传染病学英文版课件：Cholera.ppt

Cholera Robin Cochran-Dirksen Robin Cochran-DirksenHistoryMiasma TheoryThe theory that diseases were caused by miasma or bad air arising from organic decay, filth, or other conditions of the local environment.‘All smell is disease.’English Sanitary reformer Edwin Chadwick, 1842 Robin Cochran-Dirksen‘The great mass of people…. don’t know that the miasma of an impure alley is productive of cholera and disease. If they did know these things, people would take care that they inhabited better houses.’English Liberal Economist, Richard Cobden 1853 Robin Cochran-Dirksen ‘We live in muck and filth. We aint got no priviz, no dust bins, no drains, no water-splies, and no drain or suer in the hole place…The Stenche of a Gully-hole is disgustin. We all of us suffer, and numbers are ill, and if the Colera comes Lord help us.We are living like piggs, and it aint faire we shoulde be so ill treted.’Letter to the London Times 1849, signed by 54 slum dwellers Robin Cochran-DirksenEarly cholera epidemiology Robin Cochran-Dirksen‘The death of a patient from cholera represents a failure of healthcare.’Silvere Simeant, WHO Robin Cochran-DirksenWho’s at RiskFarmers, Fisherman and laborersThe poor and the malnourished Robin Cochran-DirksenConditions Leading to OutbreaksContaminated Water Robin Cochran-DirksenHuman to Human Transmissione.g. Refugee Camps Robin Cochran-DirksenSymptoms and TreatmentRehydrationAntimicrobials Robin Cochran-DirksenPreventionImproved SanitationClean waterAccess to health care Robin Cochran-DirksenCholera in Zimbabwe Robin Cochran-DirksenEcology of Cholera Robin Cochran-Dirksen Life cycle in humans Host drinks waterBacteria conserve energy during the passage through the stomach, most dieSurviving bacteria reach the intestine, produce flagellaPropel themselves through the mucus of the sm. intestineBacteria produce toxin causing diarrheaFeces carry new bacteria back into drinking water Robin Cochran-DirksenLife cycle in water Robin Cochran-DirksenDifferent s