Cholera and Other Vibrio Infections

Cholera is a dreaded epidemic diarrheal disease caused by Vibrio cholerae serogroup O1 and, since 1992, by the new serogroup O139. The disease is characterized by acute watery diarrhea. In its more severe form, a person may be severely dehydrated and in hypovolemic shock; the patient may die in a matter of a few hours after contracting the infection if treatment is not provided. Cholera is endemic today in Africa, Asia, and Latin America. Seven pandemics have been registered in history since 1817; the most recent has lasted more than five decades since its recognition in Indonesia in 1961. Changes in the climate, the environment, and the pathogen have promoted transmission to humans. Diagnosis is suspected based on clinical presentation and confirmed by molecular methods or by isolation of Vibrio in culture. Treatment is based on replacing intestinal losses with rehydration solutions and, in severe cases, providing antimicrobials. Prevention includes implementing sanitation and hygiene as well as using licensed oral vaccines in endemic and epidemic settings.