Particularly dangerous infections of cholera and brucellosis, symptoms, first emergency medical care, measures in the focus of cholera and brucellosis.

Infectious diseases of cholera and brucellosis, which are classified as especially dangerous, when they occur, can quickly spread among the population in the form of epidemics in large areas. Therefore, when identifying patients or suspecting them with such pathologies, they take all possible measures to prevent the spread of infection. 

Particularly dangerous cholera and brucellosis infections, symptoms, first emergency medical care, measures in the focus of cholera and brucellosis.

Cholera and brucellosis often occur in a severe form and pose a threat not only to a specific patient, but also to the entire population. All cases of diseases of especially dangerous infections and suspected of them, health workers must urgently report to the bodies of sanitary and epidemiological surveillance and health management.

an organism that can lead to shock. The disease is caused by cholera vibrio. The source of infection is a sick person or vibrio carrier, and infection occurs when infected water is consumed (most often), food, through contaminated objects. A man releases cholera vibrio into the environment with vomit and feces.

This microorganism is not stable in the environment and dies under the influence of disinfectant solutions, ultraviolet rays, when boiled, dried. Most often, cholera is detected in summer and autumn. Immunodeficiency conditions and a decrease in the acidity of gastric juice contribute to the development of the disease. After transferred cholera, re-infection is extremely rare. The latent period lasts from several hours to 5 days (on average 2 days).

Symptoms of Cholera.

In a typical course of cholera, it develops rapidly. Suddenly, rumbling appears in the abdomen, heaviness and fullness in the abdomen occur, stool becomes frequent and watery. Abdominal pains are not noted, body temperature can be normal or increase to 38 degrees. The tongue and mucous membranes of the patient are dry. In mild cases, after 1-2 days, the stool normalizes. With an increase in the severity of the patient’s condition, the stool is noted up to 20 times a day and looks like a rice broth. Sometimes it determines an admixture of bile.

Repeated vomiting of the fountain causes suffering to the patient. With vomiting and loose stools, each time the patient loses up to 250-300 ml of fluid. This leads to a violation of water-salt metabolism and severe dehydration. With dehydration of I degree, the deficiency of fluid in the body does not exceed 3% of body weight. The general condition of the patient does not change much, but there is thirst. Dehydration of the II degree is characterized by a loss of fluid equal to 4-6% of body weight. At the same time, thirst intensifies, the skin and mucous membranes are dry. Pulse is rapid, blood pressure decreases (especially systolic), urine output decreases.

With dehydration of the III degree, the deficit of body weight is up to 9%, pronounced metabolic disorders occur. The patient’s skin loses firmness and elasticity, becomes cyanotic, the voice hoarsens. The face takes on a characteristic appearance – pointed features, sunken eyes, dark circles around them. The amount of urine removed is reduced. Liquid deficiency in the body during dehydration of the fourth degree reaches 10% or more of body weight. Blood pressure is significantly reduced, and shock develops. The skin is cold, cramps, increasing shortness of breath. Urination stops. The patient’s consciousness is impaired, a coma may develop and death from respiratory arrest can occur. Perhaps a fulminant course of cholera, in which a coma develops during the day.

First aid for cholera.

First of all, it is necessary to fill the deficiency of fluid in the body. To determine its volume, you need to measure the number of vomit and feces of the patient. The volume of fluid injected into the body of the patient should exceed losses by 1.5 times. To combat dehydration, in light cases, glucose-salt solutions are used inside, and in severe cases, intravenously.

At home, you can prepare such a solution: 1 tsp. table salt, 4 tsp. sugar per 1 liter of water. Prescribe antibacterial agents – drugs of the tetracycline group and chloramphenicol. In a serious condition of the patient, anti-shock therapy is performed. With repeated vomiting, normal nutrition is ineffective. As the frequency of vomiting decreases, the patient can take boiled, soft food. Potassium-containing foods (dried apricots, bananas, baked potatoes) are further recommended..

Activities in the focus of cholera.

The patient must be isolated. Treatment is carried out only in an infectious diseases hospital. You can approach the patient only in special clothes – a dressing gown, arm ruffles, hat or scarf, mask, gloves, washable shoes (boots) and oilcloth apron. During severe vomiting, the contents of the stomach with cholera are ejected by a fountain and are sprayed around. All discharges of the patient are disinfected, and some are sent for bacteriological examination. The room where a patient with cholera is found is subjected to disinfection.

All contact persons are hospitalized, monitored for 5 days and subjected to a double bacteriological examination. After the withdrawal of contact persons from the outbreak, a final disinfection is performed. To prevent the development of cholera, they are prescribed a double dose of cholera bacteriophage. Children under 3 years old are given 10 ml., Children 3-10 years old – 15 ml., Older children and adults – 25 ml. drug to receive. The bacteriophage should be taken 30 minutes – 2 hours before meals, washed down with a 2% solution of baking soda. The interval between doses of the drug – 10 days.

After recovery, a person is subjected to bacteriological examination three times. Fecal analysis is carried out every 5 days. Only after this, the patient is discharged from the hospital and sent for observation for 20 days. Observed in a special room for people who have just had a particularly dangerous infection. After recovery, the patient for 1 year is at the dispensary and undergoes bacteriological examination to exclude carriage of cholera vibrio.

Brucellosis.

Brucellosis is an infectious disease characterized by intoxication, damage to the internal and genital organs, as well as the musculoskeletal system. Pathology can go into a chronic form. The disease is caused by brucella that live in the body of animals (small and cattle, deer, hares, pigs, rarely dogs). Human infection occurs when eating dairy and meat products, working with skins and wool from sick animals. Therefore, brucellosis is more common among livestock workers and veterinarians. The causative agent is stored for a long time in the external environment. The latent period of the disease is 1-6 weeks. Possible asymptomatic brucellosis.

Symptoms of Brucellosis.

The disease begins with an increase in body temperature to 39–40 degrees – it is either increasing or decreasing. Thus, fever with chills lasts 3-4 weeks. The defeat of the central nervous system is accompanied by euphoria (excessively high spirits without an external cause), so the patient may remain unable to work. In this condition, an increase in body temperature sometimes goes unnoticed. Lymph nodes increase in the axillary and inguinal areas, near the elbow and knee joints. On the 6-7th days of the disease, an increase in the liver and spleen is noted.

In some cases, after an imaginary recovery, after 1-1.5 months, the fever resumes. Such exacerbations can be repeated 3–7 times. There are pains in joints, muscles, bones, headache, sleep disturbances, euphoria. Further, diseases of the musculoskeletal system develop (bursitis, synovitis, periarthritis and others), and the genitals are affected. In men, brucellosis is accompanied by orchitis, and in women, endometritis, salpingoophoritis, spontaneous termination of pregnancy in the early stages is possible.

As complications, meningitis, hepatitis, endocarditis, myocarditis develop. In chronic brucellosis, damage to the joints predominates, and mobility in them is impaired. Meningitis with brucellosis may cause damage to the auditory and optic nerves. Infertility often develops, sexual function in men decreases.

First aid for brucellosis.

A brucellosis patient first needs antibiotics. They are prescribed for 2-3 courses (10-12 days), with breaks of 7-10 days. Metacycline, vibramycin, tetracycline, rifampicin, ciprofloxacin, ofloxacin, chloramphenicol in combination with sulfanilamides are used to treat this disease. To reduce intoxication, drug solutions are injected intravenously.

For severe pain, non-steroidal anti-inflammatory drugs (indomethacin, diclofenac sodium, phenylbutazone) are used. In chronic brucellosis, antibacterial drugs do not give an effect, therefore vaccine therapy is carried out. At high temperatures, antipyretic drugs (paracetamol, acetylsalicylic acid) are used, and during the patient’s chills, it is necessary to warm – cover heat, give a hot drink.

Activities in the outbreak of brucellosis.

A brucellosis patient is isolated and treated only in an infectious diseases hospital. All patient discharges are subject to disinfection. Identify the source of infection and carry out a complete disinfection of the outbreak (premises for livestock, pastures and others), examination of other persons at risk of developing the same disease. All persons who have undergone brucellosis, as well as those working in livestock enterprises with animals, are registered in the dispensary and are subject to medical supervision..

Brucellosis patients are under medical supervision until full recovery and for two years after it. Patients with chronic brucellosis undergo a medical examination 1 time in 5-6 months, with a latent form of the disease – 1 time per year. With exacerbation of chronic brucellosis, an examination is carried out every month.

Based on Quick Help in Emergencies.
Kashin S.P..

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