Pathophysiology and Clinical Aspects of Cholera

Rabbani, Golam; GreenoughIII, William B.

doi:10.1007/978-1-4757-9688-9_11

Cited by 21 publications

(4 citation statements)

References 71 publications

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“…The present analyses show that older patients present with more severe disease with V. cholerae infection than children, with higher purging rates and more dehydration; this is consistent with the findings of previous analyses 23,24. This difference in disease severity between older patients and children has also been documented in enterotoxigenic Esch-erichia coli (ETEC) diarrhea 25.…”

Section: Discussionsupporting

confidence: 91%

A Comparison of Clinical and Immunologic Features in Children and Older Patients Hospitalized With Severe Cholera in Bangladesh

Chowdhury

Khan²,

Harris³

et al. 2008

Pediatric Infectious Disease Journal

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Section: Discussionsupporting

confidence: 91%

A Comparison of Clinical and Immunologic Features in Children and Older Patients Hospitalized With Severe Cholera in Bangladesh

Chowdhury

Khan²,

Harris³

et al. 2008

Pediatric Infectious Disease Journal

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“…It was designated V. cholerae, serogroup O139, and it bears a mutation in the chromosome of the bacterium, altering its antigenic profile [6]. It was first seen in Pakistan in 1993 [7,8]. At the same time resistance to cheap and nontoxic antimicrobials was observed [9].…”

Section: Introductionmentioning

confidence: 99%

Cholera in a developing megacity; Karachi, Pakistan

et al. 1997

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Despite rapid urbanization and increasing affluence in Karachi, cases of cholera are frequent. We analysed computerized isolation data from the AKUH Clinical Microbiology Laboratory, Karachi, from 1990-6 to examine microbiological, temporal and demographic trends in Vibrio cholerae infections. During this period 888 strains of V. cholerae (566 V. cholerae serogroup O1, and 204 V. cholerae serogroup O139) were isolated from specimens from 886 patients; 214/464 were adult inpatients, and 250/464 paediatric inpatients, the remaining 422 outpatients. Isolations peaked between June and August. Overlapping epidemics occurred in 1993 and 1994 of serogroup O1 (May to August), and serogroup O139 (August to October). All ages and social and economic strata were affected. Forty-four percent of all isolates were from children under the age of 5 years. The mean age of all patients with serogroup O1 infections was 19.6 years (+/-0.9) compared with 367 (+/-1.7) for serogroup O139 infections (P < 0.0001, t test). More than a quarter (27%) of all serogroup O1 isolates were from babies under 2 years of age. One patient had a serogroup O1 infection followed by a serogroup O139 infection 1 year later. Another patient was infected with serogroup O1 strains 5 years apart. Emergence of resistant strains was observed, but by 1996 serogroup O139 had disappeared. An aquatic organism, cholera nevertheless continues to take its toll in this city of 11 million situated in a desert.

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“…Cholera patients have the highest purging rates, stool sodium concentrations, and loss of body sodium; adult losses exceed those of children, who have lower stool sodium concentrations, the latter linked to greater stool potassium losses. 7 Patients with noncholera diarrhea generally have lower purging rates. 8 In early studies of adults with cholera, use of oral maintenance solutions with glucose and 100 mEq/L of sodium resulted in an average negative sodium balance of 50 mEq, ranging as low as −200 mEq.…”

Section: Emonstration Of the Benefits Of Oral Therapymentioning

confidence: 99%

“…The original WHO formulation with 90 mEq/L of sodium and 111 mmol/L of glucose (Table ) proved a safe, effective formulation for all age groups and cholera or noncholera diarrhea. 2,7,9,16,25 However, failure to communicate the information needed to ensure correct solution preparation, concentration, and appropriate drinking volumes can lead to electrolyte imbalance, whatever the formulation. Thus, inaccuracies in home-mixing of solutions led to hypernatremia in Egypt, a situation that was reversed with detailed instructions broadcast via television and taught in rehydration clinics.…”

Section: Experience With the Original Who Orsmentioning

confidence: 99%