the classical Vibrio strains which cause cholera. Since the end of 1992 this new serogroup has been causing an explosive spread of cholera in Bangladesh and India.
- Published
- 1994
- Full Text
- View/download PDF
288. An epidemic of cholera due to Vibrio cholerae O139 in Dhaka, Bangladesh: clinical and epidemiological features.
- Author
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Mahalanabis D, Faruque AS, Albert MJ, Salam MA, and Hoque SS
- Subjects
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Bangladesh epidemiology, Child, Child, Preschool, Cholera physiopathology, Cholera therapy, Diarrhea microbiology, Feces microbiology, Female, Fluid Therapy, Humans, Infant, Male, Middle Aged, Sanitation, Socioeconomic Factors, Vibrio cholerae isolation & purification, Cholera epidemiology, Diarrhea epidemiology, Disease Outbreaks, Vibrio cholerae pathogenicity
- Abstract
We describe the disease spectrum and socio-demographic and epidemiological features of an epidemic of cholera due to a new pathogen, Vibrio cholerae O139, in patients attending a very large hospital in the metropolitan city of Dhaka, Bangladesh. This hospital treats 70,000-90,000 patients a year with diarrhoeal diseases. A 4% systematic sample of 1854 patients attending from January to April 1993 were studied. Five hundred and two (27%) of the 1854 patients were culture positive for V. cholerae O139 and 63 (3%) were culture positive for V. cholerae O1 biotype El Tor. Patients with V. cholerae O139 were mainly adults with a short history of watery diarrhoea. Eight-three percent of patients had moderate to severe dehydration. All recovered except one 80-year-old man with compromised renal function who died. Seventy-eight percent of patients required initial intravenous rehydration followed by oral rehydration therapy with rice ORS; they also received tetracycline to reduce diarrhoea severity. Most patients were from urban slums with inadequate sanitation facilities and hygiene practices. The newly recognized V. cholerae O139 infection produced an epidemic of severe dehydrating diarrhoea indistinguishable from clinical cholera in a population which experiences two epidemic peaks of cholera in a year due to V. cholerae O1. Infection with the latter does not appear to confer any cross-protection from V. cholerae O139. The new pathogen suppressed, albeit temporarily, V. cholerae O1. Unlike other non-O1 serogroups of V. cholerae this new serogroup appears to have epidemic potential.
- Published
- 1994
- Full Text
- View/download PDF
289. [Disordered water-mineral metabolism in cholera patients].
- Author
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Nikitin EV and Skripnik LM
- Subjects
- Acute Disease, Adult, Aged, Cholera blood, Cholera therapy, Dehydration blood, Dehydration diagnosis, Dehydration therapy, Diarrhea blood, Diarrhea diagnosis, Diarrhea therapy, Fluid Therapy, Humans, Middle Aged, Trace Elements blood, Water-Electrolyte Imbalance blood, Water-Electrolyte Imbalance therapy, Cholera diagnosis, Water-Electrolyte Imbalance diagnosis
- Abstract
Clinical analysis was carried out of El Tor cholera in 100 patients, plasma concentrations of electrolytes of potassium (K) and sodium (Na) were studied as were those of trace elements of iron (Fe), copper (Cu), magnesium (Mg) and manganese (Mn) in the whole blood before and after rehydration therapy and depending on the extent of dehydration. The results were as follows: the plasma concentration of K and Na was lowered, that of Mg in the whole blood increased in stage III as well as that of Mn in st. I and II of dehydration; the concentration of Fe, Cu was decreased in st. I, II, III, and of Mn in sit. III of dehydration. The activities of transferrin and ceruloplasmin were found to be on the decrease for the duration of the illness. Rehydration promoted the return to normal of water and electrolyte metabolism, haemodynamics, without affecting to any noticeable degree the trace element metabolism.
- Published
- 1994
290. History of development of oral rehydration therapy.
- Author
-
Bhattacharya SK
- Subjects
- Americas, Animals, Asia, Cholera history, Cholera therapy, Diarrhea therapy, Europe, History, 20th Century, Humans, Diarrhea history, Fluid Therapy history, Rehydration Solutions history
- Published
- 1994
291. Cholera. Lessons from the epidemic in Peru.
- Author
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Gotuzzo E, Cieza J, Estremadoyro L, and Seas C
- Subjects
- Cholera etiology, Cholera therapy, Humans, Peru epidemiology, Risk Factors, Cholera epidemiology
- Abstract
It is not known why the cholera epidemic, which affected all other continents, has not affected Latin America in the past 30 years. In addition, it is unclear why cholera appeared in Peru in 1991. Improvements in scientific knowledge and technology have occurred in Peru during the last 30 months. While it is impossible to summarize in only one article all these concepts, this article presents a few of the most important issues and recent developments in the treatment and prevention of cholera.
- Published
- 1994
292. Cholera toxin and diarrhoea.
- Author
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Asakura H and Yoshioka M
- Subjects
- Anti-Bacterial Agents therapeutic use, Cholera complications, Cholera physiopathology, Cholera therapy, Diarrhea physiopathology, Fluid Therapy, Humans, Intestinal Mucosa metabolism, Cholera Toxin adverse effects, Diarrhea etiology
- Published
- 1994
- Full Text
- View/download PDF
293. [Treatment of choleriform diarrhea during pregnancy].
- Author
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Grados P and Battilana CA
- Subjects
- Acute Disease, Adolescent, Adult, Cholera complications, Dehydration etiology, Dehydration therapy, Diarrhea complications, Female, Humans, Hypotension etiology, Hypotension therapy, Oliguria etiology, Oliguria therapy, Peru, Pregnancy, Pregnancy Outcome, Regression Analysis, Retrospective Studies, Water-Electrolyte Imbalance etiology, Water-Electrolyte Imbalance therapy, Cholera therapy, Diarrhea therapy, Fluid Therapy, Pregnancy Complications, Infectious therapy
- Abstract
A retrospective review was conducted of the clinical histories of 43 pregnant women treated for acute diarrheal disease in the emergency ward of the María Auxiliadora Departmental Hospital (HADMA) in Lima, Peru, and 32 of the histories were selected for this study. These 32 patients had been admitted to the cholera treatment unit (CTU) of the HADMA for acute choleraic diarrhea with moderate or severe dehydration. The objective was to analyze the clinical evolution of the patients, their response to isotonic rehydration therapy (0.9% saline solution), and the consequences for their pregnancies. The following variables were examined: age; trimester of pregnancy; heart rate and mean blood pressure (MBP) at admission; number of hours since last normal urination; duration of diarrhea; degree of dehydration; volume of diarrhea and vomiting; volume of saline solution administered in the first 2 hours and in total; volume of multi-electrolyte solution (MES) or oral rehydration salts (ORS) administered from the second to the sixth hour and in total; and hours between admission to the emergency ward and transfer to the cholera treatment unit (EME/CTU). Logistic regression analysis revealed a direct and statistically significant correlation between the time of recovery of diuresis and the EME/CTU (P = 0.001; r = 0.65), as well as between time of recovery of diuresis and the volume of diarrhea in the first 4 hours.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1994
294. Cholera and severe toxigenic diarrhoeas.
- Author
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Nalin DR
- Subjects
- Cholera prevention & control, Cholera therapy, Diarrhea etiology, Humans, Vibrio Infections transmission, Vibrio cholerae physiology, Cholera transmission, Gastroenteritis etiology
- Published
- 1994
- Full Text
- View/download PDF
295. Production, characterization, and application of monoclonal antibodies to Vibrio cholerae O139 synonym Bengal.
- Author
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Qadri F, Azim T, Chowdhury A, Hossain J, Sack RB, and Albert MJ
- Subjects
- Agglutination Tests, Animals, Antibodies, Monoclonal chemistry, Antibodies, Monoclonal pharmacology, Antibody Specificity, Antigens, Bacterial immunology, Cholera immunology, Cholera therapy, Female, Fluorescent Antibody Technique, Immunoblotting, Lipopolysaccharides chemistry, Lipopolysaccharides immunology, Mice, Mice, Inbred BALB C, Movement, Vibrio cholerae physiology, Antibodies, Monoclonal biosynthesis, Cholera diagnosis, Vibrio cholerae immunology
- Abstract
Mouse monoclonal antibodies (MAbs) were derived against acetone-treated whole cells of the newly recognized Vibrio cholerae O139 serogroup which is causing epidemics of cholera-like disease in India and Bangladesh. Four MAbs specifically recognized the lipopolysaccharide antigens of V. cholerae O139. MAbs ICL9 and ICL13 were of the immunoglobulin M (IgM) isotype, ICL11 was of the IgG3 isotype, and ICL12 was of the Ig2b isotype. A fifth MAb, ICL10, of the IgG2b isotype cross-reacted with V. cholerae O91. All five MAbs recognized V. cholerae O139 in an enzyme-linked immunosorbent assay, slide agglutination test, motility inhibition test, and indirect immunofluorescence test. During a 1-month evaluation of these MAbs in our clinical laboratory, all 86 cases diagnosed as V. cholerae O139 by a rabbit polyclonal antiserum were also detected by these MAbs, establishing their utility as highly sensitive and specific diagnostic reagents. With these MAbs, it should now be possible to screen for the V. cholerae O139 serogroup in epidemic and endemic diarrhea cases and in environmental and food samples.
- Published
- 1994
- Full Text
- View/download PDF
296. Imported cholera in a 31-year-old Peruvian female.
- Author
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Kyriacou DN, Newton EJ, and Jain A
- Subjects
- Adult, Cholera epidemiology, Cholera microbiology, Cholera therapy, Cholera transmission, Emergency Medicine, Feces microbiology, Female, Humans, Los Angeles epidemiology, Peru ethnology, Seafood, Cholera diagnosis, Cholera etiology, Food Microbiology, Population Surveillance, Travel, Vibrio cholerae
- Abstract
We present the case of a 31-year-old Peruvian female with severe dehydration due to diarrhea and vomiting. The patient was one of a number of travelers arriving in Los Angeles on an international flight from Argentina and Peru. Because of the travel history and clinical presentation, cholera was suspected and ultimately confirmed by stool culture. The patient's clinical course is outlined, and discussion of the relevant epidemiology and clinical management of cholera is provided. Physicians should suspect cholera when treating patients with severe gastroenteritis. The short incubation period, rapid onset of dehydration and shock, and high case fatality rate of untreated cholera require a consideration of cholera in patients with diarrhea and recent travel to areas where cholera is prevalent.
- Published
- 1993
- Full Text
- View/download PDF
297. [Cholera in children. A report of 8 cases].
- Author
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Lezama-Basulto LA, Mota-Hernández F, and Bravo-Barrios E
- Subjects
- Acute Disease, Child, Preschool, Cholera therapy, Combined Modality Therapy, Feces microbiology, Female, Fluid Therapy, Humans, Infant, Male, Trimethoprim, Sulfamethoxazole Drug Combination therapeutic use, Vibrio cholerae isolation & purification, Cholera diagnosis
- Abstract
Cholera is an acute intestinal infection caused by Vibrio cholerae 01. When an infected person presents severe dehydration and is not adequately treated, he or she will develop hypovolemic shock and eventually could died. There is scarce information concerning this disease in the Pediatric group. Herein we report on eight cases of Pediatric cholera, in children 17 month to four years of age. Seven patients out of eight were admitted presenting dehydration. Four presenting mild or moderate dehydration and three presenting hypovolemic shock. These three patients were rehydrated by intravenous route and thereafter the hydration was maintained by oral therapy. The outcome was uneventful in six patients. One patient developed abdominal distention probably due to hypopotassemia, and another patient presented hyponatremia and seizures. All the patients recovered within five days after admission.
- Published
- 1993
298. [Severe gastroenteritis after domestic infection with Vibrio cholerae non-O1].
- Author
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Henriksen AZ, Sandvik A, Bergh K, Reiersen R, and Natås O
- Subjects
- Aged, Cholera diagnosis, Cholera epidemiology, Cholera therapy, Diarrhea diagnosis, Diarrhea microbiology, Diarrhea therapy, Gastroenteritis diagnosis, Gastroenteritis therapy, Humans, Male, Middle Aged, Norway epidemiology, Vibrio cholerae isolation & purification, Cholera microbiology, Gastroenteritis microbiology
- Abstract
Vibrio cholerae non-O1 has previously been isolated only occasionally in Norway from patients infected abroad. This report describes the clinical course in two patients who were domestically infected with V. cholerae non-O1. In one case, contaminated seafood, i.e. crab, was the probable source of infection. Both patients displayed a cholera-like type of illness, with severe diarrhoea and electrolyte disturbances. It is recommended that Norwegian laboratories be prepared to isolate vibrios also in domestically infected cases when watery diarrhoea is present.
- Published
- 1993
299. Towards better oral rehydration.
- Author
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Bang A
- Subjects
- Bicarbonates therapeutic use, Cholera therapy, Diarrhea, Infantile therapy, Edible Grain, Glucose therapeutic use, Humans, Infant, Meta-Analysis as Topic, Potassium Chloride therapeutic use, Sodium Chloride therapeutic use, Fluid Therapy methods, Rehydration Solutions therapeutic use
- Published
- 1993
- Full Text
- View/download PDF
300. [Cholera in pediatrics].
- Author
-
Lezama-Basulto LA and Mota-Hernández F
- Subjects
- Adolescent, Child, Child, Preschool, Clinical Protocols, Female, Humans, Infant, Male, Mexico epidemiology, Cholera complications, Cholera diagnosis, Cholera epidemiology, Cholera etiology, Cholera physiopathology, Cholera therapy
- Abstract
Cholerae is a grave and acute bacterial intestine infection which is caused by a bacilo, V. cholerae 01, that produces toxic products. Its clinical symptoms range from abundant liquid diarrhoea combined with vomiting and rapid dehydration. It is highly lethal when right treatment is not applied. There are also cases of cholera where victims do not show any symptoms of it, that is asymptomatic carriers. Any clinical suspicion of cholerae has to be corroborated by epidemiological data and its diagnostic confirmation should be done by isolating the bacteria, V. cholerae. When beginning the treatment, it is not necessary to confirm the diagnostic and this is based on the restitution of the liquids lost through vomiting and facing using any methods that are recommended for any other type of diarrhoea. The antimicrobial treatment is used only for grave cases. This present revision includes recent knowledge about cholerae emphasising on the effective management of cases through an adequate use of right treatment methods and also using the principal prevention measures against dissemination of this disease.
- Published
- 1993
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