Cholera - the new strike of an old foe.

ABSTRACT

Cholera is an acute bacterial gastrointestinal infection caused by ingestion of water or food containing the pathogen Vibrio cholerae. The incubation period can be very short and it takes between several hours and 5 days. During the 19th century, cholera was spreading from India across the world. Its original reservoir was located in the Ganges delta. So far, there have been six epidemics of cholera; the current outbreak is the seventh. It started in Asia, attacked Africa and then the Americas. Cholera causes thousands of illnesses and deaths annually, mostly in South Asia and Sub-Saharan Africa. The current outbreak began in Yemen in October 2016, it peaked in December with subsequent decline, then the epidemic has re-erupted in April 2017 and it still continues. It is currently the largest outbreak in the world, with 5000 new infections a day (as of August 19th, 2017 the number of cholera cases stands at 527,000 with 1997 deaths). The most common symptoms of the illness are diarrhoea, dehydration, vomiting, and abdominal cramps. Case-fatality rate is lower than 1%, if rehydration treatment is prescribed rapidly, but it can exceed 70% in patients not treated properly. Aggressive and rapid fluid repletion is the basis of treatment for cholera. In many cases, rehydration therapy, given orally or parenterally, is enough to rescue infected patients. Antibiotics, mainly fluoroquinolones, tetracyclines, and macrolides are an adjunctive therapy for patients with moderate to severe fluid loss.