Date: 2018-01-08 06:21
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Detailed approaches to fluid repletion for adults ( algorithm 6 ) and children with acute diarrhea are found elsewhere. (See Approach to the adult with acute diarrhea in resource-limited countries , section on 'Rehydration' and Approach to the child with acute diarrhea in resource-limited countries , section on 'Fluid and electrolytes'.)
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The general approaches to acute diarrhea among adults and children in resource-limited settings are also discussed elsewhere. (See Approach to the adult with acute diarrhea in resource-limited countries and Approach to the child with acute diarrhea in resource-limited countries .)
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Laboratory testing is generally not needed, although serum electrolyte and glucose testing may be helpful to identify extreme abnormalities in patients who have ileus, confusion, seizure, or no urine output in response to fluid replacement. (See Approach to the adult with acute diarrhea in resource-limited countries , section on 'Clinical assessment' and Approach to the child with acute diarrhea in resource-limited countries , section on 'Clinical assessment'.)
In areas of high endemicity, the incidence of V. cholerae infection follows a seasonal distribution, with peaks before and after rainy seasons [ 8 ]. Superimposed epidemics may also occur, and mathematical models suggest these epidemics are dependent on fluctuations in population based immunity and climate [ 65 ]. In areas of high endemicity, the incidence of cholera is highest in children than five years, likely reflecting the lack of protective immunity [ 66 ].