Technical Guidelines for Integrated Disease Surveillance ... - PHRplus

Annex 25Treat Cases During an OutbreakUse appropriate drugs and treatments for managing cases during an outbreak. Following are treatmentrecommendations for use in an outbreak situation for cholera, dysentery, measles and bacterial meningitis.1. Treat cholera in an outbreak situationSource: WHO guidelines for management of the patient with cholera, WHO/CDD/SER/91.151. Assess the patient’s level of dehydration. (See assessment guide below.)2. Give fluids according to the appropriate treatment plan. (See below.)3. Collect a stool specimen from the first five suspected cholera patients that are seen in the healthfacility.4. Give an oral antibiotic to patients with severe dehydration.Assess the patient for signs of dehydration Look at patient’s general condition. Is the patient: lethargic or unconscious?restless and irritable? Look for sunken eyes. Offer the patient fluid. Is the patient: not able to drink, or drinking poorly?drinking eagerly, thirsty? Pinch the skin of the abdomen. Does it go back: very slowly (longer than 2 seconds)?slowly?Decide if the patient has severe, some or no signs of dehydration and give extra fluid according to thetreatment plan.If two of the following signs are present: lethargic or unconscious SEVERE DEHYDRATION* sunken eyes not able to drink or drinking poorly Give fluid for severe dehydration skin pinch goes back very slowly (Plan C).*In adults and children older than 5 years, other signs for severe dehydration are “absent radial pulse” and “lowblood pressure”.If two of the following signs are present: SOME DEHYDRATION restless, irritable sunken eyes drinks eagerly, thirsty Give fluid according to for some skin pinch goes back slowly dehydration (Plan B).If there are not enough signs to classify NO DEHYDRATIONas some or severe dehydration Give fluid and food to treatdiarrhoea at home (Plan A).Annex 25: Treat Cases During an Outbreak191