Cholera

Cholera is an epidemic secretory diarrhoeal disease caused by Vibrio cholerae. V cholerae releases a toxin that stimulates adenylate cyclase in intestinal cells. Cholera is usually a disease occurring in the context of poverty, war, or displacement, but is also well described in returning travellers.

Classically, patients present passing large quantities (litres) of rice-water stools.

Basic laboratory tests are non-specific. Culture of the organism is definitive, and rapid dipstick tests are available, while molecular detection methods are gaining importance as part of epidemic surveillance.

Most patients will recover if the effects of the ensuing profound volume depletion respond to oral and/or intravenous rehydration.

Antibiotics shorten the duration and severity of disease, but increasing rates of bacterial resistance are becoming problematic.

Cholera is a secretory diarrhoeal illness caused by the gram-negative bacterium Vibrio cholerae.[1]Kanungo S, Azman AS, Ramamurthy T, et al. Cholera. Lancet. 2022 Apr 9;399(10333):1429-40. http://www.ncbi.nlm.nih.gov/pubmed/35397865?tool=bestpractice.com [2]Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 5: travel-associated infections & diseases​ - cholera. May 2023 [internet publication]. https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/cholera ​​ Secretion of the cholera enterotoxin leads to continued activity of adenylate cyclase in intestinal epithelial cells, and secretion of water and accompanying salts into the gut lumen.