Cholera

• What is cholera classified as?

  Cholera is an acute diarrhoeal disease.
• How quickly can cholera kill if left untreated?

  Cholera can kill within hours if left untreated.
• Who does cholera primarily affect?

  Cholera primarily affects people with inadequate access to safe water and basic sanitation.
• What factors increase the risk of cholera?

  Conflict, unplanned urbanization, and climate change increase the risk of cholera.
• In how many countries is cholera endemic?


  Cholera is endemic in more than 50 countries.
• What percentage of those infected with cholera have no or mild symptoms?


  Most of those infected have no or mild symptoms.
• What is critical for preventing and controlling cholera transmission?


  Provision of safe water, basic sanitation, and hygiene practices is critical.
• What type of vaccines are available for cholera?


  Oral cholera vaccines are available.
• What was launched in 2017 to control cholera?


  A global strategy called "Ending cholera: a global roadmap to 2030" was launched.
• What is the causative organism of cholera?

  The causative organism of cholera is Vibrio cholerae.
• What shape and type is Vibrio cholerae?


  Vibrio cholerae is a Gram-negative, comma-shaped aerobic bacillus.
• What are the dimensions of Vibrio cholerae?


  Vibrio cholerae is 1-3 µm in length and 0.5-0.8 µm in diameter.
• Which serogroups of Vibrio cholerae cause outbreaks?


  Only serogroups O1 and O139 cause outbreaks.
• What is the significance of Vibrio cholerae O139?


  Vibrio cholerae O139 was first identified in Bangladesh in 1992 and caused outbreaks in the past.
• What is the difference in illness caused by serogroups O1 and O139?


  There is no difference in the illness caused by the two serogroups.
• What is necessary for epidemics of cholera to occur?

  Only vibrios secreting Cholera Toxin (CT) cause epidemics.
• Who identified the bacterium Vibrio cholerae?


  Filippo Pacini identified the bacterium Vibrio cholerae.
• When did Robert Koch discover the cholera bacillus?


  Robert Koch discovered the cholera bacillus in 1884.
• Why was Filippo Pacini not attributed with the discovery of cholera until 1965?


  Despite his discovery, he was not credited until 1965.
• How many cholera pandemics have occurred since 1817?


  There have been 7 cholera pandemics since 1817.
• Where did cholera spread from during the 19th century?

  Cholera spread from its original reservoir in the Ganges delta in India.
• When did the current (seventh) cholera pandemic start?


  The current (seventh) pandemic started in South Asia in 1961.
• How many cases and deaths were reported to WHO in 2023?


  In 2023, 535,321 cases and 4,007 deaths were reported to WHO.
• Why is cholera underreported?


  Cholera is underreported due to limitations in surveillance systems and fear of impact on trade and tourism.
• What was the geographical pattern of cholera outbreaks in 2023?


  There was a 32% reduction in cases in the Middle East and Asia, and a 125% increase in cases in Africa.
• Which countries reported very large outbreaks in 2023?


  Countries like Afghanistan, Bangladesh, DRC, Ethiopia, Haiti, Malawi, Mozambique, Somalia, and Zimbabwe reported large outbreaks.
• What may have contributed to the increase in cholera cases in Bangladesh in 2023?


  The increase may be due to enhanced cholera surveillance and reporting efforts.
• What areas are most vulnerable to cholera?


  Countries lacking access to water and sanitation are most vulnerable.
• What is the difference between endemic and epidemic cholera?


  Endemic cholera has cases detected with evidence of local transmission, while epidemics occur with at least one confirmed case in non-endemic areas.
• What is the infective dose of Vibrio cholerae?


  The infective dose is $10^8 \text{ CFU/ML}$.
• How long can infected individuals carry and transmit vibrios?


  Infected individuals can carry and transmit vibrios for 1-4 weeks.
• What are the symptoms of severe cholera?


  Severe cholera symptoms include sudden onset, intense diarrhoea, violent vomiting, and significant fluid loss.
• What is the incubation period for cholera?


  The incubation period for cholera is 12 hours to 5 days.
• How is cholera diagnosed?


  Cholera is diagnosed by isolating the pathogen from stool samples or food.
• What media is used to culture Vibrio cholerae?


  Vibrio cholerae is plated onto selective media called THIOSULFATE CITRATE BILE SALTS SUCROSE (TCBS) AGAR.
• What is the purpose of confirming cholera in index cases?


  Confirmation is necessary to identify the strain, biotype, and antibiotic sensitivity.
• What is the main cause of death in cholera patients?


  Death is primarily due to dehydration and loss of essential electrolytes.
• What is the mainstay of therapy for cholera?


  Water and electrolyte replacement therapy is the mainstay of therapy.
• What is the recommended treatment for children under 5 years of age with cholera?


  Children under 5 should be given zinc for 10 days.
• What is required for severe cholera cases?


  Severe cases require rapid administration of intravenous fluids and antibiotics.