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Chlamydia trachomatis infection 

Chlamydia trachomatis infection
Chapter:
Chlamydia trachomatis infection
DOI:
10.1093/med/9780198729228.003.0056
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date: 19 November 2019

Cholera is a bacterial infection caused by Vibrio cholerae. The pathogenic factor is the cholera endotoxin which causes an efflux of water, bicarbonate, and electrolytes from the gut, leading to dehydration and electrolyte imbalance. Cholera is spread by the faecal–oral route and occurs where sanitation and water supplies are inadequate. Cholera occurs endemically in South and South East Asia and in sub-Saharan Africa. Only 20% of people infected with V. cholerae develop symptoms (asymptomatic people still excrete V. cholerae for 1–2 weeks and are therefore also sources of transmission). Most symptomatic cases present as mild acute watery diarrhoea. Severe cholera (10% of symptomatic cases) is characterized by the abrupt onset of profuse watery diarrhoea and vomiting, resulting in dehydration. Routine laboratory techniques are able to isolate V. cholerae from stool specimens. Rapid diagnostic tests are available but lack specificity. Early detection and timely and effective case management of cholera with oral or intravenous rehydration reduce the case fatality rate to less than 1%. Appropriate antibiotics can reduce the volume and duration of diarrhoea and the excretion of cholera vibrios (doxycycline for adults, azithromycin for children under 12 years). Zinc supplementation significantly reduces the severity and duration of diarrhoea in children. Isolation and barrier nursing precautions should be established to reduce the risk of transmission within health-care settings treating cholera patients. The long-term solution for cholera control lies in universal access to potable water and adequate sanitation.

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