Active adenyl cyclase
Nester-Anderson-Roberts: I IV. Infectious Diseases I 24. Alimentary System I I © The McGraw-Hill
Microbiology, A Human Infections Companies, 2003
Perspective, Fourth Edition
24.5 Bacterial Diseases of the Lower Alimentary System 613
Table 24.5 Cholera
(T) Vibrio cholerae, the causative bacterium, enters the mouth with fecally contaminated food or drink
(2) The bacteria attach to epithelial cells of the small intestine
® V. cholerae toxin enters the cells and prevents them from down-regulating secretion of water and electrolytes
@ The epithelial cells pump water and electrolytes from the blood into the intestinal lumen, causing watery diarrhea
© Shock and death occur because of fluid loss from the circulatory system, unless the fluid can be replaced
© The bacteria exit the body with feces
Incubation period Causative agent
Prevention and treatment
Abrupt onset of massive diarrhea, vomiting, muscle cramps
Short, generally 12 to 48 hours
Vibrio cholerae, a curved, alkali and salt tolerant, Gram-negative rod bacterium
Heat-labile exotoxin causes excessive secretion of water and electrolytes by the intestinal epithelium; leads to dehydration and shock
Ingestion of fecally contaminated food or water; sometimes natural sources associated with marine crustaceans
Purification of water, careful handwashing; vaccination.Treatment: Rehydration with a solution of electrolytes and glucose, given intravenously in severe cases; or similar electrolyte solution containing a glucose source given by mouth in milder cases available in a number of countries outside the United States. One consists of a living, genetically altered strain of V. cholerae, and another, killed V. cholerae in combination with the purified recombinant B subunit of cholera toxoid. Treatment of cholera depends on the rapid replacement of electrolytes and water before irreversible damage to vital organs can occur. The prompt administration of intravenous or oral rehydration fluid decreases the mortality of cholera to less than 1%.
The main features of cholera are summarized in table
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