Summary: Cholera is an acute, intestinal, infectious disease caused by the cholera fungi, which has caused a global epidemic on several occasions in human history, with enormous human health and socio-economic impacts. The paper details the pathological characteristics of cholera, its epidemiology, morbidity mechanisms, clinical performance, diagnostic methods, treatment strategies and preventive control measures, with the aim of raising public awareness of the disease, raising awareness of prevention and control and effectively curbing its spread and prevalence.
Introduction
Cholera, which has been raging around the world since the nineteenth century, has been characterized by a dramatic outbreak, rapid spread, widespread reach and severe hazards. In periods of relatively poor medical conditions, the cholera epidemic is often accompanied by high mortality rates and social unrest. Although modern medicine has made significant progress in the prevention and control of cholera, it remains one of the diseases of global public health focus, especially in areas with weak health infrastructure and poor sanitation, where the threat of cholera remains.
II. Pathological characteristics
Cholera fungus is a fungus fungus of the fungus, which is chromosomal negative, in arc or comma form. The fungus has a single-end lashes, which can move quickly in liquid culture, in a shuttle or meteoroid form. The cholera fungus can be divided into several serogroups, of which the O1 and O139 are the main serogroups responsible for the cholera epidemic. O1 groups of cholera fungus can be divided into classical and Elto, which vary slightly in morphology, biochemical properties and are highly pathogenic. Cholera fungus can produce cholera toxin, which is a key cause of severe diarrhoea. Cholera toxin consists of sub-units A and B, which can be combined with receptors of the upper skin of small intestinal mucous cells, enabling sub-unit A to enter the cell, activate glandic acid cyclic enzymes, and increase the cAMP concentration in the cell, which in turn causes a large amount of intestines to be distributed, leading to diarrhoea.
Epidemiological characteristics
(i) Sources of infection
Cholera patients and vectors are the main sources of infection. Patients can emit large amounts of cholera fungus during the onset of the disease, especially among light patients and those with retrofitting conditions, who, because of their unusual or non-symptomatic symptoms, can easily be overlooked for transmission in the population.
(ii) Means of dissemination
It’s mainly transmitted through the mouth. Drinking of water contaminated with cholera is the most common mode of transmission, such as untreated raw water, contaminated well water or river water. In addition, the consumption of contaminated foods, in particular uncooked sea products, vegetables, fruits, etc., as well as exposure to contaminated articles can lead to infection. Cholera can easily spread rapidly in areas with poor sanitation and population density, such as slums, refugee camps, etc.
(iii) Vulnerability
People are generally vulnerable, but people with insufficient stomach acidity, malnutrition, low immunity are more vulnerable and may be more seriously ill. In newly introduced areas, the lack of specific immunity for populations tends to lead to outbreaks.
(iv) Epidemic characteristics
Cholera is common in the tropics and subtropical regions, with marked seasonality, usually occurring in the summer and autumn, at a time of high temperatures and high humidity, which facilitates the survival and reproduction of the cholera fungus in the environment. The cholera epidemic can be divided into distribution, outbreaks and epidemics. While outbreaks are often caused by one-time contamination of water or food, the pandemic can spread rapidly across national and continental borders to multiple countries and regions.
IV. EMERGENCY MECHANISMS
Cholera fungus, which enters the human body through the mouth, can generally be extinguished by stomach acid, but can enter the intestines through the stomach when the stomach acid is reduced or the ingestion of the bacteria is higher. In the intestines, the cholera fungus is adhesive to the upper skins of the microintestinal mucous membranes and breeds in large numbers through structures such as lashes and adhesives. Subsequently, the cholera toxin produced by the cholera fungi acts in small intestinal mucous cells, disrupting the functioning of water and electrolyte in the cells and causing diarrhoea through large quantities of liquid and electrolyte into the enteric cavity. As a result of the high number of diarrhoeas, rapid dehydration, electrolyte disorders and acid alkali balance disorders can occur, and serious deaths can occur as a result of circulatory failure. In addition, a number of other toxins and enzymes, such as internal toxins, solubles, etc., can be produced by the cholera fungus, further aggravating pathological changes in the intestinal tract and the whole body.
V. Clinical performance
(i) Vacuum period
The average is between 1 and 3 days, short of hours and up to 7 days for the elderly.
(ii) Diarrhea period
Most patients suddenly developed a disease, starting with severe diarrhoea and then vomiting. Diarrhoea is characterized by a lack of abdominal pain and a lack of a sense of excruciation, and can take several to dozens of times per day, even incalculable. One of the typical characteristics of cholera is the blubber of poop, which begins to be yellow and then rapidly transforms into a “mith-water” sample. Absorption usually occurs after diarrhoea, mostly in the form of ejection, where vomiting begins to be a stomach content and can then be followed by a “mixed water”. Patients generally have no fever during this period and a few have low fever.
(iii) Dehydration period
As a result of the high levels of diarrhoea and vomiting, the patients are rapidly suffering from dehydration, such as dry skin, reduced elasticity, dents in their eyes and flogged fingerprints. Severe dehydration can lead to circulatory failure, in the form of reduced blood pressure, pulsation speeds, cold limbs, reduced urine and even no urine. Patients can also suffer from electrolyte disorders, such as low potassium haematosis, which can cause muscle weakness, abdominal swelling, cardiac disorders, etc., and sodium haematosis, which can lead to dementia, muscle spasms, etc., accompanied by metabolic acid poisoning, which can be manifested in a high rate of breathing, mental confusion, etc.
(iv) Recovery period
After prompt treatment, the patient ‘ s diarrhoea, vomiting and dehydration are stopped, the symptoms are gradually reduced, the amount of urine is increased and the physical strength is gradually restored. However, some patients may recover from intestinal disorders, such as constipation or diarrhoea, that may occur during intestinal mucus repair.
VI. Diagnosis
(i) Clinical diagnosis
Clinical diagnosis can be made on the basis of typical clinical manifestations of patients in endemic areas and during the popular season, such as severe diarrhoea, vomiting, and “mithic water”. However, in non-prevalence areas or in cases of distribution, clinical symptoms alone are prone to error and need to be further confirmed in conjunction with laboratory examinations.
(ii) Laboratory diagnosis
General inspection of faeces: Observed slime and a few red and white cells.
Screech dyeing: Guerranne vaginal fungus can be observed under microscopes, in herds.
3. Excreta culture: The vaccination of faeces to cultures such as alkaline protein platinum or TCBS can produce cholera Vibrio, which can be determined by further biochemical tests and serobiology as seromas and biotypes of cholera Vibrio, which is an important basis for the diagnosis of cholera.
Sero-psychiatry: The detection of cholera Vibrio antibodies in patients’ serums, such as condensers, fungus antibodies, etc., can be used for diagnostic assistance, but generally cannot be used for early diagnosis.
Treatment
(i) Rehydration therapy
Remediation is a key component in the treatment of cholera and is intended to correct dehydration, electrolyte disorders and acid alkali balance disorders and restore normal physiology of the body. The rehydration principle is quick and slow, salt and sugar, and urine and potassium. People with mild dehydration may receive oral rehydration salts, while those with moderate and severe dehydration require intravenous rehydration. The liquids commonly used for intravenous rehydration are physico-saline, 5% glucose physico-saline, Lingel, etc., adjusted to the patient ‘ s dehydration, blood pressure, pulse, urine, etc. During the rehydration process, changes in the vital signs and electrolyte of the patient should be closely monitored and the rehydration programme adjusted in a timely manner.
(ii) Antibacterial treatment
Antibacterial drugs reduce the frequency of disease, diarrhoea and bacterial levels, and are common antibacterial drugs such as tetracycline, dossicycline, cyclopropsa, and left-oxen fluoride. However, with the widespread use of antibiotics, the resistance of cholera Vibrio has become a concern, so that antibacterial drugs should be reasonably selected during treatment based on the results of sensitive tests.
(iii) Other treatment
In cases of shock, there should be active anti-convulsive treatment, such as supplementary blood capacity and the application of vascular active drugs. For patients with electrolyte disorders such as potassium and sodium, the corresponding electrolyte should be supplemented in a timely manner. At the same time, care for patients should be strengthened to keep their skin clean and dry and to prevent complications such as scabies.
Preventive control measures
(i) Control of transmission sources
Timely quarantine treatment of cholera patients and vectors and strict disinfection of patients ‘ excreta and vomit to prevent disease transmission. Those in close contact should be subjected to medical observation and excreta testing and, if necessary, preventive medicine.
(ii) Cut off transmission channels
(c) Strengthen water sanitation management, ensure safe drinking water and disinfect water sources, such as chlorination. (c) Strengthen food hygiene regulations and strictly enforce food hygiene standards to prevent contamination of food by the cholera virus. Improve environmental health, strengthen the construction of public health facilities, such as latrines, garbage disposal facilities, etc., and carry out regular sanitation to disinfect and eliminate vector organisms such as flies and cockroaches.
(iii) Protection of vulnerable populations
In cholera-endemic or high-risk areas, cholera vaccinations are available to increase the immunity of the population. At the same time, health education is being strengthened, information about cholera prevention and treatment is being disseminated, and public health awareness and self-protection are being promoted, such as good hygiene practices, hand washing before meals, drinking raw water and eating unclean food.
Conclusions
Cholera as a sexually transmitted disease, while modern medicine has made great strides in its diagnosis, treatment and prevention, it cannot be ignored. Awareness of cholera pathology, epidemiology, morbidity mechanisms, clinical performance, diagnostic and treatment methods and preventive control measures are important for the general public. Comprehensive measures such as strengthened global cooperation, improved public health systems, increased public health awareness and an active vaccination campaign are expected to further reduce cholera morbidity and mortality and guarantee human health and social stability.
Cholera
