Cholera, sometimes known as Asiatic or epidemic cholera, is an infectious gastroenteritis caused by enterotoxin-producing strains of the bacterium ''Vibrio cholerae''. Transmission to humans occurs through eating food or drinking water contaminated with ''Vibrio cholerae'' from other cholera patients. The major reservoir for cholera was long assumed to be humans themselves, but considerable evidence exists that aquatic environments can serve as reservoirs of the bacteria.
''Vibrio cholerae'' is a Gram-negative bacterium that produces cholera toxin, an enterotoxin, whose action on the mucosal epithelium lining of the small intestine is responsible for the disease's most salient characteristic, exhaustive diarrhea.
The majority of reported gross cholera cases worldwide occur in Africa. It is estimated that most cases of cholera are unreported due to poor surveillance systems, particularly in Africa. Fatality rates are 5% of total cases in Africa, and less than 1% elsewhere.
In most cases cholera can be successfully treated with oral rehydration therapy. Prompt replacement of water and electrolytes is the principal treatment for cholera, as dehydration and electrolyte depletion occur rapidly. Oral rehydration therapy or ORT is highly effective, safe, and simple to administer. In situations where commercially produced ORT sachets are too expensive or difficult to obtain, alternative homemade solutions using various formulas of water, sugar, table salt, baking soda, and fruit offer less expensive methods of electrolyte repletion (i.e. Gatorade or Powerade). In severe cholera cases with significant dehydration, the administration of intravenous rehydration solutions may be necessary.
Antibiotics shorten the course of the disease, and reduce the severity of the symptoms. However Oral rehydration therapy remains the principal treatment. Tetracycline is typically used as the primary antibiotic, although some strains of ''V. cholerae'' exist that have shown resistance. Other antibiotics that have been proven effective against ''V. cholerae'' include cotrimoxazole, erythromycin, doxycycline, chloramphenicol, and furazolidone. Fluoroquinolones such as norfloxacin also may be used, but resistance has been reported.
Rapid diagnostic assay methods are available for the identification of multidrug resistant ''V. cholerae''. New generation antimicrobials have been discovered which are effective against ''V. cholerae'' in ''in vitro'' studies.
The success of treatment is significantly affected by the speed and method of treatment. If cholera patients are treated quickly and properly, the mortality rate is less than 1%; however, with untreated cholera the mortality rate rises to 50–60%.
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