title: Cholera in the 21st century.
abstract: OBJECTIVE
  This review will focus on recent advances in our understanding of biologic and environmental factors that shape current cholera outbreaks, advances in our understanding of host-pathogen interactions during cholera, and recent evolution of current treatment and cholera prevention strategies.
  
  
  RESULTS
  New research studies have improved our understanding of a number of dynamic factors that shape the ecology of Vibrio cholerae and influence its transmission, including the role of lytic bacteriophage, biofilm formation, a hyperinfectious state of human-passaged V. cholerae, and the impact of severe weather events. Provision of safe water and improved sanitation continue to be the mainstays of preventing cholera transmission; however, the role of cholera vaccination as a control measure in both endemic and epidemic settings is evolving. Recent advances in our understanding of long-lived protective immunity after natural infection may aid in the global efforts to control cholera.
  
  
  CONCLUSIONS
  Improved understanding of factors associated with protective immunity and dynamic factors associated with cholera outbreaks may lead to improved control and prevention strategies for cholera.
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
authors.forename: Richelle C
authors.initials: RC
authors.lastname: Charles
authors.forename: Edward T
authors.initials: ET
authors.lastname: Ryan
mesh_terms: D002771:Cholera / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D022121:Cholera Vaccines / Q000276:immunology; D004196:Disease Outbreaks / Q000517:prevention & control; D006801:Humans; D012499:Sanitation; D014611:Vaccination; D014734:Vibrio cholerae / Q000472:pathogenicity*
chemical_list: D022121:Cholera Vaccines