Cholera in children: symptoms, treatment, prevention

The symptoms of cholera

Cholera is an acute intestinal infectious disease. Its causative agent is Vibrio cholerae. It causes problems with the gastrointestinal tract, severe loss of body fluid. The human body is very highly sensitive to the pathogen. Asian countries, and countries with poor sanitation often fall under the risk of Contracting this virus. The infestation has dostigali such heights that it ranked among quarantine diseases. For example, in 2008, the virus has claimed 5,000 lives. Every year in the world die almost 100,000 people. To date, the cholera was registered in 90 countries. People who are susceptible to this disease, can die in just a day, if not in time to help.

What is a Vibrio cholerae?

Has the shape of a wand in the form of a comma. It is located in fresh and salt waters, the infected and those who carry the virus. Residence Vibrio cholerae is a human intestinal. Here they feed, breed, and then go along with feces into the environment. In such an environment they can live for about a month at temperatures to 5 degrees. The vibrios are killed at high temperatures, drying and UV rays. This disease is not sick animals, however, he is a parasite also in crustaceans, molluscs and algae. In the warm season, when water becomes a favorable temperature, they can live up to 2-3 months.

To enter the body, they can only through the mouth. In the stomach due to the influence of the sour environment there is a mass destruction of pathogens, so they often can get only on an empty stomach and drink plenty of liquids. After penetration of the small intestine, in an alkaline environment they breed and live.

At the death of the vibrios in the digestive tract begin to accumulate cholera toxins. They are striking in the Central and autonomic nervous system and organs, thereby causing many symptoms.

Toxins begin to affect the gut. By the action of choleragen, the mucous membrane produces a lot of isotonic fluid, which could not be absorbed in the large intestine. Excess fluid in the intestine activates peristalsis, in connection with what starts the diarrhea and vomiting that cause loss of water and salts. The body is dehydrated and obessolivanija. The blood begins to thicken and is reduced efficiency of the heart, blood vessels, extreme lowering of temperature, respiratory failure, acidosis. Also there is a violation of the health of the liver and kidneys. The urine ceases to flow into the bladder.

What symptoms can occur with cholera?

Vomiting in cholera

Duration of latent infection in children lasts from 2 to 5 days. If children were vaccinated, the duration of up to 10 days. In teenagers the symptoms of the cholera are very similar to adults. Onset of the disease begins acutely with the appearance of diarrhea. The child becomes weak and feels discomfort. Often these symptoms are attributed to fever and headache, and slight fever.

Cholera in children is manifested as a strong diarrhea. The symptoms begin abruptly, often in the morning or evening. The diarrhea is painless. Stool become mushy in nature, are frequent and dull-white in color, can swim small flakes resembling Fig. Such impurities are the first signs of acute bacterial infections. Sometimes the stool becomes green, yellow or brown.

In typical cases the disease develops acutely, often suddenly: night or morning patients feel an imperative urge to defecate without tenesmus or abdominal pain. Often marked by discomfort, rumbling and transfusion around the navel or in the abdomen. The chair is usually abundant, stool initially have fecal character, with particles of undigested food, then become liquid, watery, yellow with floating flakes, in the future, lighter, acquiring the form of rice-water without odor, with the smell of fish or grated potatoes. In the case of mild course of disease can be from 3 to 10 bowel movements per day. Patient have a decreased appetite, appear quickly thirst and muscle weakness. The body temperature usually remains normal in some patients revealed low-grade fever. On examination can detect increased heart rate, dryness of the tongue. Stomach, painless, determined by the rumbling and transfusion of fluids during the small intestine. Under favorable course of the disease diarrhea lasts from several hours to 1-2 days.

The second symptom after diarrhea – severe vomiting, accompanied by spasm. The child asks to drink, and the nausea is only getting stronger. Most often nausea beforevomiting does not appear. The first vomit contains undigested food residues, bile.

The initial course of the disease are not accompanied pain and discomfort in the digestive tract. The pain occurs only after copious vomiting, when the stomach starts cramping. At palpation stomach is retracted and the sick. When it starts paresis, occurs swelling.

Do not stop the vomiting and diarrhea lead to dehydration. They stop a little later, however, the patient gets worse. With the advent of the symptoms of dehydration occur:

• change the appearance of the patient,
• skin and mucous membranes become dry,
• it's hard to say, the patient speaks or whispers, or siplo,
• decreases the amount of water in the tissues,
• disrupts the function of the blood. It becomes thick and poorly circulating,
• chills, convulsions,
• body temperature decreases below normal,
• in connection with dehydration, the urine no longer flows into the bladder,
• heavy breathing,
• the skin takes on a deathly pale blue shade.

When it comes to cholera in children, facial features become sharp, the area around the eyes acquires a cyanotic hue, the eyes sink. Due to the dysfunction of blood, there is a lack of circulation in the capillaries, so the body becomes bluish tint. Most of all cyanosis is expressed in areas that are far from the heart: extremities hands, feet, lips, nose, ears. Skin folds and extremities become cold, the skin fold is not straightened.

The more is the dehydration, the longer and more often start to twitch chewing and calf muscles. There is a decrease of potassium in the blood. The blood becomes very thick, which violates the health of organs including can occur renal failure. The body is a disturbance of acid-alkaline balance (acidosis).

How is the treatment of cholera?

Treatment of cholera

Cholera of children is hard because they have a lower tolerance for dehydration. Patients with all forms of cholera subject to compulsory hospitalization in hospitals (specialized or temporary) where is causal and pathogenetic therapy.

First, you need to make up for the lack of body weight and correction of water deficit. This helps to cope Registratsionnaya therapy.

To rehydrant are glucose-saline nature:

• Rehydron is a powder consisting of glucose, potassium chloride and sodium, sodium citrate. They are geared to managing the health of the digestive tract and stop diarrhea, and correction of acid-base balance. When mixed with water gives a clear solution with a salty-sweet flavor.
• Glyukosolan. The composition includes sodium and potassium chloride, sodium bicarbonate, sodium citrate, glucose. It regulates the water-salt metabolism and leads to loss of fluid.

In addition, the loss of fluid ahead of it compensation with drink, and sometimes lack even the massive infusion directly into the two subclavian catheter.

Cholera in children is treated by the method of oral therapy. Initially, glucose saline mixture administered in the volume of the deficit of water and electrolytes which fill up fractionally in 2-4 hrs, if vomiting occurs, it is advisable to enter the solution via a nasogastric tube. In the subsequent introduction of glucose and salt mixture is carried out in a volume of ongoing losses of fluid, which is determined by the number of bowel movements every 2-4 h. Oral rehydration is continued until the complete cessation of diarrhea, in most cases within 1-2 days.

During treatment necessary to monitor your baby's weight. To determine the daily fluid volume, you can use the table.

Simultaneously with rehydration measures in patients with cholera is carried out etiotropic treatment – prescribed oral tetracycline (adults 0.3–0.5 g every 6 hours) or chloramphenicol (adult 0.5 g 4 times a day) for 5 days. In severe disease with the presence of vomiting, the initial dose of antibiotics administered parenterally. On a background of reception of antibiotics the severity of the diarrheal syndrome is getting smaller, therefore the need for rehydration fluids reduced by almost half.

Complication of cholera in children

With fast and good treatment, these complications are extremely rare. Small children, children with problems of the gastrointestinal tract, and lowered immunity may receive the following complications:

• a sharp drop in blood pressure,
• renal failure,
• purulent inflammation of the tissues,
• erysipelas,
• Vibrio typhoid.

Prevention of cholera in children

To avoid this disease is necessary to detect infected adults and children. After detecting the need of the patient to isolate and treat the causative agent. To eliminate the source of the disease need to be isolated carefully not only the patient, but also those people who had contact with him, and to conduct a comprehensive diagnosis to identify this disease.

Preventioncholera includes the following recommendations:

• Do not drink dirty water. Purchase a water filter, morozte her boil. Also, do not drink from unknown sources. It is better to buy bottled water.
• Swim only in designated areas – it will significantly reduce the risk of any infection, because there the water is always checked.
• After the disease will be necessary to conduct a thorough disinfection of the rooms in the house where the patient was.
• To observe the rules of hygiene and rules of food. Thoroughly wash vegetables and fruits, prevaricate food, etc.

Now cholera is treated at 90% with no complications and lethal outcomes. To prevent this disease, doctors developed the vaccine. In India, after use of this vaccine for 10 years, the number of infections decreased. At the moment this vaccine is used in countries where cholera is widespread.

In the vaccine include the toxin of Vibrio cholera, which the body are not yet infected man forms the immune system. It should be about those people who travel to countries with risk of Contracting cholera.

Doses used for vaccination against cholera:

• to 5 years children do the vaccine 2 times per month by 0.2 ml,
• from 5 to 10 years is 2% per month to 0.3 ml,
• after 10 years and adults the dose rate of 0.5 ml 2 times per month.