A multiplex PCR assay for detection of Vibrio vulnificus, Aeromonas hydrophila, methicillin-resistant Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus agalactiae from the isolates of patients with necrotizing fasciitis. Most infections occur from May through October when water temperatures are warmer. No one aboard a vessel flying a yellow flag would be allowed ashore for an extended period, typically 30 to 40 days.[106]. Choi HJ, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. [10], Prevention methods against cholera include improved sanitation and access to clean water. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. [129] Even though humans are the only host of cholera, the bacterium can persist in the environment without a human host. [34] Of particular interest have been the genetic mechanisms by which cholera bacteria turn on the protein production of the toxins that interact with host cell mechanisms to pump chloride ions into the small intestine, creating an ionic pressure which prevents sodium ions from entering the cell. [61] However, as of 2010[update], it has limited availability. Cris Jagar, MD Staff Physician, Department of Psychiatry, Trinitas Regional Medical CenterDisclosure: Nothing to disclose. 2019 Jan 4. Shanchol and Euvichol-Plus are the vaccines currently available for mass vaccination campaigns through the Global OCV Stockpile. sharing sensitive information, make sure youre on a federal These induced characteristics allow the cholera vibrios to survive in the "rice water" stools, an environment of limited oxygen and iron, of patients with a cholera infection. of the disease is due many cases not being recorded due to limitations in surveillance systems and fear of impact on trade and tourism. Early bullous lesions appear over the dorsum of the foot of a patient with cirrhosis. Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School [76] People will recover without them, however, if sufficient hydration is maintained. [13], Vibrio vulnificus infection is an acute illness that is quickly resolved with antibiotics and does not have any long-term consequences. An oyster that contains harmful bacteria doesn't look, smell, or even taste different from any other oyster. 72 / No. It takes between 12 hours and 5 days for a person to show symptoms after ingesting contaminated food or water, Severely dehydrated patients are at risk of shock and require the rapid administration of intravenous fluids. Please confirm that you would like to log out of Medscape. People who survive an episode of cholera have long-lasting immunity for at least 3 years (the period tested. Tiba-Casas MR, Lemes-Marques EG, Almeida EA, Soares FB, Camargo CH. [QxMD MEDLINE Link]. Viviparity. J Dermatol. Surveillance and prompt reporting allow for containing cholera epidemics rapidly. 2007 Mar. The development and implementation of multi-sectoral cholera control plans is a useful mechanism to bring together all relevant sectors, and forge lines of communication and coordination that are valuable beyond cholera control. [58] It is available in over 60 countries. Abstract Bacteria from the Vibrio genus are autochthonous to aquatic environments and ubiquitous in aquaculture production systems. Prutkin JM, Haq R. A dish best served hot. [1] and potentially fatal necrotizing fasciitis in them and in individuals with liver cirrhosis. [104] Between 1900 and 1920, perhaps eight million people died of cholera in India. These were due primarily to a high rate of premature death with a mortality rate of 31% for seafood-related infection and 18% for infections from direct exposure. This carries the multiplying new generations of V. cholerae bacteria out into the drinking water of the next host if proper sanitation measures are not in place.[32]. David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological SocietyDisclosure: Nothing to disclose. revealed high mortality rates, even through aggressive surgical debridement and antibacterial therapies. J Food Sci Technol. 1 support kit with logistical materials including solar lamps, fencing, water bladders and taps. In his major "state of the art" review of 1855, he proposed a substantially complete and correct model for the cause of the disease. [100] This pandemic had initially subsided about 1975 and was thought to have ended, but, as noted, it has persisted. See this image and copyright information in PMC, Effect of Seawater Temperature Increase on the Occurrence of Coastal. Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine Some believed that abdominal chilling made one more susceptible, and flannel and cholera belts were included in army kits. Blood pressure drops due to dehydration, peripheral pulse is rapid and thready, and urine output decreases with time. 26 June 30, 2023 INSIDE . When autocomplete results are available use up and down arrows to review and enter to select. coli. 2015; 21 (2 . [17] If the severe diarrhea is not treated, it can result in life-threatening dehydration and electrolyte imbalances. [5] Cholera vaccines that are given by mouth provide reasonable protection for about six months, and have the added benefit of protecting against another type of diarrhea caused by E. V vulnificus necrotizing skin and soft-tissue infections may result in multiple organ failure and death. Strengthening surveillance and early warning systems are important measures to allow detection of the first cases in an outbreak and to put in place control measures as quickly as possible. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTA1NTUyMy1vdmVydmlldw==. In the same year, the Catalan Joaquim Balcells i Pascual discovered the bacterium. Accessibility The associated diarrheal illness should be referred to as cholera and must be reported in the United States.[42]. Currently there are three WHO pre-qualified oral cholera vaccines (OCV): Dukoral, Shanchol, and Euvichol-Plus. Rapid access to treatment is essential during a cholera outbreak. 2014 May. Those who are immunocompromised are at a much greater risk for contracting V vulnificus and dying from overwhelming sepsis. [1] [Guideline] Stevens DL, Bisno AL, Chambers HF, et al. [3] Diarrhea can be so severe that it leads within hours to severe dehydration and electrolyte imbalance. 6 (7):[QxMD MEDLINE Link]. [QxMD MEDLINE Link]. This inhibited physicians' abilities to detect cholera cases early. [41], Stool and swab samples collected in the acute stage of the disease, before antibiotics have been administered, are the most useful specimens for laboratory diagnosis. Vital rates refer to how fast vital statistics change in a population (usually measured per 1000 individuals). 2010 Feb 12. PLoS Negl Trop Dis. Cholera (/klr/) is an infection of the small intestine by some strains of the bacterium Vibrio cholerae. Vibrio vulnificus carries the highest mortality rate of any foodborne pathogen (Rippey, 1994). Hong G, Wu B, Lu C, Li M, Zhao G, Lu Z. The protective efficacy was 28% lower in children less than five years old. Vibrio vulnificus infection is a highly fatal disease resulting from the consumption of raw or undercooked seafood and exposure to seawater containing the organism. [108] T. J. Ritter's Mother's Remedies book lists tomato syrup as a home remedy from northern America. Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. We analyzed the incidence trends of V. vulnificus infection by year, month, and region in 913 cases reported to the Korea Centers for Disease Control and Prevention (KCDC, currently Korea Disease Control and Prevention Agency) by the National Infectious Disease Surveillance System from 2001 to 2016. [2] Vomiting and muscle cramps may also occur. However, for upper-middle-income countries, the highest mortality rate was found in infants < 1 year, followed by older adults aged 65 years. [QxMD MEDLINE Link]. 2009 Mar. [71] In most cases, cholera can be successfully treated with oral rehydration therapy (ORT), which is highly effective, safe, and simple to administer. [17] Individuals' susceptibility to cholera is also affected by their blood type, with those with type O blood being the most susceptible. These vital rates are widely used and facilitate much useful comparison of time trends and of local variations within or among countries. [2] Areas with an ongoing risk of disease include Africa and Southeast Asia. Shortage of cholera vaccines leads to temporary suspension of two-dose strategy, as cases rise worldwide, Donors making a difference: healthier communities across Africa, Donors making a difference: for refugees and other displaced people, Independent Oversight and Advisory Committee, More about the Global Task Force on Cholera Control (GTFCC), http://apps.who.int/iris/bitstream/10665/258764/1/WER9234-477-498.pdf, Global Task Force on Cholera Control (GTFCC). 55 (8):1007-10. [17], Spanish physician Jaume Ferran i Clua developed a cholera inoculation in 1885, the first to immunize humans against a bacterial disease. All three vaccines require two doses for full protection. Vibrio vulnificusis a gram-negative bacterium that can cause serious wound infections, septicemia, and diarrhea. [94], The first cholera pandemic occurred in the Bengal region of India, near Calcutta starting in 1817 through 1824. MeSH Upon binding, the complex is taken into the cell via receptor-mediated endocytosis. These patients are also given appropriate antibiotics to diminish the duration of diarrhoea, reduce the volume of rehydration fluids needed, and shorten the amount and duration of V. cholerae excretion in their stool. They are given to all individuals over the age of one year. A total of 152 patients who were not followed up were excluded from the analysis. [17] This method was first tried on a mass scale during the Bangladesh Liberation War, and was found to have much success. research aims at discovering "the signal that makes the cholera bacteria stop swimming and start to colonize (that is, adhere to the cells of) the small intestine. [19]. Regardless of the publication dates of these studies and their sample sizes, mortality rates varied widely: from 0-68.4%, and followed a V-shape graph with the vertex located at the lowest. There was a rapid increase in the number of cases from several hundred cases in early December 2017 to approximately 2,000 by early January 2018. David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic [107] In the 18541855 outbreak in Naples, homeopathic camphor was used according to Hahnemann. Monomicrobial gram-negative necrotizing fasciitis: An uncommon but fatal syndrome. In the year 2000 in the state of Kerala in India, the Kottayam district was determined to be "Cholera-affected"; this pronouncement led to task forces that concentrated on educating citizens with 13,670 information sessions about human health. Sangeetha MS, Shekar M, Venugopal MN. It was not until the 1830s that the name for severe yellow diarrhea changed in English from "cholera" to "cholera morbus" to differentiate it from what was then known as "Asiatic cholera", or that associated with origins in India and the East. 89(3):631-6. Through the GTFCC and with support from donors, WHO works to: To strengthen GTFCC support to countries, in 2020 a Country Support Platform ( CSP) was established. The bacteria stop producing the protein flagellin to conserve energy and nutrients by changing the mix of proteins that they express in response to the changed chemical surroundings. In-hospital mortality associated with necrotizing soft tissue infection due to Vibrio vulnificus: a matched-pair cohort study. Vibrio vulnificus septicemia presenting as purpura fulminans. Children aged 2 -5 require a third dose. The suspicion is then confirmed by identifying V. cholerae in stool samples from affected patients. Cholera is an easily treatable disease. [3] Genome sequencing has been performed. Genome Announc. The fourth pandemic lasted from 1863 to 1875, spreading from India to Naples and Spain, and reaching the United States at New Orleans, Louisiana in 1873. Results: For the most part, Cluster I consists of strains from the 1960s and 1970s, while Cluster II largely contains strains from the 1980s and 1990s, based on the change in the clone structure. [3], Cholera is caused by a number of types of Vibrio cholerae, with some types producing more severe disease than others. Vibrio infections. Recent data are consistent with the existence of 2 genotypes of V vulnificus, with the C-type being a strong indicator of potential virulence. Methodology We examined all reported cases . Cholera had disappeared from the Americas for most of the 20th century, but it reappeared toward the end of that century, beginning with a severe outbreak in Peru. Vibrio vulnificus infection. Cholera remains a global threat to public health and an indicator of inequity and lack of social development. V vulnificus infects the body in 2 ways, either by exposure to contaminated seafood, such as raw oysters, or through an open wound exposed to contaminated seawater. "[34], Amplified fragment length polymorphism fingerprinting of the pandemic isolates of V. cholerae has revealed variation in the genetic structure. 59(2):e10-52. 2005. [QxMD MEDLINE Link]. Selective pressures exist however in the aquatic environment that may reduce the virulence of V. 66(3):899-905. A cholera outbreak/epidemic can occur in both endemic countries and in countries where cholera does not regularly occur. Kussmaul breathing, a deep and labored breathing pattern, can occur because of acidosis from stool bicarbonate losses and lactic acidosis associated with poor perfusion. [88] Between September 2019 and September 2020, a global total of over 450,000 cases and over 900 deaths was reported; however, the accuracy of these numbers suffer from over-reporting from countries that report suspected cases (and not laboratory confirmed cases), as well as under-reporting from countries that do not report official cases (such as Bangladesh, India and Philippines).[88]. Historically many different claimed remedies have existed in folklore. References to cholera appear in the European literature as early as 1642, from the Dutch physician Jakob de Bondt's description in his De Medicina Indorum. 2014 Jul 15. [90], The word cholera is from Greek: kholera from khol "bile". 94:103630. [156] With intensification of the rains, new cases increased on a daily basis reaching a peak on the first week of January 2018 with over 700 cases reported. [9] Evaluation of the graveyard skeletons of two American Civil War soldiers revealed they may have died as a result of V vulnificus septicemia. [QxMD MEDLINE Link]. Cholera surveillance should be part of an integrated disease surveillance system that includes feedback at the local level and information-sharing at the global level. [55][57], Persons who survive an episode of cholera have long-lasting immunity for at least 3 years (the period tested. [18], The presence of hemorrhagic bullous skin lesions, necrotizing fasciitis, primary septicemia, a greater severity-of-illness, absence of leukocytosis, and hypoalbuminemia were found to be the significant risk factors for mortality in patients with V vulnificus infection. hygiene measures such as handwashing with soap, safe preparation and storage of food and safe disposal of the faeces of children.funeral practices for individuals who die from cholera to prevent infection among attendees. The biology of Vibrio vulnificus . Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, American College of RheumatologyDisclosure: Received income in an amount equal to or greater than $250 from: Biogen US (Adjudicator for study entry cutaneous lupus erythematosus); Priovant (Adjudicator for entry into a dermatomyositis study); IQVIA (Serono - adjudicator for a study of cutaneous LE)
Received honoraria from UpToDate for author/editor; Received royalty from Elsevier for book author/editor; Received dividends from trust accounts, but I do not control these accounts, and have directed our managers to divest pharmaceutical stocks as is fiscally prudent from Stock holdings in various trust accounts include some pharmaceutical companies and device makers for these trust accounts for: Stocks held in various trust accounts: Allergen; Amgen; Pfizer; 3M; Johnson and Johnson; Merck; Abbott Laboratories; AbbVie; Procter and Gamble;; Celgene; Gilead; CVS; Walgreens; Bristol-Myers Squibb. doi:10.1371/journal.pntd.0003832. Vaccine. Cholera ( / klr /) is an infection of the small intestine by some strains of the bacterium Vibrio cholerae. and transmitted securely. Chin Med J (Engl). This dramatic mortality level coincides with an increase in the detection frequency of herpes virus and with the identification of OsHV-1 variants, the OsHV-1 var being the most predominant genotype ( Segarra et al., 2010; Martenot et al., 2011, 2013 ). These epidemics had a lower number of fatalities because physicians and researchers had a greater understanding of the cholera bacteria. Itabashi K, Horiuchi T, Kusuda S, et al. Patients can be lethargic and might have sunken eyes, dry mouth, cold clammy skin, or wrinkled hands and feet. "This is why it's $1," the TikTok user says as she digs into the oyster. 2018;379(4):375. Trends Microbiol. When autocomplete results are available use up and down arrows to review and enter to select. Inoue Y, Ono T, Matsui T, Miyasaka J, Kinoshita Y, Ihn H. Epidemiological survey of Vibrio vulnificus infection in Japan between 1999 and 2003. 2017 Jan. 13 (1):e1006053. [QxMD MEDLINE Link]. CDC Cholera Illness and Symptoms Cholera is an acute diarrheal illness caused by infection of the intestine with Vibrio cholerae bacteria. -, Baker-Austin C, Oliver JD, Alam M, Ali A, Waldor MK, Qadri F, et al. Lancet Infect Dis. [26] This transcriptional change results in a loss of ability of V. cholerae to be cultured on standard media, a phenotype referred to as 'viable but non-culturable' (VBNC) or more conservatively 'active but non-culturable' (ABNC). Local capacity to detect (diagnose) and monitor 2. In 1883, Robert Koch identified V. cholerae with a microscope as the bacillus causing the disease. On reaching the intestinal wall, V. cholerae start producing the toxic proteins that give the infected person a watery diarrhea. J Bone Joint Surg Am. V. cholerae O1 has caused all recent outbreaks. [QxMD MEDLINE Link]. Cholera is an extremely serious disease that can cause severe acute watery diarrhoea with severe dehydration. de Klerk A. 2008 Mar. 2022 The Korean Academy of Medical Sciences. Prognostic factor of mortality and its clinical implications in patients with necrotizing fasciitis caused by Vibrio vulnificus. Jpn J Infect Dis. 2016 Jan-Feb. 129 (1-2):48-51. Preventing and controlling cholera in endemic countries. In the past, vessels flew a yellow quarantine flag if any crew members or passengers had cholera. Uninfected dead bodies have never been reported as the source of epidemics. Sigma Xi, The Scientific Research Honor Society. The samples are sent to a laboratory for confirmation by culture or PCR. Early detection and quick response to contain outbreaks: the strategy focuses on containing outbreakswherever they may occur through early detection and rapid multisectoral response including community, engagement, 2012 Feb 15. [88], In many developing countries, cholera still reaches its victims through contaminated water sources, and countries without proper sanitation techniques have greater incidence of the disease. (1) Updated global burden of cholera in endemic countries. Background Vibrio vulnificus necrotizing skin and soft tissue infections (VNSSTIs) are associated with a high mortality rate that varies remarkably with host susceptibility. He also gave first European descriptions of other diseases.) Jeffrey P Callen, MD Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine This was a frequent practice of the time. [53][54][55][56] He conducted a massive inoculation program in British India. [78], Antibiotics improve outcomes in those who are both severely and not severely dehydrated. 2020 Feb. 20 (2):170-171. [35] They also stress the importance of an effective surveillance system. [131], The GTFCC targets 47 countries, 13 of which have established vaccination campaigns. Overview What is Vibrio vulnificus? Two doses of Shanchol and Euvichol-Plus provide protection against cholera at least for three years, while one dose provides short term protection. These patients are also given appropriate antibiotics to diminish the duration of diarrhoea, reduce the volume of rehydration fluids needed, and shorten the amount and duration of. The WASH solutions for cholera are aligned with those of the Sustainable Development Goals (SDG 6). [51] For prevention to be effective, it is important that cases be reported to national health authorities. [105] Cholera officially became the first reportable disease in the United States due to the significant effects it had on health. Actions targeting environmental conditions include the implementation of adapted long-term sustainable Cholera is now endemic in many countries. Kuo Chou TN, Chao WN, Yang C, Wong RH, Ueng KC, Chen SC. There were a rise in cases in the 1990s and since. If V. cholerae serogroup O1 is not isolated, the laboratory should test for V. cholerae O139. World J Surg. [33] Binding exposes its active site, allowing it to permanently ribosylate the Gs alpha subunit of the heterotrimeric G protein. Researchers have estimated that every year, there are 1.3 to 4.0 million cases of cholera, and 21 000 to 143 000 deaths worldwide due to the infection. The country led strategy aims to reduce cholera deaths by 90% and to eliminate cholera in as many as 20 countries by 2030. Shanchol is prequalified to be used in a Controlled Temperature Chain, an innovative approach to vaccine management allowing vaccines to be kept at temperatures outside of the traditional cold chain of +2C to +8C for Countries affected by cholera are encouraged to strengthen disease surveillance and national preparedness to rapidly detect and respond to outbreaks. Vibrio vulnificus: new insights into a deadly opportunistic pathogen. Preventing and controlling cholera requires interventions beyond the health sector and it is vital to engage with partners across other sectors. [95] The movement of British Army and Navy ships and personnel is believed to have contributed to the range of the pandemic, since the ships carried people with the disease to the shores of the Indian Ocean, from Africa to Indonesia, and north to China and Japan. [15] The study of cholera in England by John Snow between 1849 and 1854 led to significant advances in the field of epidemiology because of his insights about transmission via contaminated water, and a map of the same was the first recorded incidence of epidemiological tracking. Barbieri R, Aboudharam G, Raoult D, Drancourt M. Vibrio vulnificus casualties during the American Civil War. Craig A Elmets, MD is a member of the following medical societies: American Academy of Dermatology, American Association of Immunologists, American College of Physicians, American Federation for Medical Research, Society for Investigative DermatologyDisclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: University of Alabama at Birmingham; University of Alabama Health Services Foundation
Serve(d) as a speaker or a member of a speakers bureau for: Ferndale Laboratories
Received research grant from: NIH, Veterans Administration, California Grape Assn
Received consulting fee from Astellas for review panel membership; Received salary from Massachusetts Medical Society for employment; Received salary from UpToDate for employment. Baker-Austin C, Oliver JD. However, unlike other species of this family, V. vulnificus can cause serious and fatal infections [ 1, 2 ], such as gastroenteritis, skin and soft tissue infections, and primary sepsis that may progress to necrotizing fasciitis and death [ 1, 2 ]. The role of Vibrio vulnificus virulence factors and regulators in its infection-induced sepsis. Rosche TM, Yano Y, Oliver JD. [133], Similarly, South Africa's cholera outbreak was exacerbated by the government's policy of privatizing water programs. [25][note 1], V. cholerae also exists outside the human body in natural water sources, either by itself or through interacting with phytoplankton, zooplankton, or biotic and abiotic detritus. Microbiol Spectr. During the 19th century, cholera spread across the world from its original reservoir in the Ganges delta in India. The first is an overwhelming primary septicemia caused by consuming raw or undercooked seafood, particularly raw oysters. Local culture practices and beliefs are central to promoting actions such as the adoption of protective Cholera is an extremely virulent disease that can cause severe acute watery diarrhoea. delayed surgical intervention after the first 12 or 24 hours was associated with higher mortality rates (OR . )[12] A number of safe and effective oral vaccines for cholera are available. [17][1], For certain genetic strains of cholera, such as the one present during the 2010 epidemic in Haiti and the 2004 outbreak in India, death can occur within two hours of becoming ill.[82], Cholera affects an estimated 2.8million people worldwide, and causes approximately 95,000deaths a year (uncertainty range: 21,000143,000) as of 2015[update]. This is opposed to oviparity which is a reproductive mode in which females lay developing eggs that complete their development and hatch externally from the mother. [6]. [22], People infected with cholera often have diarrhea, and disease transmission may occur if this highly liquid stool, colloquially referred to as "rice-water", contaminates water used by others. Provision of safe water and sanitation is critical to prevent and control the transmission of cholera and other waterborne diseases. It is in the same family as bacteria that cause cholera. cholerae. A brief summary of the March 2010 position paper" (PDF). Emerg Infect Dis. [17] A higher mortality rate was noted with the Vibrio cholerae non-O1 group (57%) compared with the V vulnificus group (30%). Protective Effects of Chicken Egg Yolk Immunoglobulins (IgYs) against Vibrio vulnificus Infections. J Dermatol. This, and the unpleasant course of the disease which includes voluminous "rice-water" diarrhea, the hemorrhaging of liquids from the mouth, and violent muscle contractions which continue even after death has discouraged the disease from being romanticized, or even being factually presented in popular culture. Comparison of necrotizing fasciitis and sepsis caused by Vibrio vulnificus and Staphylococcus aureus. [17] Ten percent of a person's body weight in fluid may need to be given in the first two to four hours. Prevention of Vibrio vulnificus infections. Prevalence and antimicrobial resistance of Vibrio spp. Oftentimes, this will allow public health programs to determine and control the cause of the cases, whether it is unsanitary water or seafood that have accumulated a lot of Vibrio cholerae specimens. Other bad prognostic signs included a systolic blood pressure of less than or equal to 90 mm Hg, decreased platelet counts, and leukopenia. [66] Between uses the cloth should be rinsed in clean water and dried in the sun to kill any bacteria on it. To ensure efficient and effective deployment of necessary materials for the investigation and confirmation of cholera outbreaks, as well as the treatment of cholera patients, WHO has developed a set of cholera kits. A combination of surveillance, water, sanitation and hygiene, social mobilisation, treatment, and oral cholera vaccines are used. Example of a urine-diverting dry toilet in a cholera-affected area in Haiti. Cholera is an acute diarrhoeal infection caused by eating or drinking food or water that is contaminated with the bacterium. Under the International Health Regulations, notification of all cases of cholera is no longer mandatory. Tsai YH, Wen-Wei Hsu R, Huang KC, Huang TJ. [18] The diarrhea is frequently described as "rice water" in nature and may have a fishy odor. Used cloth is more effective than new cloth, as the repeated washing reduces the space between the fibers. J Bone Joint Surg Am. [75], Doxycycline is typically used first line, although some strains of V. cholerae have shown resistance. 2009 Apr. "Cholera vaccines. Li G, Wang MY. 1989. [92] (The "Indorum" of the title refers to the East Indies. (4) Cholera vaccines: WHO position paper August 2017 http://apps.who.int/iris/bitstream/10665/258764/1/WER9234-477-498.pdf. J Microbiol Immunol Infect. 2018 Feb 15. [141], Unlike tuberculosis ("consumption") which in literature and the arts was often romanticized as a disease of denizens of the demimonde or those with an artistic temperament,[152] cholera is a disease which almost entirely affects the poor living in unsanitary conditions. [17] Other antibiotics proven to be effective include cotrimoxazole, erythromycin, tetracycline, chloramphenicol, and furazolidone.
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