title: Cholera.
abstract: Cholera is an acute, secretory diarrhoea caused by infection with Vibrio cholerae of the O1 or O139 serogroup. It is endemic in more than 50 countries and also causes large epidemics. Since 1817, seven cholera pandemics have spread from Asia to much of the world. The seventh pandemic began in 1961 and affects 3-5 million people each year, killing 120,000. Although mild cholera can be indistinguishable from other diarrhoeal illnesses, the presentation of severe cholera is distinct, with pronounced diarrhoeal purging. Management of patients with cholera involves aggressive fluid replacement; effective therapy can decrease mortality from more than 50% to less than 0·2%. Antibiotic treatment decreases volume and duration of diarrhoea by 50% and is recommended for patients with moderate to severe dehydration. Prevention of cholera depends on access to safe water and sanitation. Two oral cholera vaccines are available and the most effective use of these in integrated prevention programmes is being actively assessed.
authors: Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
authors: Jason B
authors: JB
authors: Harris
authors: Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
authors: Regina C
authors: RC
authors: LaRocque
authors: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
authors: Firdausi
authors: F
authors: Qadri
authors: Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA.
authors: Edward T
authors: ET
authors: Ryan
authors: Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA, USA. Electronic address: scalderwood@partners.org.
authors: Stephen B
authors: SB
authors: Calderwood
mesh_terms: D000900:Anti-Bacterial Agents; D002771:Cholera / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D022121:Cholera Vaccines / Q000627:therapeutic use; D005440:Fluid Therapy; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents; D022121:Cholera Vaccines