Cholera

A00.0-1/A00.9

Note: notifiable condition.

DESCRIPTION

Very acute severe watery diarrhoea due to infection with Vibrio cholerae.
Clinical features include:

  • rice water appearance of stools:
    • no blood in stools
    • no pus in stools
    • no faecal odour
  • possible vomiting
  • rapid severe dehydration

GENERAL MEASURES

Rehydrate aggressively with oral rehydration solution (ORS).

MEDICINE TREATMENT

Treat dehydration

Children

Treat dehydration. See: Diarrhoea, acute in children.

Adults

Oral treatment:

  • Oral rehydration solution.

OR
Homemade sugar and salt solution. See: Diarrhoea.
The volume of fluid required for oral rehydration depends on the severity of the dehydration.

Oral rehydration is preferred. In stuporose patients administer IV fluids or ORS by nasogastric tube.

IV treatment:

  • Sodium chloride, 0.9%, IV.

AND

Antibiotic treatment

Children

  • Ciprofloxacin, oral, 15 mg/kg/dose 12 hourly for 3 days. See paediatric dosing tool. (Ciprofloxacin is specifically used for this indication in children).

LoE:III[1]

Adults

  • Ciprofloxacin, oral, 500 mg 12 hourly for 3 days. Adjust antibiotic choice, according to the sensitivity of the isolate responsible for the local epidemic.

LoE:III[2]

AND

Nutritional supplementation

In all children who are able to take oral medication

  • Zinc (elemental), oral for 14 days
    • If < 10 kg give 10 mg/day.
    • If > 10 kg give 20 mg/day.

REFERRAL

  • Severely ill patients.
  • According to provincial and local policy.