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May stop additional isolation when:
End of Illness
Symptoms
Sudden onset, profuse painless watery stools, nausea and vomitting
early in course of illness, fever and in untreated cases rapid
dehydration, acidosis, circularoty collapse, and renal failure.
Comments:
Cholera pandemics occur intermittently. Cholera is a Gram negative
organism. Fecal-oral transmission is common. Potential biowarfare
agent. Good hand hygiene and disinfection is imperative. Refugee or
travel may be an issue. Cholera has the potential for epidemic spread.
In institutions where the population has underlying comorbid conditions,
cholera can be particularly pathogenic. In healthy adult populations
(military populations) morbidity and mortality from cholera should
be low although it could have a significant impact on troop
readiness.
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Incubation Period
2-3 days usual, can range from a few hours to 5 days.
Period of Communicability
Until a few days after resolution of symptoms. Treatment shortens
period of communicability. A carrier state has rarely been reported.
Cohort (Inf. with Inf./Exp. with Exp./Non-Exp. with Non-Exp.)
Yes
Transport Issues
Limit unless medically essential
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Who’s susceptible
Non-immunes. Blood group O is more susceptible to cholera gravis.
Strain specific protective immunity is conferred after infection.
Who’s exposed
Consumption of contaminated food or water. Those with close proximity
to a case, unprotected exposure to body fluids.
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Exclusion of symptomatic personnel from duty
Yes, until fit to work and 3 days after resolution of symptoms.
Exclusion of exposed susceptible personnel from duty
Not required
Isolation of exposed susceptible asymptomatic patients
Not required
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Prophylaxis for exposed
Vaccine minimally efficacious, otherwise no prophylaxis.
Treatment for ill
Hydration. Antimicrobials are indicated in serious illness
only (blood stream or extra intestinal). Doxy 300mg PO X1 or Cipro
1gm PO X 1.
Military/Institutional Populations Special Issues
Refugee or travel may be an issue. Military personnel in areas with cholera
transmission should be educated on the risk of infection. Remove
infected persons from common living areas. Potential biowarfare agent.
Hand hygiene and disinfection are imperative. May return to duty
after released by healthcare provider.
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