Kamble T K, More S R, Chavan S S, Kulkarni N D, Lodha N S, Kamble A S
Department of Medicine, SRTR Medical College and Hospital, Ambajogai, District Beed, Maharashtra-431 517.
J Assoc Physicians India. 2000 May;48(5):505-6.
To study clinical profile of the newly emerged novel strain non-O1, O139 of Vibrio cholerae, in the region of Ambajogai, District Beed of Maharashtra.
Out of 208 patients of acute gastroenteritis, 41 revealed to be positive for Vibrio cholerae by recommended method of stool examination. All the strains were sent to National Institute of Cholera and Infectious Diseases, Calcutta for confirmation.
Out of 41 cases, 12 were of Vibrio cholerae O1, 29 Non-O1, of which nine found to be O139 strain. All patients were from 2-80 years of age with low-socioeconomic status and maximum incidence was in August (64.70%), presented with severe rice watery loose motions. Vomiting was observed in 26 (63.41%), more so in patients of O139 infection (88.88%) than four (33.33%) of O1 infection. Sweating was observed in three patients (33.33%) of O139 infection, cramps in gastrocnemis muscles in three patients (33.33%) of O139 infection and two (16.66%) of O1 infection. Signs of dehydration were mild to moderate in four patients (33.33%) of O1 infection; severe dehydration in six (66.66%), moderate in two (22.22%) and mild in one patient (11.11%) of O139 infection. While dehydration was severe in four (20%), moderate in one (5%) and mild in three patients (15%) of Non-O1 infection (excluding O139 cases). Clinical features were more severe in patients of serotype O139 than the patients of O1 and Non-O1 (excluding O139 cases). However all patients responded to intravenous fluids, oral rehydration and antibiotics (tetracycline) within 24-48 hours without any mortality.
This study reflects the first emergence of Non-O1, strain O139 during the year 1997 with severe and critical clinical features in Ambajogai region causing high morbidity in the form of severe dehydration and peripheral circulatory collapse which requires early and correct diagnosis and prompt treatment.
研究马哈拉施特拉邦比德区安巴乔盖地区新出现的霍乱弧菌非O1、O139新型菌株的临床特征。
在208例急性肠胃炎患者中，通过推荐的粪便检查方法，有41例霍乱弧菌检测呈阳性。所有菌株均被送往加尔各答的国家霍乱和传染病研究所进行确认。
41例病例中，12例为霍乱弧菌O1型，29例为非O1型，其中9例为O139菌株。所有患者年龄在2至80岁之间，社会经济地位较低，发病率最高的月份是8月（64.70%），均表现为严重的米泔水样腹泻。26例（63.41%）出现呕吐，O139感染患者中的呕吐发生率（88.88%）高于O1感染患者中的4例（33.33%）。3例（33.33%）O139感染患者出现出汗，3例（33.33%）O139感染患者和2例（16.66%）O1感染患者出现腓肠肌痉挛。4例（33.33%）O1感染患者有轻度至中度脱水迹象；6例（66.66%）O139感染患者出现严重脱水，2例（22.22%）出现中度脱水，1例（11.11%）出现轻度脱水。非O1感染（不包括O139病例）患者中，4例（20%）出现严重脱水，1例（5%）出现中度脱水，3例（15%）出现轻度脱水。O139血清型患者的临床特征比O1型和非O1型（不包括O139病例）患者更为严重。然而，所有患者在24至48小时内对静脉输液、口服补液和抗生素（四环素）治疗均有反应，无死亡病例。
本研究反映了1997年安巴乔盖地区首次出现非O1型O139菌株，其临床特征严重且危急，以严重脱水和外周循环衰竭的形式导致高发病率，这需要早期正确诊断和及时治疗。
