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Cholera: diagnosis
Last reviewed: 23.04.2024
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Clinical diagnosis of cholera in the presence of epidemiological data and a characteristic clinical picture (the onset of the disease with diarrhea followed by vomiting, the absence of pain and fever, the nature of vomiting) is not complex, but light, erased forms of the disease, especially single cases, are often seen. In these situations, laboratory diagnostics is crucial.
[Specific and nonspecific laboratory diagnostics of cholera
Laboratory diagnosis of cholera is based on the use of bacteriological research. As a material used excrement and vomit, vibrio-carrying is investigated feces; in persons who died from cholera, they take a subsidized segment of the small intestine and gall bladder.
When conducting a bacteriological study, three conditions must be observed:
- as soon as possible to sow the material from the patient (the cholera vibrio persists in the excrement for a short time):
- The dishes in which the material is taken should not be disinfected with chemicals and should not contain traces of it, since the cholera vibrio is very sensitive to them:
- Exclude the possibility of contamination and contamination of others.
The material must be delivered to the laboratory within the first 3 hours; if this is not possible, use preservative media (alkaline peptone water, etc.). The material is collected in individual vessels washed from disinfectant solutions, the bottom of which is placed a smaller, disinfected vessel or sheets of parchment paper. When shipped, the material is packed in a metal container and transported in a special transport with an accompanying person. Each sample is supplied with a label on which the name and surname of the patient, the name of the sample, the place and time of collection, the alleged diagnosis and the name of the material taken are indicated. In the laboratory, the material is sown on liquid and dense nutrient media to isolate and identify the pure culture. The results of the rapid analysis are obtained after 2-6 h (an approximate response), the accelerated analysis after 8-22 h (preliminary answer), the complete analysis after 36 h (final answer).
Serological diagnosis of cholera has an auxiliary significance and can be used mainly for retrospective diagnosis. To this end, microagglutination in phase contrast, RIGA can be used, but it is better to determine the titer of vibriocidal antibodies or antitoxins (anti-cholerogen antibodies are determined by ELISA or by immunofluorescence method).