Cholera
Description General Measures Medicine Treatment Referral ICD-10 code: A00.0-1/A00.9 Note: This is a 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 aggressi
ICD-10 code: A00.0-1/A00.9
Note: This is a 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
To treat dehydration:
Children
- Treat dehydration. See: Diarrhoea, acute in children.
Adults
Oral treatment:
- Oral rehydration solution.
OR
- Homemade sugar and salt solution. See: Diarrhoea.
Note:
- The volume of fluid required for oral rehydration depends on the severity of the dehydration.
- Oral rehydration is preferred. Administer IV fluids or ORS by nasogastric tube in patients with reduced levels of consciousness.
IV treatment:
- Ringers lactate, IV (preferred).
OR
- Sodium chloride, 0.9%, IV.
Antibiotic treatment:
Children
- Ciprofloxacin, oral, 20 mg/kg as a single dose (See dosing tables).
- Maximum dose: 750 mg.
Adults
- Ciprofloxacin, oral, 1 g as a single dose.
- Adjust antibiotic choice, according to the sensitivity of the isolate responsible for the local epidemic.
Nutritional supplementation:
In all children who are able to take oral medication:
- Zinc (elemental), oral for 14 days.
Caution
Dextrose 5% should not be used for fluid replacement in patients with cholera as it does not contain electrolytes, which are required to ensure adequate fluid resuscitation.
REFFERAL
- Severely ill patients.
- According to provincial and local policy.
Click here for the NEMLC Recommendations for medicine amendments (2020-4 review cycle).
Standard Treatment Guidelines And Essential Medicines List For South Africa, Primary Healthcare, 2020-4_Version 1_June 2024
Chapter 2: Gastro-Intestinal Conditions, 2.7 Cholera