Summary
Cholera is an infectious disease characterized by severe diarrhea and vomiting and caused by Vibrio cholerae, a small gram-negative bacillus. The reservoir for this disease is strictly human: infected individuals shed the germ in stools. Transmission occurs via soiled water and/or food. Symptoms appear several hours or days after contamination, with rapid and severe onset of profuse watery diarrhea with a 'rice water' aspect, typical of cholera, together with vomiting, but no fever. Resulting dehydration may be severe enough to cause collapse and anuria. With correct treatment, patients are usually totally cured, whereas mortality due to dehydration reaches 50% when left untreated. Diagnosis is predominantly clinical but the isolation of the vibrio is necessary for bacteriological confirmation. The disease is endemic in the third world and causes small outbursts of epidemic in Eastern Europe. Effective preventive measures include water treatment and eating well-washed food. Classic killed whole-cell cholera vaccines are not very effective. A live attenuated vaccine, administered orally and effective after one dose, is recently available. Cholera is a notifiable disease. *Author: Dr E. Aslangul (August 2006)*.
