Cholera in children.

J. Lindenbaum; R. Akbar; R. S. Gordon; W. B. Greenough; N. Hirschorn; M. R. Islam

doi:10.1016/s0140-6736(66)91011-7

Cholera in children.

J. Lindenbaum, R. Akbar, R. S. Gordon, W. B. Greenough, N. Hirschorn, M. R. Islam

Research output: Contribution to journal › Article › peer-review

Original language	English (US)
Pages (from-to)	1066-1068
Number of pages	3
Journal	Lancet
Volume	1
Issue number	7446
DOIs	https://doi.org/10.1016/s0140-6736(66)91011-7
State	Published - May 14 1966
Externally published	Yes

ASJC Scopus subject areas

General Medicine

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10.1016/s0140-6736(66)91011-7

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@article{8ac52c1631904ebaba3ac7b6be58ab3f,

title = "Cholera in children.",

author = "J. Lindenbaum and R. Akbar and Gordon, {R. S.} and Greenough, {W. B.} and N. Hirschorn and Islam, {M. R.}",

note = "Funding Information: Discussion Our experience with this large series of patients with cholera indicates that, despite a higher incidence of cer- tain complications such as hypoglyceemia and central- nervous-system dysfunction in children, the disease is generally similar in children and adults in its clinical manifestations and response to adequate replacement therapy. Clinical estimates of dehydration, without the use of direct measurements of hasmoconcentration, such as specific gravity, were found to be adequate in estimating fluid requirements, an approach that has also been used successfully in adults in Calcutta (Carpenter, Mitra et al. 1965). The results obtained in the present series did not depend on the presence of modern hospital facilities or readily available expert consultation. Similar therapeutic success has been obtained in a treatment centre located on a barge near Matlab Bazar in East Pakistan (Gordon et al. 1966) where patients are treated by young Pakistani physicians and nurses trained in our Dacca hospital wards. Cholera cots, intravenous fluids, tetracycline, and a stethoscope are available, but there are no laboratory facilities other than those for bacteriological diagnosis. During the 19-month period ending in June, 1965, 496 patients with documented V. cholerae infection were admitted. There were 4 deaths, a mortality-rate for the entire group of 0-81%; in 268 patients below the age of 10, there were 2 deaths (0-75%). Summary Cholera in children is in most respects similar to cholera in adults. An approach to therapy utilising clinical criteria combined with measurement of stool volume to determine fluid requirements, and the prompt correction of acidosis as well as sodium chloride and potassium deficits, has been used in a series of 769 patients treated in Dacca, East Pakistan. The mortality was less than 1% in both children and adults. Similar results have been obtained with this method at an isolated field treatment centre. We thank the nursing staff of the Pakistan-SEATO Cholera Research Laboratory for their excellent work and the following physicians who contributed to the care of the patients: Dr. J. Ahmed, Dr. A. K. M. J. Alam, Dr. M. M. Ali, Dr. K. M. Ally, Dr. R. K. Barui, Dr. J. Cole, Dr. Z. Haque, Dr. M. S. Islam, Dr. A. S. M. M. Rahman, Dr. M. Rahman, and Dr. M. S. Zoha. This work was supported in part by Research Agreement no. 196802 between the National Institutes of Health, Bethesda, Maryland, U.S.A., and the Pakistan-SEATO Cholera Research Laboratory. Requests for reprints should be addressed to Dr. John Lindenbaum, First Medical Division, Bellevue Hospital, 462 First Avenue, New York, New York, U.S.A.",

year = "1966",

month = may,

day = "14",

doi = "10.1016/s0140-6736(66)91011-7",

language = "English (US)",

volume = "1",

pages = "1066--1068",

journal = "Lancet",

issn = "0140-6736",

publisher = "Elsevier B.V.",

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}

TY - JOUR

T1 - Cholera in children.

AU - Lindenbaum, J.

AU - Akbar, R.

AU - Gordon, R. S.

AU - Greenough, W. B.

AU - Hirschorn, N.

AU - Islam, M. R.

N1 - Funding Information: Discussion Our experience with this large series of patients with cholera indicates that, despite a higher incidence of cer- tain complications such as hypoglyceemia and central- nervous-system dysfunction in children, the disease is generally similar in children and adults in its clinical manifestations and response to adequate replacement therapy. Clinical estimates of dehydration, without the use of direct measurements of hasmoconcentration, such as specific gravity, were found to be adequate in estimating fluid requirements, an approach that has also been used successfully in adults in Calcutta (Carpenter, Mitra et al. 1965). The results obtained in the present series did not depend on the presence of modern hospital facilities or readily available expert consultation. Similar therapeutic success has been obtained in a treatment centre located on a barge near Matlab Bazar in East Pakistan (Gordon et al. 1966) where patients are treated by young Pakistani physicians and nurses trained in our Dacca hospital wards. Cholera cots, intravenous fluids, tetracycline, and a stethoscope are available, but there are no laboratory facilities other than those for bacteriological diagnosis. During the 19-month period ending in June, 1965, 496 patients with documented V. cholerae infection were admitted. There were 4 deaths, a mortality-rate for the entire group of 0-81%; in 268 patients below the age of 10, there were 2 deaths (0-75%). Summary Cholera in children is in most respects similar to cholera in adults. An approach to therapy utilising clinical criteria combined with measurement of stool volume to determine fluid requirements, and the prompt correction of acidosis as well as sodium chloride and potassium deficits, has been used in a series of 769 patients treated in Dacca, East Pakistan. The mortality was less than 1% in both children and adults. Similar results have been obtained with this method at an isolated field treatment centre. We thank the nursing staff of the Pakistan-SEATO Cholera Research Laboratory for their excellent work and the following physicians who contributed to the care of the patients: Dr. J. Ahmed, Dr. A. K. M. J. Alam, Dr. M. M. Ali, Dr. K. M. Ally, Dr. R. K. Barui, Dr. J. Cole, Dr. Z. Haque, Dr. M. S. Islam, Dr. A. S. M. M. Rahman, Dr. M. Rahman, and Dr. M. S. Zoha. This work was supported in part by Research Agreement no. 196802 between the National Institutes of Health, Bethesda, Maryland, U.S.A., and the Pakistan-SEATO Cholera Research Laboratory. Requests for reprints should be addressed to Dr. John Lindenbaum, First Medical Division, Bellevue Hospital, 462 First Avenue, New York, New York, U.S.A.

PY - 1966/5/14

Y1 - 1966/5/14

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IS - 7446

ER -

Cholera in children.

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