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Microbial Diseases on of the Feces Will Reveal a Predominance

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Microbial Diseases on of the Feces Will Reveal a Predominance

Microbial Diseases on of the Feces Will Reveal a Predominance of mononuclear cells. Sigmoidoscopy reveals under-mined ulcers with normal intervening mucosa. Blood cultures are often positive. Staphylococcal food poisoning and many forms of viral gastroenteritis are more prominently associated with nausea and vomiting than with diarrhea. Treatment.

Sulfonamides were effective in the treatment of shigellosis when they were first used. The resistance of Shigella to multiple antimicrobials has been induced by episomal transfer from other enteric bacilli. At present, ampicillin in a dosage of 2 or more grams orally each day in divided doses for five days is the preferred agent in the treatment of shigellosis in adults. Opiates such as paregoric or morphine may alleviate the abdominal discomfort and tenesmus but should be used cautiously. Prognosis. The mortality rate in untreated bacillary dysentery is about 0.1 percent or less, but it may be higher during famine or starvation. In addition, the fatality rate with dysentery caused by Shigella dysenteriae (Shiga) is higher than that attributed to other Shigella. Death rarely occurs when appropriate treatment is prescribed.

Dammin, G. J.: The pathogenesis of acute diarrhea! disease in early life. Bull. WHO, 31:29, 1964. Gordon, J. E., Behar, M., and Scrimshaw, N. S.: Acute diarrhea! disease in less developed countries: I. An epidemiological basis for control. Bull. WHO, 31:1, 1964. Ramos-Alvarez, M., et al.: Diarrhea! the disease of children. The occurrence of enteropathogenic viruses and bacteria. Amer. J. IDs. Child., 107:218, 1964. Reller, L. B., et al.: Shigellosis in the United States, 1964-1968. J. Infect. Dis., 120:393, 1969. Watanabe, T.: Infective heredity of multiple drug resistance in bacteria, Back. Rev., 27:87, 1963. Wilson, G. S., and Miles, A. A.: Tapley and Wilson's Principles of Bacteriology and: Immunology. 5th ed. Baltimore; Williams and Wilkins Company, 1964; Vol. II. p. 1876.

CHOLERA (Asiatic Cholera) Leighton E. Cluff
Definition. Cholera is a specific infectious dis-ease of man-caused by Vibrio cholera. cholera can be characterized and differentiated from noncholera vibrios by its fermentative, nonhemolytic, pathogenic, and anti-genic reactions. Incidence and Prevalence. Cholera is endemic in India, China, Burma, Pakistan, Thailand, and a few other' areas in Asia. Prior to the nineteenth century, cholera was unknown outside India, but during that century it was observed sporadically and as an epidemic in Europe, Eng-land, Russia, and North America. India and in Pakistan.

The last pandemic of cholera began in 1902. The only man is naturally infected with V.cholerae. The infection is transmitted most commonly by contaminated water, but it can be transmitted by contamination of fresh leafy' or root vegetables and fruit fertilized With human feces or contaminated with water containing the microorganism. V. Cholera is primarily a disease of persons who live in love y or who have poor standards of living and sanitation. Outbreaks of cholera usually appear during dry, hot weather preceding a rainy season.

The reason for this seasonal occurrence of cholera is unexplained. Although sporadic cases may occur throughout the year, there are rare chronic carriers of V. cholera, as there are of typhoid bacilli, and the principal reservoir of the organism in interepidemic periods is unclear. In endemic areas around river basins, V.cholerae can be iso-

Rarely Does Carriage of the Bacilli Persist as Long as Three Months

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