Vibrio Cholerae Management
CHEMOPROPHYLAXIS:
- Treatment of Choice:Rehydration therapy
- Mild to moderate rehydration:ORS
- For severe: IV fluid.Ringer lactate is best
- DOC :single dose of doxycycline/tetracycline
- Oral Tetracycline tends to reduce stool output in cholera and shortens the period of excretion of vibrio’s
-
TMP-SMX – antibiotic of choice for children.
-
Furazolidone – antibiotic of choice for pregnant women.
VACCINES:
Killed vaccine
- The licensed parenteral cholera vaccine provides only limited and brief protection against V cholerae 01
- Not provide any protection against V cholerae 0139
- High cost-benefit ratio; therefore, the vaccine is not recommended for travellers.
- New oral cholera vaccines are being developed.
- Cholera vaccine effectiveness is 85% for 6 months which declines to 50% for 12 months
-
Oral cholera vaccine is effective for 3 years
Two types of oral cholera vaccines are available:
1. Dukoral (WC-rBS)
- Dukoral is a monovalent vaccine
- Based on formation and heat-killed whole cells (WC) of V. cholerae 01 (classical and El Tor, Inaba and Ogawa) plus recombinant cholera toxin B Subunit.
- Provided in 3 ml. single dose vials together with the bicarbonate buffer.
- Primary immunization consists of 2 oral doses given 7 days apart (but < 6 weeks apart) for adults and children aged 6 years.
- Children aged 2-5 years should receive 3 doses. Intake of food and water should be avoided for 1 hour before and after vaccination.
- 1 booster dose is recommended after 2 years for adults aged 2-5 years and children aged 6 years. For children aged 2-5 years, 1 booster dose is recommended every 6 months.
- Dukoral is not licensed for children < 2 years
2. Shanchol and mORCVAX.
- It is Bivalent oral vaccine based on serogroups 0-1 and 0-139.
- This vaccines do not contain the bacterial toxin B Subunit.
- Vaccine is given in 2 doses 14 days apart for individuals 1 year.
- A booster dose is recommended after 2 year.
NEWER VACCINES:
- CDC – On Vaccination for Cholerae
- Cholera vaccine is no longer required, nor recommended for the vast majority of travellers by the Centres for Disease Control and Prevention (CDC).
Exam Important
CHEMOPROPHYLAXIS:
- Treatment of Choice:Rehydration therapyDOC :single dose of doxycycline/tetracycline
- Mild to moderate rehydration:ORS
- For severe: IV fluid.Ringer lactate is best
- Oral Tetracycline tends to reduce stool output in cholera and shortens the period of excretion of vibrio’s
- TMP-SMX – antibiotic of choice for children.
- Furazolidone – antibiotic of choice for pregnant women.
VACCINES:
Killed vaccine
- Cholera vaccine effectiveness is 85% for 6 months which declines to 50% for 12 months
- Oral cholera vaccine is effective for 3 years
Two types of oral cholera vaccines are available:
Dukoral (WC-rBS)
- Dukoral is a monovalent vaccine based on formation and heat-killed whole cells (WC) of V. cholerae 01 (classical and El Tor, Inaba and Ogawa) plus recombinant cholera toxin B Subunit.
Shanchol and mORCVAX.
- NEWER VACCINES:Cholera vaccine is no longer required, nor recommended for the vast majority of travellers by the Centres for Disease Control and Prevention (CDC).
- CDC – On Vaccination for Cholerae
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