Epidemiology, management, and prevention of cholera

ABSTRACT

Cholera is an acute secretory form of diarrhea caused by a potent enterotoxin (cholera toxin) after ingestion of toxigenic Vibrio cholerae of the O1 or O139 serogroups. Although cholera is very common in Africa and Asia as a whole, the incidence of cholera has been very low in recent years in Korea. Dehydration and electrolyte abnormalities due to massive watery diarrhea can lead to death, and the mortality rates in untreated patients with severe cholera can exceed 70%. Effective rehydration therapy is the cornerstone of the management of patients with cholera and can reduce the mortality rate to less than 0.2%. Antibiotics reduce the volume and duration of diarrhea, but are recommended for patients with severe disease because of the rapid emergence and spread of multidrug-resistant V. cholerae across the globe. Two oral cholera vaccines are available, and the World Health Organization recommends that these oral vaccines be considered in integrated prevention programs in endemic countries at risk for outbreaks.