Diagnosis, Management, and Future Control of Cholera

Abstract

Cholera, caused by Vibrio cholerae , persists in developing countries due to inadequate access to safe water, sanitation, and hygiene. There are approximately 4 million cases and 143,000 deaths each year due to cholera.

A snap-shot of a diarrheal epidemic in Dhaka due to enterotoxigenic Escherichia coli and Vibrio cholerae O1 in 2022

“…At present, Dukoral is the only vaccine available which provides protection against diarrheal diseases caused by V. cholerae (85%) and ETEC (67%) (26). However, the cost of the Dukoral vaccine is too high and is very difficult to use in emergency setting as it requires a buffer solution to protect its functionality (5). Bangladesh Government is implementing its National Cholera Control Plan (NCCP) to eradicate cholera from the country.…”

“…Both ETEC and V. cholerae O1 diarrhea can lead to severe dehydration, in adults and children and can contribute to significant morbidity and mortality in resource-poor settings (4). These two bacterial pathogens have similar modes of transmission and can cause community-based infections, as well as hospitalization (5,6). Both pathogens are endemic with a biannual seasonal peak between March to May (spring/pre-monsoon) and September to November (post-monsoon) (7).…”

Insights into SARS‐CoV‐2 in Angola during the COVID‐19 peak: Molecular epidemiology and genome surveillance

“…These include the largest recorded outbreak of the Marburg virus occurring in 2004–2005, 24 which began in the province of Uíge in northern Angola and quickly spread to other parts of the country. Also, a large outbreak of yellow fever that occurred during 2015–2016 in the northern and central parts of the country, 32 cholera outbreaks reported between 2016 and 2019, 33 and a recent measles outbreak during 2019 and 2020 34 . These outbreaks emphasize the need for enhanced pathogen and genome surveillance within these regions.…”

Post-flood outbreaks of Cholera in Pakistan; Endemic-to-epidemic

“…The improper clinical management showed a 50% case fatality rate, but it can be decreased to 01% or less if treated promptly with antibiotics and rehydration. The transmission of the disease takes place through contaminated food or water by the fecal-oral route [3].…”

“…Hygiene, sanitation, safe water, prophylactic antibiotic, and awareness are additionally helpful in preventing the outbreak. The WHO and the Global Task Force for Cholera Control (GTFCC) have set a strategy entitled 'Ending Cholera: A Global Roadmap to 2030' with the ambitious goal to eliminate cholera in 20 countries and reduce 90% mortality by 2030 in areas with greater risk [3]. There may be certain economic challenges but sufficient steps need to be taken at existing levels and capacities.…”