Learn about cholera

This lesson is about cholera since it is the news as being in Haiti.

Cholera is an acute infection of the gastrointestinal tract. It is caused by vibrio comma [V.cholerae] which is a gram negative, short,curved bacillus [bacteria] with a terminal flagellum. It is aerobic meaning it needs air to thrive, and is mobile,grows on ordinary culture mediums, and exists in favorable condtions for a few days but dies out in the bowel movement in 1-2 days. Cholera is acquired by ingestion [eating,swallowing] food or drink contaminated with feces which conatins the v.Chloerae bacteria. Which is why you should always wash your hands before eating,before handling food,after touching your shoes,or being in areas where feces might be on handles,seats,etc [public btahrooms, or in rural remote areas those places designated as 'outhouses',or outdoor bathrooms.
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History of disease

Cholera is always present in the lower Ganges River in India, because of the contaminated water of that river where animals and humans bathe [and probably defecate]. It spread to China in the 17th century. A number of pandemics [defined by WHO] occurred in the US during the 19th and 20th centuries but was practically eradicated at the seaports after 1873. During and after World War I, there were epidemics in Europe. Also during WWII there were epidemics in the "Far East" and "Near East' but at that time they did not reach the Americas or Europe.
Improved sanitation and enforcement of the International Sanitary Regulations has resulted in cholera being mostly in lower Ganges River now and in areas where flooding,and sanitation merged [sewers ran over, and cesspools did, and contaminated flooding with feces happened] .

Epidemiology

Subclinical disease may be present in some communities.Sub-clinical means that symptoms have not appeared yet. The most likely sources of the bacteria are those people in the incubation stage or with mild symptoms. Contaminated water is the most often method of the disease spreading. [Which is why if you are in areas where flooding occurred,or known cholera disease reported,or known fecal contamination
you shoud boil your water before drinking or bathing. Flies also spread the disease bacteria. The conditions which cause it to rapidly spread are high tempaerature, high relative humidity,and intermittent rains[monsoons,flooding]. It is possible for it to spread rapidly but everyone who comes into contact with it does not necessarily contract it.

Symptoms,signs,and morbid anatomy

It is characterized by diarrhea,vomiting,dehydration, which is severe in most cases. Striking changes to the person's appearance occur because of the extreme dehydration. After death of cholera-infected persons,the rigor mortis is unusually marked. Dryness and shrinkage of person's flesh/bulk is apparent everywhere. Inflammatory changes are not usually present. The person's blood is thick and scanty. The walls of the intestines are bluish looking and congested. The membranes look like
ground glass and are sticky. The lumen of the bowel contains gray opalescent liquid not feces.
Large areas of mucosa may be gone but ulceration is not present. The lymphoid tisse of the ileum may be prominent. The kidneys show marked congestion.

Pathology

The cholera vibrio is primarily found in the ileum,but may be also in small numbers in the lungs and other organs of the body. They are seldom found in the blood stream. The bacteria does not produce an exotoxin,but does produce a powerful endotoxin. The usual first effect of infection is loss of large amounts of fluid and salt as a result of profuse vomiting and diarrhea.
That affects the acid-base balance of the body. The extraction of massive amounts of fluid from the cells,tissues,spaces,in a short period of time,is rarely found in any other disease except infant diarrhea,and hemorrhage of blood. The blood quickly becomes concentrated with specific gravity of 1.070;20 gms hemoglobin per 100 cc of blood,and 75 for erythrocite volume percentage,and 7,000,000
per cu mm for erythrocyte count. The concentration of plasma proteins is also inreased,and the circulation of blood throughout the body is greatly effected. The blood pressure falls,and the cardiac output [blood pumped by heart] is much decreased [shock]. Because of these systemic problems,the
renal function is greatly compromised and impaired unto death. [When enough blood does not get to to the brain,heart and kidneys, the person dies.] The sodium lost from the infected bowel results in a shift of the acid-base balance of sodium and chloride and is accentuated by the acid which is
retained when the kidneys start failing. Values as low as 7.1 were noted in some people for pH,and 138 milliequivalents per liter for the total base in the blood. Urea and nitrogen are retained because of renal failure. If a person dies in the early stages of cholera it is usually because of dehydration.
But in the later stages death is usually from renal failure.
Having cholera and surviving it does not prevent another infection later i.e. it does not cause the person to build antibodies against it.

Incubation and physiology

The incubation period is 1-5 days, with sudden onset usually. It might be preceded by depression, malaise,and simple diarrhea. Cholera infection is manifested by volumes of watery stools,copious vomiting,and being unable to get up. The speed with which it becomes overwhelming to the body is striking. Stools are so frequent that soon lose any fecal content and start sloughing off the inside of the bowel, but no blood or pus is noted. The absence of tenesmus is often noted.
Vomiting may occur without nausea or retching [projectile and sudden]. Great thirst occurs but fluids or food are vomited up. The person becomes gaunt, and pinched looking with sunken eyes.
The skins becomes bluish [cyanotic] and shriveled. The voice becomes thick and feeble.
Marked tachycardia [fast racing pulse] occurs and pulse may be barely perceptible. The blood pressure may fall below 60 mm mercury for systolic. Urine may cease [a particularly important sign of approaching death] and uremia may result. The body temperature falls.

Diagnosing cholera

Patient history is very important. If the person lives in an area where cholera reported, or conditions ripe for it to flourish,it should be suspected in cases of extreme vomiting and diarrhea.
Other condtions which give similar symptoms are bacillary desentery, food poisoning,heat exhaustion,some forms of malaria, and other conditions associated with shock secondary to diarrhea. It is very important that the accurate diagnosis be made as quickly as possbile as the implications for the household and community are enormous when misdiagnosed.
The specific diagnosis is made by testing the stools passed, by agglutination of V cholerae. Cultures have be done on fresh stool, and examined under microscope for the bacillus.

Prognosis
The outcome depends on how quickly cholera was diagnosed and treated, and how good the person's health was before contracting cholera. The course of the disease averages 3-5 days but death could occur in hours, and after many days also. If not treated quickly, the mortality rate is about 60 percent. With quick and appropriate treatment,the death rate is about 5 percent.

Treatment

Strict Isolation of infected or exposed persons.
Boil clothing of infected persons and drinking,eating utensils.
Disinfect as for typhoid standards.
Keep person warm.
Give fliuds but usually cannot retain those by mouth,so give intravenously.
Do not give sedatives,pain medicines, because likely to mask or worsen situation.
Give electrolytes by IV and or by mouth when better.
Do not give blood or blood products [blood already concentrated].
Start physiological saline intravenously as soon as diagnosis is made-critical to survival of patient.
Dextrose 5 % solutions IV ar rate so as not to exceed 50 gm of dextrose per hour after saline.
Patients with cholera need rehydration faster than almost any other disease but it is possible to overload their circulatory system if too fast.
The best indicator of improvement is the specific
gravity of the blood. As as the specific gravity approaches its normal [1.056-1058] for the blood, IV fluids should be slowed.
As a general rule, two liters of Normal Saline are needed in first 2 hours,
and more afterwards at slower rate so that 4-8 liters is often required to bring blood viscosity to normal.
In some cases the loss of alkali will have to be replaced. The acidosis of cholera is different from the acidosis of diabetes or nephritis. Ketone is not present in cholera patients' urine. Alkali replacement may be IV sodium bicarbonate with 18 gm sodium bicarb and 6 gm sodium chloride to one liter of sterile distilled water. It is not unusual for cholera patients to need 500 cc of alkali replacement fluids
Also potassium and phosphate have to be replaced via IV.

Prevention
Handwashing after toileting,after handling shoes,after being in area known for cholera present,after touching sick person,or handling food trays/paltes.utensils.
Proper disposal of stool contaminated items used by infected patients .
Blood and body precautions for medical personnel.
Quarantine infected persons.
Eradicate flies.
Strict control of water supply,with boil water command for community issued at diagnosis first case.
Disposal of food touched by infected persons.
Do not allow eating of raw foods,[vegetables,fruits,cheeses,etc] when cholera in community.
Close supervision of food handlers to ensure proper hand-washing,and disposal.

Vaccination
There is a cholera vaccine and it is recommended for those traveling or living in places known to harbor cholera bacillus.


References used
A Textbook of Medicine by Cecil & Loeb, with all put into laymen's terminology and simple words
to avoid jargon and reach more people.

Gloria Poole,RN; 7:18 PM 12/4/2010;
licensed in Missouri, and resident of Missouri

Stop genetically modifying humans

In the news.yahoo.com today at 6:30 am is an Associated Press [AP] article entitled "Scientists' trick..." that tells of the genetically modified humans scheme of some scientists. They use embryonic stem cells but call them IPS cells [after they modify them ] and inject chemicals into the cells to 'trick' the genes that are built into the cells by the blueprint of GOD HIMSELF to cause the cells to mutate to something other than what GOD intended. [ An aside: According to David Prentice an expert in this field,that is why those macabre experiments have only produced tumours in the humans they were injected into.]

Altering the built-in plan of GOD with chemicals cannot cause anything good. Cannabalizing tiny human embroyes to get BIG BUCKS from NIH* for research that violates the Nuremberg Code of International law adopted by almost all nations after Hitler and his evil medical team/scientists were tried for crimes against humanity,is evil. It violates that set of protections against inhumane and macabre experimentation on humans because those tiny human embryoes did not consent to be slaughtered or ripped from their mothers' wombs, nor did they consent to be cannibalized, nor did they consent to violent death at hands of womb-assassin, nor did they consent to be torn apart,decapitated and ground up,nor did they consent to be made into products to sell to so-called biotech industries. Therefore that research is illegal by international law. And labeling such evil as 'medical research' is morally equivalent to Hitler saying he gassed the jews to death to give them the 'best treatment available to them.' It is deliberate propaganga with euphemisms to attempt to make acceptable what is morally repugnant. Read Nazi Doctors by medical doctor Robert J Lifton for more on this.

That wicked experimentation has to end, and so does abortion-on-demand. It is the most awful evil that ever existed, and it cannot be sugar-coated to make it acceptable to those who know there is a GOD, and HE does not live in the White House or the NIH in Bethesda Maryland. All of you who believe in GOD, pray that GOD does something to stop the evil experimentation on tiny humans and to stop abortion and quickly for the sake of the human race and in particular the US before it is bombed out of existence by the nation GOD raises up to do that.

*footnote; NIH is abbreviation for National Institute of Health in Maryland,which is the US version of Hitler's research methods to kill humans then make them into products for sale. It does not treat any patients nor have real medical doctors doing research but highly programmed [brain-washed] do-as-you-are-told-evil-scientists.

Gloria Poole,RN;6:52am;29/Nov/2010;at home in Missouri

BBC article today makes known Pres's kill-internet

In the BBC news today on Thanksgiving * is aan article in the US & Canada section of the news entitled " Should Obama's internet-kill-switch power be curbed". And it makes the point that the President of US has had the power to force shutdown of all computers or select systems for decades. I know for certain that power has been abused because for the past 3 Presidential elections and the past 19 yrs of politics in the US, there was an absolute block- forced shutdown of my privately owned computers for opposing first B.Clinton then H Clinton, then Obama in elections. Entire hosting accounts of mine were manipulated/blocked by those in Senate [H Clinton,Arlen Specter, Barney Frank,T. Kennedy] for writing against them.

My reply in open letter format is YES Congress should absolutely remove that power from the President. If that had done that before he took office there would have been no financial meltdown because he would not have controlled banks and Wall Street by manipulating,turning off their internet access at crucial times to cause losses to them to gain control of them and wield power over the nation.

BBC thank you for publishing this article. Please keep it in the news until next week so those traveling for holiday will also see it and read it. Not one US paper raised this question or made any effort to notify the public about this. You have served the world well today by making known the power of the US President to interfere in all internet events by simply 'killing' a hosting company's servers or a particular person's access to the services they pay for. I paid for services for months that evil Obama blocked me from using in his effort to control manipulate US economy,elections and his press coverage. Obama is nor aat all above totally destroying privately bought and privately owned/used computers for political gain. And neither is that jezebel Hillary Clinton.


*footnote- Timed for today's publication no doubt so they hope no one in US reads it because of holiday of Thanksgiving. The usual tactics of the Press when they are trying to make excuses for abuse of power.

Gloria Poole, 6:54am;25-Nov-2010; at my apt in Missouri

Harry Reid of Nevada illegally invaded my blog

Before the election, I wrote on another blog of mine at gloriapoolepappas.blogspot.com [that began during second marriage but now divorced and resumed maiden name but kept that blog], about the Angle-Reid contest in Nevada. I also wrote how harry Reid's staff smeared Angle for being Southern Baptist.
Since then Reid has abused his Senate powers, invaded that blog [his cybercriminal staff], and blocked it so I cannot log into it.

i make a point of publicly recording when my civil liberties are suppressed by members of Congress and or President, or news agencies; so this documentation of that.
Also Sharon Angle said Reid was strong-arming the gambling casinos in his state to force their employees to vote for him.Why was that not investigated by Dept of Justice since it violates the RICO Act of buying elections/rigging elections? Was his payback to the indian controlled gamblinmg casinos,the long awaited billions in payments to the Indian tribes of Nevada? Could you spell c-o-r-r-u-p-t-i-o-n? as in the Senate office of Reid?

Also, was publicist Ronni Chasen either Reid's PR person or Obama's? I think so.
Sudden death seems to follow losses in the Democratic party.And what about Obama transporting his 8 ton armored tank disguised as a limo to UK then to Portugal, to show off, while their leaders arrived in more reasonable vehicles and electric cars?
Obama IS the problem with the US--he is a profligate spender of taxpayer's money, and that certainly proves it. Airlifting his limo across the Atlantic to show off shows his character or lack of. He thinks himself too good to ride in European limos, provided for visiting dignataries .
Gloria Poole; at my apt in Missouri;6:55am;20-Nov-2010

Open Request for Press Enquiry into Twitter censors

I am posting here the press request I sent while signed into my Twitter acct a few minutes ago. I tried twice to tweet and then changed my password and tried again but tweet was blocked. I said in the tweet they blocked three times these words:
never ever vote democrats because they plan to depopulate America. read more http;//prolife-nurse.blogspot.com".
So then I sent a press request to ask for enquiry into how Twitter is controlled by democrats Here is the exact message sent to field marked "Press" while signed into my twitter account:

Twitter routinely censors {exercises prior restraint against me} which is illegal under Us Constitution First Amendment. Political speech is absolutely protected by First Amendment but when I write tweet opposing dems they refuse to post it--block it. That could cause them triple penalties at law if I sue them for violating my civil liberties. Would you investigate please? My current RN license is is moved to Missouri now and in my real name obviously [Gloria Poole,RN].

Don't vote for strong-arm tactics of socialists-communists who control the presses and the rights of citizens to debate,discuss,publish their opinions including political and religious.
Gloria Poole;RN [my license is in Missouri now] @ home in Missouri;12:05PM;1-nov-2010

Open Request for Press Enquiry into Twitter censors

I am posting here the press request I sent while signed into my Twitter acct a few minutes ago. I tried twice to tweet and then changed my password and tried again but tweet was blocked. I said in the tweet they blocked three times these words:
never ever vote democrats because they plan to depopulate America. read more http;//prolife-nurse.blogspot.com".
So then I sent a press request to ask for enquiry into how Twitter is controlled by democrats Here is the exact message sent to field marked "Press" while signed into my twitter account:

Twitter routinely censors {exercises prior restraint against me} which is illegal under Us Constitution First Amendment. Political speech is absolutely protected by First Amendment but when I write tweet opposing dems they refuse to post it--block it. That could cause them triple penalties at law if I sue them for violating my civil liberties. Would you investigate please? My current RN license is is moved to Missouri now and in my real name obviously [Gloria Poole,RN].

Don't vote for strong-arm tactics of socialists-communists who control the presses and the rights of citizens to debate,discuss,publish their opinions including political and religious.
Gloria Poole;RN [my license is in Missouri now] @ home in Missouri;12:05PM;1-nov-2010

Open Request for Press Enquiry into Twitter censors

I am posting here the press request I sent while signed into my Twitter acct a few minutes ago. I tried twice to tweet and then changed my password and tried again but tweet was blocked. I said in the tweet they blocked three times these words:
never ever vote democrats because they plan to depopulate America. read more http;//prolife-nurse.blogspot.com".
So then I sent a press request to ask for enquiry into how Twitter is controlled by democrats Here is the exact message sent to field marked "Press" while signed into my twitter account:

Twitter routinely censors {exercises prior restraint against me} which is illegal under Us Constitution First Amendment. Political speech is absolutely protected by First Amendment but when I write tweet opposing dems they refuse to post it--block it. That could cause them triple penalties at law if I sue them for violating my civil liberties. Would you investigate please? My current RN license is is moved to Missouri now and in my real name obviously [Gloria Poole,RN].

Don't vote for strong-arm tactics of socialists-communists who control the presses and the rights of citizens to debate,discuss,publish their opinions including political and religious.
Gloria Poole;RN [my license is in Missouri now] @ home in Missouri;12:05PM;1-nov-2010

"Can you really afford another 2 yrs of democrats?"

I read the title only of an inflammatory article in the msn.com 'news' [Public relations page/propaganda for Planned Parenthood-Democratic Party sponsored by Microsoft and NBC] that asked the pretend question of if you could afford to have a second child. If you do not see the blatant screaming against life intent of that article then you are brainwashed to the max! And should go to a desert island for about 7 years far from the madding crowds and clear your mind.

That article TITLE made me so mad I decided I would write in my blog about it. HOW DARE they write such evil? The US is depopulating! The United States will become the United States of the Saudi Emirates and or the Iranians and or the Latinos from South America if those blockheads from Washington DC have their way.

Do not ever ever ever ever vote democrat. Those people are from hell.

Their agenda for the nation is killing off the unborn children in massive slaughters reminiscent of the days of Herod in the Bible. The current administration should be tried for treason against the nation NOT reelected to any thing. Treason because depopulation destroys the nation.

Vote prolife and that means do not vote democrat. There is no such policy as prolife in the democratic socialist party of the US which is in control of the current US Congress. Read what the democrats stand for: the 'choice' to kill human babies whent they are tiniest in the womb, and chop them, shred them, dice them, make a 'jam' of their cells and smear them on agar plates to study under a microscope to get billions from the wicked in high places. A better idea is to kick out the wicked from high places from office and begin by voting these listed from office :
Arlen Specter in Pennsylvania
Barbara Boxer in California
Obama from White House
H Clinton from any position
Robin Carnahan from Missouri
Charles Schumer from NY
Charles Lewis from GA
Nancy Pelosi from California
These names are some of the most RADICAl against human life that has ever been in any elected position since Hitler held office in Germany. Vote them out of office!
Gloria Poole,RN; Missouri; 11:54AM; 29-Oct-2010

Voter Information to help you vote Prolife

The National Prolife Alliance sent me information today that is very relevant to this
upcoming election for all elections across the nation. They regularly conduct a survey
asking wannabe candidates for office for their responses to a set of questions. For the
public record, these are the questions:
1) Will you support federal legislation giving parents the right to stop any abortion
being performed on their minor daughter except to prevent the death of the mother?
2) Will you support requiring a 48 hour cooling off period and mandatory counseling on
the risks and consequences of abortion for persons who believe that they may want to
have an abortion? [This common sense informed consent is required for virtually every
other form of invasive procedure that is not an emergency life-saving event.]
3) Will you support federl legislation giving spouses the right to be notified and
intervene before any abortion is performed on the couple's baby?
4) Will you support legislation to outlaw so-called 'sex selection' abortions?
5) Would you vote to prohibit the US government from granting any public funds to
groups that recommend or perform abortions in the United States or abroad?
6) Should the federal government bar the distribution of 'home abortion drugs" like
RU-486?
7) Will you support nominees to the United States Supreme Court and the lower federal
courts who will uphold the constitutional right to life of every person born and unborn?
8) Will you support legislation which under Article III, Section 2 of the United States
Constitution would remove from the federal courts jurisdiction over the question of
abortion?
9) Would you support and cosponsor a Life at Conception Act defining that life begins
at the moment of conception [fertilization when human male sperm enters human female
egg], thereby resolving for all time, as stated by the Supreme Court in Roe v Wade,
'the difficult question of when life begins"? {It is not medically difficult since it
was detemined medically when that event happens decades ago.]
10). Will you support an Amendment to the US Constitution banning abortion except
to prevent death of the mother?

In the case of Missouri, Robin Carnahan refused to answer any of these questions.
And Hon Roy Blunt answered YES to all ten questions.

Ask your state candidates how they answered this questionaire and ask your newspaper
to publish their answers. It matters. Human life has to matter as much to this planet
as the environment and as the seals and the frogs and the insects. Remember that it is
written, "so GOD created man in HIS own image; in the image of GOD created HE him;
male and female created HE them; and GOD blessed them, and GOD said unto them: be
fruitful and multiply and replenish the earth,and subdue it and have dominion over
the fish of the sea, and over the fowl of the air and over every living thing that
moveth upon the earth." Genesis 1:27-28,King James Holy Bible.
Gloria Poole,RN; at home in Missouri; 4:35PM;13-Oct-2010

How to avoid breast cancer--its not wearing pink

I read the usual annual marketing ploy of wearing pink and donating money to fake ngos collecting money that goes to planned parenthood [ do your homework]. I want to tell you women how to really avoid breast cancer, and it is simple.Do what GOD intended with your female bodies and that is have living babies and feed them naturally. In other words produce living babies and breast feed them. And do not use artificial estrogen or progesterone replacement so-called therapies that are powerful steroids used the wrong way at the wrong time and from wrong sources. Your own body produces those steroids when they are needed to produce new human beings and that is the proper time for those steroids, and not when you are post-menopausal.
And of course do not smoke or use any form of tobacco.
That is much hype in the news but much of it is a fund-raising hype to get people to run for money to support causes that have nothing to do with curing breast cancer. If there was a cure for it, it would be suppressed from the public because then the NIH would go out of business and those phony scientists would be unemployed and unemployable. They feed off the misery off those with cancer.
I believe that cancer is a form of the body literally digesting itself by the rapid multiplication of cells of that were thwarted in some way from doing what they were intended to do and went rogue, wild. And I think that if there is to be a real cure it will begin with recognizing that cancer begins within a human body not from outside it. JESUS said it is not what goes into a man's mouth that defiles him but what comes out of it. The thoughts and spirit of man that are defiled are the starting points of cancer, I believe. But I also believe it has a physical turning point in the body when the cells intended to produce living human babies such as in a pregnancy aborted that run rampant and keep on producing and multiplying that produce tumors instead of living babies when the baby was killed by the mother when the baby was in the womb. And perhaps in men for example prostate cancer in men when the sperm is blocked as in vasectomies and the sperm is absorbed by the men into his bloodstream instead of producing new humans as GOD intended.
Gloria Poole, RN,; at home in Missouri; 7:01PM;7-Oct-2010