Cholera
Etiologia i przyczyny

Cholera jest ostrą infekcją przewodu pokarmowego wywołaną przez bakterię Vibrio cholerae, głównie serogrupy O1 i O139, które produkują toksynę cholerową (CTX). Patogen kolonizuje jelito cienkie, gdzie toksyna cholerowa indukuje masywne wydzielanie płynów i elektrolitów (Na+, Cl-, HCO3-, K+), prowadząc do gwałtownej wodnistej biegunki i ciężkiego odwodnienia. Dawka zakaźna wynosi około 10^8 bakterii, a czynniki predysponujące do zakażenia to m.in. obniżona kwaśność soku żołądkowego, niedożywienie oraz grupa krwi O. Transmisja odbywa się głównie drogą fekalno-oralną poprzez spożycie skażonej wody lub żywności, zwłaszcza surowych owoców morza i warzyw. Epidemiologia choroby obejmuje obszary endemiczne, neoepidemiczne oraz sporadyczne ogniska w krajach rozwiniętych, z globalną liczbą zachorowań szacowaną na 1,3-4 miliony rocznie i 21 000-143 000 zgonów.

Definicja i ogólna charakterystyka cholery

Cholera to ostra choroba zakaźna przewodu pokarmowego wywoływana przez bakterię Vibrio cholerae. Jest to zakażenie jelita cienkiego, które charakteryzuje się gwałtowną, wodnistą biegunką prowadzącą do ciężkiego odwodnienia i zaburzeń elektrolitowych, które nieleczone mogą szybko doprowadzić do śmierci.12 Bakteria ta została odkryta w 1883 roku przez niemieckiego badacza Roberta Kocha, który potwierdził, że patogen rozprzestrzenia się poprzez skażoną wodę i żywność.3

Cholera może wystąpić jako choroba endemiczna, epidemiczna lub pandemiczna. Obecnie świat doświadcza siódmej pandemii cholery, która rozpoczęła się w Azji Południowej w 1961 roku, dotarła do Afryki w 1971 roku, a do Ameryki w 1991 roku.45 Każdego roku na świecie odnotowuje się szacunkowo od 1,3 do 4 milionów zachorowań na cholerę oraz między 21 000 a 143 000 zgonów z tego powodu.67

Czynnik etiologiczny cholery

Charakterystyka Vibrio cholerae

Vibrio cholerae to Gram-ujemna, zakrzywiona, ruchliwa bakteria należąca do rodziny Vibrionaceae. Posiada pojedynczą wić (flagellum) umożliwiającą poruszanie się oraz struktury podobne do włosków (pile) służące do przytwierdzania się do tkanek.89 Jest to fakultatywnie beztlenowa pałeczka posiadająca zdolność do kolonizacji jelita cienkiego człowieka.10

Zidentyfikowano ponad 200 serotypów Vibrio cholerae, jednak tylko szczepy wytwarzające toksynę cholerową mogą powodować cholerę. Spośród nich jedynie serogrupy O1 i O139 wywołują epidemie cholery.1112 Serogrupa O1 zawiera dwa serotypy: klasyczny i El Tor. Łagodniejsze lub bezobjawowe zakażenia częściej występują w przypadku biotypu El Tor.13

Toksyna cholerowa

Głównym czynnikiem zjadliwości Vibrio cholerae jest toksyna cholerowa (CTX lub CT). Jest to kompleks oligomeryczny składający się z sześciu podjednostek białkowych: jednej kopii podjednostki A (część A) i pięciu kopii podjednostki B (część B), połączonych mostkiem disiarczkowym.14

Toksynogeniczne szczepy posiadają bakteriofag CTXφ, który koduje toksynę cholerową. Gen kodujący toksynę cholerową został wprowadzony do Vibrio cholerae w procesie horyzontalnego transferu genów.1516

Po wytworzeniu przez bakterię, toksyna cholerowa wiąże się z receptorem na komórkach wyściełających jelito cienkie. Aktywuje ona wewnątrzkomórkowy szlak prowadzący do masowego wydzielania płynów do światła jelita cienkiego, co skutkuje utratą dużych ilości płynów zawierających wysokie stężenia sodu, chlorków, wodorowęglanów i potasu.1718

Mechanizm patogenezy cholery

Aby doszło do zakażenia, Vibrio cholerae musi przetrwać kwaśne środowisko żołądka, a następnie przytwierdzić się do jelita cienkiego i wytworzyć toksynę cholerową.19 Bakterie przyczepiają się do mikrokosmków komórek nabłonkowych jelita cienkiego, gdzie namnażają się i uwalniają toksynę cholerową, mucinazę i endotoksynę. Nie naciekają one błony śluzowej.20

Toksyna cholerowa zwiększa aktywność enzymu regulującego komórkowy mechanizm pompujący, który kontroluje przepływ wody i elektrolitów między jelitem a układem krążenia.21 Mechanizm ten powoduje, że komórki jelita cienkiego wydzielają ogromne ilości wody i elektrolitów, co prowadzi do wodnistej biegunki i szybkiej utraty płynów.

Wszystkie objawy kliniczne cholery można przypisać ekstremalnej utracie wody i soli.22 Zwiększone wydzielanie elektrolitów jest spowodowane przez toksynę cholerową, w sytuacji gdy nie występują morfologiczne uszkodzenia błony śluzowej jelita.23

Drogi transmisji cholery

Główne źródła zakażenia

Głównym źródłem zakażenia cholerą są skażone źródła wody.24 Bakterie Vibrio cholerae mogą być obecne w:

  • Wodzie powierzchniowej lub studziennej – skażone studnie publiczne są częstym źródłem epidemii cholery25
  • Wodzie słonawej (lekko słonej) i wodach przybrzeżnych – spożywanie surowych owoców morza, szczególnie skorupiaków, może być źródłem cholery2627
  • Żywności przygotowywanej przy użyciu skażonej wody28

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Droga fekalno-oralna

Cholera szerzy się głównie drogą fekalno-oralną poprzez spożycie wody lub żywności skażonej bakteriami pochodzącymi z kału osoby zainfekowanej.2930 Do najczęstszych mechanizmów transmisji należą:

  • Spożycie wody skażonej fekaliami zawierającymi bakterie cholery31
  • Spożycie surowych warzyw i owoców uprawianych przy użyciu skażonej wody32
  • Spożycie surowych lub niedogotowanych owoców morza, szczególnie skorupiaków33
  • Spożycie gotowanych ziaren, takich jak ryż i proso, które zostały skażone po ugotowaniu i przechowywane w temperaturze pokojowej przez wiele godzin34

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Warto podkreślić, że bezpośredni kontakt międzyludzki (np. kaszlenie czy kichanie) rzadko prowadzi do zakażenia. Aby zachorować na cholerę, konieczne jest spożycie wody lub żywności skażonej bakteriami.3536

Czynniki sprzyjające szerzeniu się cholery

Czynniki środowiskowe

Rozwojowi cholery sprzyja szereg czynników środowiskowych:

  • Zanieczyszczone źródła wody – brak odpowiedniego uzdatniania wody37
  • Nieodpowiednie warunki sanitarne – brak właściwej infrastruktury sanitarnej38
  • Klęski żywiołowe (powodzie, trzęsienia ziemi) – mogą uszkodzić infrastrukturę wodociągową i sanitarną, prowadząc do zanieczyszczenia źródeł wody39
  • Ciepłe temperatury – sprzyjają namnażaniu się bakterii40

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Czynniki związane z gospodarzem

Do zakażenia cholerą predysponują następujące czynniki ze strony gospodarza:

  • Obniżona kwaśność soku żołądkowego (hipochlorhydria lub achlorhydria) – spowodowana:
  • Grupa krwi O – częstość występowania cholery jest dwukrotnie wyższa u osób z grupą krwi O. Przyczyna tej zwiększonej podatności jest nieznana, ale może być związana z większą wrażliwością tej grupy krwi na toksynę cholerową454647
  • Niedożywienie – zwiększa podatność na cholerę48

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Czynniki socjoekonomiczne

Cholera jest często określana jako „choroba ubóstwa” ze względu na jej związek z następującymi czynnikami socjoekonomicznymi:

  • Ubóstwo – choroba nieproporcjonalnie dotyka społeczności o niskich dochodach4950
  • Przeludnienie – zatłoczone warunki życia ułatwiają szybkie rozprzestrzenianie się cholery51
  • Ograniczony dostęp do opieki zdrowotnej – utrudnia szybką diagnostykę i leczenie52
  • Wojny i konflikty – niszczą infrastrukturę i tworzą warunki sprzyjające wybuchom epidemii53

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Znaczenie dawki zakaźnej

Dawka zakaźna Vibrio cholerae potrzebna do wywołania cholery jest stosunkowo wysoka. Aby wywołać chorobę u zdrowej osoby dorosłej, typowo trzeba spożyć około 100 milionów bakterii (10^8).5455 Ta wysoka dawka zakaźna wynika z faktu, że bakterie są wrażliwe na kwaśne środowisko żołądka, które stanowi naturalną barierę ochronną.

Kwas żołądkowy może szybko unieszkodliwić inokulum V. cholerae zanim dotrze ono do miejsca kolonizacji w jelicie cienkim. Dlatego też osoby z obniżoną kwaśnością soku żołądkowego są bardziej podatne na zakażenie nawet przy mniejszej liczbie bakterii.5657

Epidemiologia cholery

Wzorce epidemiologiczne

Cholera wykazuje trzy główne wzorce epidemiologiczne:

  • Obszary wysoce endemiczne – gdzie choroba występuje stale58
  • Obszary neoepidemiozne – nowo zajęte, podatne na cholerę tereny59
  • W krajach rozwiniętych o dobrych warunkach sanitarnych – sporadyczne, ograniczone ogniska60

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Cholera jest chorobą endemiczną w wielu krajach, głównie w Afryce Subsaharyjskiej, Azji Południowej i obu Amerykach.61 Ogniska epidemiczne często wybuchają po katastrofach naturalnych, takich jak powodzie czy trzęsienia ziemi, które zaburzają infrastrukturę wodną i sanitarną.62

Rezerwuar choroby

Cholera ma dwa główne rezerwuary: ludzi i wodę.63 Vibrio cholerae rzadko jest izolowany od zwierząt, a zwierzęta nie odgrywają roli w przenoszeniu choroby. W naturalnych warunkach cholera dotyka tylko ludzi, co teoretycznie oznacza, że Vibrio cholerae jako czynnik etiologiczny mógłby zniknąć wraz z ostatnim ludzkim zakażeniem.64

Bakterie cholery mogą jednak przetrwać w środowisku wodnym, szczególnie w wodach przybrzeżnych, gdzie przytwierdzają się do małych skorupiaków zwanych widłonogami.65 Ta zdolność do przetrwania w środowisku wodnym umożliwia bakteriom utrzymywanie się nawet bez ludzkiego rezerwuaru.

Nosicielstwo i szerzenie epidemii

Osoby zakażone Vibrio cholerae wydalają bakterie w kale przez 7-14 dni, nawet jeśli nie mają objawów choroby.6667 Oznacza to, że mogą zarażać innych poprzez zanieczyszczenie źródeł wody i żywności.

Pojedynczy epizod biegunki u osoby zakażonej cholerą może spowodować milionkrotny wzrost liczby Vibrio cholerae w środowisku.68 Ta ogromna liczba bakterii wydalanych z kałem, połączona z niskimi standardami higienicznymi i sanitarnymi, stanowi główny mechanizm szerzenia się epidemii cholery.

Wnioski i implikacje kliniczne

Zrozumienie etiologii i mechanizmów przenoszenia cholery ma kluczowe znaczenie dla skutecznej kontroli tej choroby. Cholera jest chorobą łatwą do leczenia, jeśli zostanie szybko zdiagnozowana.69 Przy odpowiednim leczeniu wskaźnik śmiertelności wynosi poniżej 1%, ale bez leczenia może przekraczać 50%.7071

Długoterminowe rozwiązanie problemu cholery leży w rozwoju gospodarczym i powszechnym dostępie do bezpiecznej wody pitnej, podstawowych urządzeń sanitarnych i dobrych praktyk higienicznych.72 Ważne jest również zaangażowanie społeczności w skuteczne informowanie o potencjalnych zagrożeniach i objawach cholery, środkach ostrożności, które należy podjąć, aby uniknąć cholery, oraz o znaczeniu natychmiastowego leczenia w przypadku wystąpienia objawów.73

Ostatnie badania dotyczące genomu Vibrio cholerae dają nadzieję na lepsze zrozumienie i kontrolę tej choroby. Pełne sekwencjonowanie genomu szczepów V. cholerae może być wartościowym narzędziem do nadzoru, zapobiegania i kontroli cholery.74

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  1. 13.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1
    https://www.who.int/news-room/fact-sheets/detail/cholera
    Cholera is an acute diarrheal infection caused by consuming food or water contaminated with the bacterium Vibrio cholerae. […] Cholera is linked to limited access to safe water, basic sanitation facilities and poor hygiene practices. […] Only two serogroups, O1 and O139, cause cholera outbreaks. […] Cholera outbreaks occur regularly in some countries. […] The long-term solution for cholera control lies in economic development and universal access to safe drinking water, basic sanitation and good hygiene practices. […] Cholera is an easily treatable disease. […] Community engagement is essential for effectively communicating the potential risks and symptoms of cholera, precautions to take to avoid cholera, when and where to report cases, and the importance of seeking immediate treatment if symptoms appear.
  • #2 Vibrio cholerae Infection – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK526099/
    Cholera is an acute secretory diarrhea caused by toxigenic strains of Vibrio cholerae, a gram-negative, comma-shaped bacterium. […] Cholera is characterized by severe, acute, large-volume, watery diarrhea resulting in rapid dehydration and is associated with high mortality if not treated promptly. […] Transmission occurs via the fecal-oral route through contaminated water or food. […] Toxigenic strains of Vibrio cholerae are a major cause of acute, severe, dehydrating diarrhea in low- and middle-income countries with unsatisfactory hygienic conditions and those affected by natural disasters and humanitarian crises. […] V cholerae is transmitted through the fecal-oral route by contaminated water or food. Risk factors for acquiring V cholera include poverty, inadequate sanitation, contaminated water, and food.
  • #3 Science in the time of cholera
    https://www.yourgenome.org/theme/science-in-the-time-of-cholera/
    Cholera is an extremely infectious disease of the small intestine caused by strains of the bacterium Vibrio cholerae. […] A few decades later, the German physician Robert Koch identified the cause of cholera: the bacterium Vibrio cholerae. Koch confirmed that the bacterium was indeed spread via unclean water or food, providing concrete support for John Snows theory. […] The disease remains a major public health issue today, with up to 4 million people affected every year. […] With DNA sequencing, we can now gain a much deeper understanding of the bacterium that causes cholera by looking at its genome. […] Further research has since pinpointed this stretch of water as the worlds equivalent of the Broad Street Pump identified by John Snow, from which the worlds cholera pandemics stem.
  • #4 Cholera: a public health threat that still causes devastating outbreaks – News from the Institut Pasteur
    https://www.pasteur.fr/en/cholera-public-health-threat-still-causes-devastating-outbreaks?language=fr
    These findings show that cholera was not only introduced into Africa in 1970 before subsequently taking up residence there, but is repeatedly introduced on a regular basis. […] The areas of Africa most susceptible to the introduction of cholera will have to be targeted more specifically in order to stem the cholera waves before they sweep the rest of the continent. […] All of these studies demonstrate the added value of whole-genome sequencing of V. cholerae strains for cholera surveillance, prevention and control. […] The world is currently witnessing its seventh cholera pandemic. […] The seventh pandemic began in South Asia in 1961, reaching Africa in 1971 and America in 1991. […] The events currently unfolding in Yemen have tragically proved it right.
  • #5 Cholera: Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/962643-overview
    Cholera can be an endemic, epidemic, or a pandemic disease. Initiation and maintenance of epidemic and pandemic disease by V cholerae result from human infection and poor sanitation with assistance from human migration and seasonal warming of coastal waters. […] Owing to the relatively large infectious dose, transmission occurs almost exclusively via contaminated water or food. V cholerae O1 has been shown to survive in crabs boiled for 8 minutes, but not in crabs boiled for 10 minutes. Transmission via direct person-to-person contact is rare. […] Cholera has 2 main reservoirs, humans and water. V cholerae is rarely isolated from animals, and animals do not play a role in transmission of disease. […] Infection rates predictably are highest in communities in which water is not potable and personal and community hygiene standards are low.
  • #6 Cholera: Causes, Symptoms, Treatment, and Prevention
    https://www.webmd.com/a-to-z-guides/cholera-faq
    Cholera is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae. […] Vibrio cholerae is usually found in food or water contaminated by feces from a person with the infection. […] Common sources of cholera bacteria include public water supplies, foods and drinks sold by street vendors, raw vegetables, raw or undercooked fish and seafood, and grains. […] When a person consumes the contaminated food or water, the bacteria release a toxin in the intestines that produces severe diarrhea. […] Cholera is contagious, but doesn’t spread through casual contact with someone, like coughing or sneezing. To get cholera, you have to drink water, or eat food prepared with water, that has been contaminated with the bacteria. […] According to the World Health Organization, there are between 1.3 million and 4 million cases of cholera worldwide each year.
  • #7 Cholera: Epidemiology, clinical features, and diagnosis – UpToDate
    https://www.uptodate.com/contents/cholera-epidemiology-clinical-features-and-diagnosis
    Cholera is a life-threatening diarrheal illness caused by cholera toxin-producing strains of Vibrio cholerae. […] The disease cholera is caused by cholera toxin-producing (toxigenic) strains of V. cholerae, which are in serogroups O1 and O139. […] Toxigenic strains harbor the bacteriophage CTXφ, which encodes cholera toxin. […] Cholera is associated with people whose incomes are below federal poverty thresholds and lack of access to safe food, water, and adequate sanitation. […] Cholera occurs primarily in settings where there is inadequate access to clean water and sanitation; it occurs endemically as well as epidemically. […] Each year, there are an estimated 3 million cases of diarrheal illness and approximately 100,000 deaths worldwide caused by Vibrio cholerae. […] The infectious dose of V. cholerae required to cause cholera is thought to be relatively high; an inoculum of 10^8 V. cholerae or higher resulted in severe infection among healthy volunteers.
  • #8 Cholera Causes, Symptoms, Treatment, Vaccine
    https://www.medicinenet.com/cholera/article.htm
    Cholera is an acute infectious disease caused by a bacterium, Vibrio cholerae (V. cholerae), which usually results in painless, watery diarrhea in humans. […] Most people who get the disease ingest the organisms through food or water sources contaminated with V. cholerae. […] Cholera is caused by the bacterium Vibrio cholerae. This bacterium is Gram-stain-negative, comma-shaped, and has a flagellum (a long, tapering, projecting part) for motility and pili (hairlike structures) used to attach to tissue. […] Although many V. cholerae serotypes can produce cholera symptoms, the O groups O1 and O139, which also produce a toxin, cause the most severe symptoms of cholera. […] The toxin produced by these V. cholerae serotypes is an enterotoxin composed of two subunits, A and B; the genetic information for the synthesis of these subunits is encoded on plasmids (genetic elements separate from the bacterial chromosome).
  • #9 Vibrio cholerae Infection – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK526099/
    V cholerae is a gram-negative, comma-shaped bacterium responsible for causing cholera. […] Transmission of V cholera occurs via the fecal-oral route through contaminated water and food, fomites, and direct contact with infected individuals. […] More than 200 serogroups of V cholerae have been identified, but only the toxigenic strains of V cholera cause cholera, and of those, only serogroups O1 and O139 cause cholera epidemics. […] The O139 Bengal strain of V cholerae acts similarly, except that it has a novel O139 lipopolysaccharide and an immunologically linked O-antigen capsule. […] Cholera is an infectious disease caused by ingesting food or water contaminated by the bacteria V cholerae. […] Infection begins with the ingestion of food or water contaminated with V cholerae. V cholerae subsequently colonizes the small intestine and produces toxins that induce changes in the electrolyte channels in the small intestine, causing massive fluid and electrolyte loss, clinically manifesting as watery diarrhea.
  • #10 Department of Agriculture | Cholera
    https://www.nj.gov/agriculture/divisions/ah/diseases/cholera.html
    Cholera results from infection by Vibrio cholerae, a Gram negative, facultatively anaerobic rod in the family Vibrionaceae. Two serogroups, 01 and 0139 („Bengal”), can cause disease. Serogroup O1 contains two serologically indistinguishable biotypes, classical and El Tor. Mild or asymptomatic infections are seen more often with the El Tor biotype. Cholera caused by serogroup 0139 emerged in 1992, in epidemics in India and Bangladesh. […] Transmission is by the fecal-oral route. Infections are particularly common after ingesting contaminated water or food. Cases are occasionally seen in people who have eaten raw or undercooked shellfish, particularly oysters, from contaminated waters. […] Cholera can be diagnosed by observing the organisms characteristic motility during direct, bright-field or dark-field microscopic examination of the feces; the addition of specific antibodies to V. cholerae stops the movement.
  • #11 Vibrio cholerae Infection – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK526099/
    V cholerae is a gram-negative, comma-shaped bacterium responsible for causing cholera. […] Transmission of V cholera occurs via the fecal-oral route through contaminated water and food, fomites, and direct contact with infected individuals. […] More than 200 serogroups of V cholerae have been identified, but only the toxigenic strains of V cholera cause cholera, and of those, only serogroups O1 and O139 cause cholera epidemics. […] The O139 Bengal strain of V cholerae acts similarly, except that it has a novel O139 lipopolysaccharide and an immunologically linked O-antigen capsule. […] Cholera is an infectious disease caused by ingesting food or water contaminated by the bacteria V cholerae. […] Infection begins with the ingestion of food or water contaminated with V cholerae. V cholerae subsequently colonizes the small intestine and produces toxins that induce changes in the electrolyte channels in the small intestine, causing massive fluid and electrolyte loss, clinically manifesting as watery diarrhea.
  • #12
    https://www.who.int/news-room/fact-sheets/detail/cholera
    Cholera is an acute diarrheal infection caused by consuming food or water contaminated with the bacterium Vibrio cholerae. […] Cholera is linked to limited access to safe water, basic sanitation facilities and poor hygiene practices. […] Only two serogroups, O1 and O139, cause cholera outbreaks. […] Cholera outbreaks occur regularly in some countries. […] The long-term solution for cholera control lies in economic development and universal access to safe drinking water, basic sanitation and good hygiene practices. […] Cholera is an easily treatable disease. […] Community engagement is essential for effectively communicating the potential risks and symptoms of cholera, precautions to take to avoid cholera, when and where to report cases, and the importance of seeking immediate treatment if symptoms appear.
  • #13 Department of Agriculture | Cholera
    https://www.nj.gov/agriculture/divisions/ah/diseases/cholera.html
    Cholera results from infection by Vibrio cholerae, a Gram negative, facultatively anaerobic rod in the family Vibrionaceae. Two serogroups, 01 and 0139 („Bengal”), can cause disease. Serogroup O1 contains two serologically indistinguishable biotypes, classical and El Tor. Mild or asymptomatic infections are seen more often with the El Tor biotype. Cholera caused by serogroup 0139 emerged in 1992, in epidemics in India and Bangladesh. […] Transmission is by the fecal-oral route. Infections are particularly common after ingesting contaminated water or food. Cases are occasionally seen in people who have eaten raw or undercooked shellfish, particularly oysters, from contaminated waters. […] Cholera can be diagnosed by observing the organisms characteristic motility during direct, bright-field or dark-field microscopic examination of the feces; the addition of specific antibodies to V. cholerae stops the movement.
  • #14 Cholera – Wikipedia
    https://en.wikipedia.org/wiki/Cholera
    About 100 million bacteria must typically be ingested to cause cholera in a normal healthy adult. […] Individuals’ susceptibility to cholera is also affected by their blood type, with those with type O blood being the most susceptible. […] The cholera toxin (CTX or CT) is an oligomeric complex made up of six protein subunits: a single copy of the A subunit (part A), and five copies of the B subunit (part B), connected by a disulfide bond. […] The gene encoding the cholera toxin was introduced into Vibrio cholerae by horizontal gene transfer.
  • #15 Cholera – Wikipedia
    https://en.wikipedia.org/wiki/Cholera
    About 100 million bacteria must typically be ingested to cause cholera in a normal healthy adult. […] Individuals’ susceptibility to cholera is also affected by their blood type, with those with type O blood being the most susceptible. […] The cholera toxin (CTX or CT) is an oligomeric complex made up of six protein subunits: a single copy of the A subunit (part A), and five copies of the B subunit (part B), connected by a disulfide bond. […] The gene encoding the cholera toxin was introduced into Vibrio cholerae by horizontal gene transfer.
  • #16 Cholera: Epidemiology, clinical features, and diagnosis – UpToDate
    https://www.uptodate.com/contents/cholera-epidemiology-clinical-features-and-diagnosis
    Cholera is a life-threatening diarrheal illness caused by cholera toxin-producing strains of Vibrio cholerae. […] The disease cholera is caused by cholera toxin-producing (toxigenic) strains of V. cholerae, which are in serogroups O1 and O139. […] Toxigenic strains harbor the bacteriophage CTXφ, which encodes cholera toxin. […] Cholera is associated with people whose incomes are below federal poverty thresholds and lack of access to safe food, water, and adequate sanitation. […] Cholera occurs primarily in settings where there is inadequate access to clean water and sanitation; it occurs endemically as well as epidemically. […] Each year, there are an estimated 3 million cases of diarrheal illness and approximately 100,000 deaths worldwide caused by Vibrio cholerae. […] The infectious dose of V. cholerae required to cause cholera is thought to be relatively high; an inoculum of 10^8 V. cholerae or higher resulted in severe infection among healthy volunteers.
  • #17 Cholera: Epidemiology, clinical features, and diagnosis – UpToDate
    https://www.uptodate.com/contents/cholera-epidemiology-clinical-features-and-diagnosis
    For infection to occur, V. cholerae must survive the acidic environment of the stomach, then attach to the small intestine and produce cholera toxin. […] Cholera toxin is the main virulence factor of pathogenic V. cholerae strains; it activates an intracellular pathway resulting in massive fluid secretion into the small intestine, leading to large volumes of fluid loss with high concentrations of sodium, chloride, bicarbonate, and potassium.
  • #18 Cholera Causes, Symptoms, Treatment, Vaccine
    https://www.medicinenet.com/cholera/article.htm
    The enterotoxin causes human cells to extract water and electrolytes from the body (mainly the upper gastrointestinal tract — small intestine) and pump it into the intestinal lumen where the fluid and electrolytes are excreted as diarrheal fluid. […] Cholera outbreaks will likely continue to happen.
  • #19 Cholera: Epidemiology, clinical features, and diagnosis – UpToDate
    https://www.uptodate.com/contents/cholera-epidemiology-clinical-features-and-diagnosis
    For infection to occur, V. cholerae must survive the acidic environment of the stomach, then attach to the small intestine and produce cholera toxin. […] Cholera toxin is the main virulence factor of pathogenic V. cholerae strains; it activates an intracellular pathway resulting in massive fluid secretion into the small intestine, leading to large volumes of fluid loss with high concentrations of sodium, chloride, bicarbonate, and potassium.
  • #20
    https://www.atsu.edu/faculty/chamberlain/website/lectures/tritzid/infgas.htm
    V. cholerae is very acid sensitive and the majority of ingested organisms are killed by stomach acidity; it takes ingestion of 108-1010 cells to cause disease. Those few organisms that survive stomach and upper intestinal acidity attach to the microvilli of the glycocalyx of epithelial cells of the jejunum and ileum. There they multiply and liberate cholera enterotoxin, mucinase and endotoxin. They do not invade the mucosa. All signs, symptoms and metabolic derangements in cholera result from the rapid loss of liquid from the gut. […] The increased electrolyte secretion is caused, in the absence of morphologic damage to the gut mucosa, by a protein enterotoxin coded for by a chromosomal gene. The enterotoxin has a molecular mass of 84,000 daltons and consists of a binding (B) moiety and an activating (A) moiety.
  • #21 Cholera | Cause, Symptoms, Treatment, & Prevention | Britannica
    https://www.britannica.com/science/cholera
    The toxin increases the activity of an enzyme that regulates a cellular pumping mechanism that controls the movement of water and electrolytes between the intestine and the circulatory system. […] All of the clinical manifestations of cholera can be attributed to the extreme loss of water and salts. […] The rapid loss of fluid from the bowel can, if untreated, lead to death sometimes within hours in more than 50 percent of those stricken. […] A safe and clean supply of water is the key to cholera prevention. […] Methods have been developed to test and monitor environmental water supplies for the presence of V. cholerae. […] Another important intervention is the hygienic disposal of human waste. […] The first time that a vaccine against cholera was used in humans was in 1885, when an injectable agent containing a weakened form of V. cholerae was used to limit the disease’s spread during an outbreak in Valencia, Spain.
  • #22 Cholera | Cause, Symptoms, Treatment, & Prevention | Britannica
    https://www.britannica.com/science/cholera
    The toxin increases the activity of an enzyme that regulates a cellular pumping mechanism that controls the movement of water and electrolytes between the intestine and the circulatory system. […] All of the clinical manifestations of cholera can be attributed to the extreme loss of water and salts. […] The rapid loss of fluid from the bowel can, if untreated, lead to death sometimes within hours in more than 50 percent of those stricken. […] A safe and clean supply of water is the key to cholera prevention. […] Methods have been developed to test and monitor environmental water supplies for the presence of V. cholerae. […] Another important intervention is the hygienic disposal of human waste. […] The first time that a vaccine against cholera was used in humans was in 1885, when an injectable agent containing a weakened form of V. cholerae was used to limit the disease’s spread during an outbreak in Valencia, Spain.
  • #23
    https://www.atsu.edu/faculty/chamberlain/website/lectures/tritzid/infgas.htm
    V. cholerae is very acid sensitive and the majority of ingested organisms are killed by stomach acidity; it takes ingestion of 108-1010 cells to cause disease. Those few organisms that survive stomach and upper intestinal acidity attach to the microvilli of the glycocalyx of epithelial cells of the jejunum and ileum. There they multiply and liberate cholera enterotoxin, mucinase and endotoxin. They do not invade the mucosa. All signs, symptoms and metabolic derangements in cholera result from the rapid loss of liquid from the gut. […] The increased electrolyte secretion is caused, in the absence of morphologic damage to the gut mucosa, by a protein enterotoxin coded for by a chromosomal gene. The enterotoxin has a molecular mass of 84,000 daltons and consists of a binding (B) moiety and an activating (A) moiety.
  • #24 Cholera – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/cholera/symptoms-causes/syc-20355287
    Cholera is a disease that is caused by bacteria. Most often, it spreads through water that’s been tainted with bacteria. It also can spread through tainted food. […] A type of bacteria called Vibrio cholerae causes cholera infection. The deadly effects of the disease are the result of a toxin the bacteria make in the small intestine. The toxin causes the body to purge huge amounts of water. This leads to diarrhea and a rapid loss of fluids and salts. […] Cholera bacteria might not cause illness in all people who are exposed to them. But infected people still pass the bacteria in their stool, which can taint food and water supplies. […] Tainted water supplies are the main source of cholera infection. The bacteria can be found in: Surface or well water. Tainted public wells are frequent sources of large-scale cholera outbreaks.
  • #25 Cholera – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/cholera/symptoms-causes/syc-20355287
    Cholera is a disease that is caused by bacteria. Most often, it spreads through water that’s been tainted with bacteria. It also can spread through tainted food. […] A type of bacteria called Vibrio cholerae causes cholera infection. The deadly effects of the disease are the result of a toxin the bacteria make in the small intestine. The toxin causes the body to purge huge amounts of water. This leads to diarrhea and a rapid loss of fluids and salts. […] Cholera bacteria might not cause illness in all people who are exposed to them. But infected people still pass the bacteria in their stool, which can taint food and water supplies. […] Tainted water supplies are the main source of cholera infection. The bacteria can be found in: Surface or well water. Tainted public wells are frequent sources of large-scale cholera outbreaks.
  • #26 Cholera: Causes and How It Spreads | Cholera | CDC
    https://www.cdc.gov/cholera/causes/index.html
    People can get cholera by drinking water or eating food contaminated with cholera bacteria. […] Cholera can spread quickly in areas where sewage and drinking water aren’t adequately treated. […] Cholera bacteria also can live in brackish (slightly salty) and coastal waters. Eating raw shellfish like shrimp and crab can be a source of cholera. […] Cholera is caused by the bacteria Vibrio cholerae.
  • #27 About Cholera | Cholera | CDC
    https://www.cdc.gov/cholera/about/index.html
    Cholera is a bacterial disease spread through contaminated water and food. […] Cholera is an infection of the intestines caused by the bacterium Vibrio cholerae. You can get cholera from drinking water or eating food containing cholera bacteria. […] Cholera can cause life-threatening watery diarrhea and vomiting. […] People living in areas with unsafe drinking water, poor sanitation, and inadequate hygiene are at highest risk of getting cholera. […] People usually get cholera from drinking water or eating food that contains traces of poop from someone with cholera. […] Cholera bacteria also can live in brackish (slightly salty) and coastal waters. Eating raw shellfish can cause cholera. […] Cholera, caused by the bacteria Vibrio cholerae, is rare in the US and other industrialized nations. Cholera can be life-threatening, but it is easily prevented and treated.
  • #28 How Does Cholera Cause Diarrhea? | Passport Health
    https://www.passporthealthusa.com/2022/01/how-does-cholera-cause-diarrhea/
    Cholera causes severe diarrhea in many cases. […] Caused by the bacterium Vibrio cholerae, cholera is an acute infectious disease. […] The bacteria start to produce toxic proteins which disrupt your small intestines regular functions and cause the small intestine to start to secrete fluid. […] The severity of the disease differs from strain to strain. But, they can all cause the body to secrete enormous amounts of water, leading to watery diarrhea and rapid loss of fluids and electrolytes.
  • #29 Vibrio cholerae Infection – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK526099/
    Cholera is an acute secretory diarrhea caused by toxigenic strains of Vibrio cholerae, a gram-negative, comma-shaped bacterium. […] Cholera is characterized by severe, acute, large-volume, watery diarrhea resulting in rapid dehydration and is associated with high mortality if not treated promptly. […] Transmission occurs via the fecal-oral route through contaminated water or food. […] Toxigenic strains of Vibrio cholerae are a major cause of acute, severe, dehydrating diarrhea in low- and middle-income countries with unsatisfactory hygienic conditions and those affected by natural disasters and humanitarian crises. […] V cholerae is transmitted through the fecal-oral route by contaminated water or food. Risk factors for acquiring V cholera include poverty, inadequate sanitation, contaminated water, and food.
  • #30 Causes and Symptoms of Cholera – MN Dept. of Health
    https://www.health.state.mn.us/diseases/cholera/basics.html
    Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae. […] A person may get cholera by drinking water or eating food contaminated with the cholera bacterium. […] The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. […] The cholera bacterium may also live in the environment in brackish rivers and coastal waters. […] The disease is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk for becoming ill.
  • #31
    https://continentalhospitals.com/diseases/cholera/
    Cholera is an acute diarrheal disease caused by the bacterium Vibrio cholerae. […] Cholera infection can lead to severe dehydration and electrolyte imbalances, resulting in rapid and potentially fatal fluid loss. […] Contaminated Water: Ingesting water contaminated with human feces containing the cholera bacterium is a common mode of transmission. […] Poor Sanitation: Inadequate sewage disposal and lack of access to clean drinking water contribute to the spread of cholera. […] Unhygienic Food Handling: Consuming raw or undercooked seafood, fruits, and vegetables irrigated with contaminated water can transmit the bacterium. […] Crowded Living Conditions: Overcrowded and unsanitary living environments facilitate the rapid spread of cholera among communities. […] Natural Disasters: Cholera outbreaks often occur in the aftermath of natural disasters, such as floods or earthquakes, which disrupt sanitation infrastructure and contaminate water sources.
  • #32
    https://byjus.com/biology/cholera/
    Cholera is a bacterial disease caused by the bacterium Vibrio cholerae. This type of bacteria is usually present in contaminated foods. […] Vibrio cholerae is the causative agent of the disease. […] It is caused due to factors like contaminated water supply. […] It arises due to the consumption of contaminated foods and drinks. […] The vegetables that are grown with the use of water with human wastes. […] The consumption of contaminated sea foods, which are polluted with sewage. […] Caused by the consumption of foods that affect the digestive system.
  • #33 Cholera: Causes, Symptoms, Treatment, and Prevention
    https://www.webmd.com/a-to-z-guides/cholera-faq
    Cholera is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae. […] Vibrio cholerae is usually found in food or water contaminated by feces from a person with the infection. […] Common sources of cholera bacteria include public water supplies, foods and drinks sold by street vendors, raw vegetables, raw or undercooked fish and seafood, and grains. […] When a person consumes the contaminated food or water, the bacteria release a toxin in the intestines that produces severe diarrhea. […] Cholera is contagious, but doesn’t spread through casual contact with someone, like coughing or sneezing. To get cholera, you have to drink water, or eat food prepared with water, that has been contaminated with the bacteria. […] According to the World Health Organization, there are between 1.3 million and 4 million cases of cholera worldwide each year.
  • #34 Cholera Causes, Symptoms, Diagnosis and Treatment – Cura4U
    https://cura4u.com/conditions/cholera
    Cholera is an acute illness that involves intestinal infection caused by bacteria named Vibrio Cholera. It is a bacterial infection spread by drinking contaminated water. Cholera causes dehydration and severe diarrhea. […] The bacterium Vibrio Cholera is present in contaminated food and water from where it can be transmitted to the population. This bacterium produces toxins in the intestine that releases water and create electrolyte imbalance in the body. This imbalance causes symptoms to appear. […] The leading cause of cholera infection is contaminated water supply. […] Cholera bacteria can be spread by eating raw or undercooked seafood. […] In cholera-affected areas, raw fruits and vegetables are a common cause of cholera infection due to uncomposted manure fertilizers or irrigation water containing raw sewage that may contaminate the fields. […] In areas where cholera is prevalent, grains such as rice and millet can produce cholera bacteria if they are contaminated after cooking and stored at room temperature for many hours.
  • #35 Cholera: Causes, Symptoms, Treatment, and Prevention
    https://www.webmd.com/a-to-z-guides/cholera-faq
    Cholera is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae. […] Vibrio cholerae is usually found in food or water contaminated by feces from a person with the infection. […] Common sources of cholera bacteria include public water supplies, foods and drinks sold by street vendors, raw vegetables, raw or undercooked fish and seafood, and grains. […] When a person consumes the contaminated food or water, the bacteria release a toxin in the intestines that produces severe diarrhea. […] Cholera is contagious, but doesn’t spread through casual contact with someone, like coughing or sneezing. To get cholera, you have to drink water, or eat food prepared with water, that has been contaminated with the bacteria. […] According to the World Health Organization, there are between 1.3 million and 4 million cases of cholera worldwide each year.
  • #36 Causes and Symptoms of Cholera – MN Dept. of Health
    https://www.health.state.mn.us/diseases/cholera/basics.html
    Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae. […] A person may get cholera by drinking water or eating food contaminated with the cholera bacterium. […] The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. […] The cholera bacterium may also live in the environment in brackish rivers and coastal waters. […] The disease is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk for becoming ill.
  • #37
    https://www.who.int/news-room/fact-sheets/detail/cholera
    Cholera is an acute diarrheal infection caused by consuming food or water contaminated with the bacterium Vibrio cholerae. […] Cholera is linked to limited access to safe water, basic sanitation facilities and poor hygiene practices. […] Only two serogroups, O1 and O139, cause cholera outbreaks. […] Cholera outbreaks occur regularly in some countries. […] The long-term solution for cholera control lies in economic development and universal access to safe drinking water, basic sanitation and good hygiene practices. […] Cholera is an easily treatable disease. […] Community engagement is essential for effectively communicating the potential risks and symptoms of cholera, precautions to take to avoid cholera, when and where to report cases, and the importance of seeking immediate treatment if symptoms appear.
  • #38
    https://continentalhospitals.com/diseases/cholera/
    Cholera is an acute diarrheal disease caused by the bacterium Vibrio cholerae. […] Cholera infection can lead to severe dehydration and electrolyte imbalances, resulting in rapid and potentially fatal fluid loss. […] Contaminated Water: Ingesting water contaminated with human feces containing the cholera bacterium is a common mode of transmission. […] Poor Sanitation: Inadequate sewage disposal and lack of access to clean drinking water contribute to the spread of cholera. […] Unhygienic Food Handling: Consuming raw or undercooked seafood, fruits, and vegetables irrigated with contaminated water can transmit the bacterium. […] Crowded Living Conditions: Overcrowded and unsanitary living environments facilitate the rapid spread of cholera among communities. […] Natural Disasters: Cholera outbreaks often occur in the aftermath of natural disasters, such as floods or earthquakes, which disrupt sanitation infrastructure and contaminate water sources.
  • #39
    https://continentalhospitals.com/diseases/cholera/
    Cholera is an acute diarrheal disease caused by the bacterium Vibrio cholerae. […] Cholera infection can lead to severe dehydration and electrolyte imbalances, resulting in rapid and potentially fatal fluid loss. […] Contaminated Water: Ingesting water contaminated with human feces containing the cholera bacterium is a common mode of transmission. […] Poor Sanitation: Inadequate sewage disposal and lack of access to clean drinking water contribute to the spread of cholera. […] Unhygienic Food Handling: Consuming raw or undercooked seafood, fruits, and vegetables irrigated with contaminated water can transmit the bacterium. […] Crowded Living Conditions: Overcrowded and unsanitary living environments facilitate the rapid spread of cholera among communities. […] Natural Disasters: Cholera outbreaks often occur in the aftermath of natural disasters, such as floods or earthquakes, which disrupt sanitation infrastructure and contaminate water sources.
  • #40
    https://continentalhospitals.com/diseases/cholera/
    Drinking or using water contaminated with Vibrio cholerae bacteria is the primary mode of transmission. […] Lack of adequate sanitation facilities increases the risk of cholera transmission. […] Cholera outbreaks are more common in areas with warm temperatures, flooding, or natural disasters, which can contaminate water sources. […] Limited access to healthcare facilities for prompt diagnosis and treatment exacerbates the severity of cholera outbreaks. […] Cholera is usually spread through contaminated water or food. Consuming water or food contaminated with the Vibrio cholerae bacterium is the most common way of getting infected. Poor sanitation and hygiene practices contribute significantly to its spread. […] Cholera remains a significant health concern in many parts of the world, especially in areas with poor sanitation and limited access to clean water.
  • #41 Cholera: Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/962643-overview
    Malnutrition increases susceptibility to cholera. Because gastric acid can quickly render an inoculum of V cholerae noninfectious before it reaches the site of colonization in the small bowel, hydrochlorhydria or achlorhydria of any cause (including Helicobacter pylori infection, gastric surgery, vagotomy, use of H2 blockers for ulcer disease) increases susceptibility. […] The incidence of cholera appears to be twice as high in people with type O blood. The reason for this increased susceptibility is unknown. […] An attack of the classic biotype of V cholerae usually results in the generation of antibodies that protect against recurrent infection by either biotype. Those who have had El Tor cholera are not protected against further attacks. Attacks of V cholerae 01 do not lead to immunity against V cholerae 0139.
  • #42 Cholera: Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/962643-overview
    Malnutrition increases susceptibility to cholera. Because gastric acid can quickly render an inoculum of V cholerae noninfectious before it reaches the site of colonization in the small bowel, hydrochlorhydria or achlorhydria of any cause (including Helicobacter pylori infection, gastric surgery, vagotomy, use of H2 blockers for ulcer disease) increases susceptibility. […] The incidence of cholera appears to be twice as high in people with type O blood. The reason for this increased susceptibility is unknown. […] An attack of the classic biotype of V cholerae usually results in the generation of antibodies that protect against recurrent infection by either biotype. Those who have had El Tor cholera are not protected against further attacks. Attacks of V cholerae 01 do not lead to immunity against V cholerae 0139.
  • #43 Cholera: Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/962643-overview
    Malnutrition increases susceptibility to cholera. Because gastric acid can quickly render an inoculum of V cholerae noninfectious before it reaches the site of colonization in the small bowel, hydrochlorhydria or achlorhydria of any cause (including Helicobacter pylori infection, gastric surgery, vagotomy, use of H2 blockers for ulcer disease) increases susceptibility. […] The incidence of cholera appears to be twice as high in people with type O blood. The reason for this increased susceptibility is unknown. […] An attack of the classic biotype of V cholerae usually results in the generation of antibodies that protect against recurrent infection by either biotype. Those who have had El Tor cholera are not protected against further attacks. Attacks of V cholerae 01 do not lead to immunity against V cholerae 0139.
  • #44 Cholera: Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/962643-overview
    Malnutrition increases susceptibility to cholera. Because gastric acid can quickly render an inoculum of V cholerae noninfectious before it reaches the site of colonization in the small bowel, hydrochlorhydria or achlorhydria of any cause (including Helicobacter pylori infection, gastric surgery, vagotomy, use of H2 blockers for ulcer disease) increases susceptibility. […] The incidence of cholera appears to be twice as high in people with type O blood. The reason for this increased susceptibility is unknown. […] An attack of the classic biotype of V cholerae usually results in the generation of antibodies that protect against recurrent infection by either biotype. Those who have had El Tor cholera are not protected against further attacks. Attacks of V cholerae 01 do not lead to immunity against V cholerae 0139.
  • #45 Cholera: Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/962643-overview
    Malnutrition increases susceptibility to cholera. Because gastric acid can quickly render an inoculum of V cholerae noninfectious before it reaches the site of colonization in the small bowel, hydrochlorhydria or achlorhydria of any cause (including Helicobacter pylori infection, gastric surgery, vagotomy, use of H2 blockers for ulcer disease) increases susceptibility. […] The incidence of cholera appears to be twice as high in people with type O blood. The reason for this increased susceptibility is unknown. […] An attack of the classic biotype of V cholerae usually results in the generation of antibodies that protect against recurrent infection by either biotype. Those who have had El Tor cholera are not protected against further attacks. Attacks of V cholerae 01 do not lead to immunity against V cholerae 0139.
  • #46 Cholera – Wikipedia
    https://en.wikipedia.org/wiki/Cholera
    About 100 million bacteria must typically be ingested to cause cholera in a normal healthy adult. […] Individuals’ susceptibility to cholera is also affected by their blood type, with those with type O blood being the most susceptible. […] The cholera toxin (CTX or CT) is an oligomeric complex made up of six protein subunits: a single copy of the A subunit (part A), and five copies of the B subunit (part B), connected by a disulfide bond. […] The gene encoding the cholera toxin was introduced into Vibrio cholerae by horizontal gene transfer.
  • #47 Cholera: Causes, Symptoms, Diagnosis, Treatment & Risk Factors
    https://www.prepladder.com/neet-pg-study-material/microbiology/cholera-causes-symptoms-types-of-carriers-risk-factors-diagnosis-treatment
    The cholera bacteria cannot survive in conditions that are highly acidic. […] Serious sickness is more likely to affect those with type O blood. This might be because type O blood has a greater sensitivity to CTX than other blood types. […] There is a higher risk of developing cholera if you consume shellfish from waters that have cholera bacteria present.
  • #48 Cholera: Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/962643-overview
    Malnutrition increases susceptibility to cholera. Because gastric acid can quickly render an inoculum of V cholerae noninfectious before it reaches the site of colonization in the small bowel, hydrochlorhydria or achlorhydria of any cause (including Helicobacter pylori infection, gastric surgery, vagotomy, use of H2 blockers for ulcer disease) increases susceptibility. […] The incidence of cholera appears to be twice as high in people with type O blood. The reason for this increased susceptibility is unknown. […] An attack of the classic biotype of V cholerae usually results in the generation of antibodies that protect against recurrent infection by either biotype. Those who have had El Tor cholera are not protected against further attacks. Attacks of V cholerae 01 do not lead to immunity against V cholerae 0139.
  • #49 Cholera: Epidemiology, clinical features, and diagnosis – UpToDate
    https://www.uptodate.com/contents/cholera-epidemiology-clinical-features-and-diagnosis
    Cholera is a life-threatening diarrheal illness caused by cholera toxin-producing strains of Vibrio cholerae. […] The disease cholera is caused by cholera toxin-producing (toxigenic) strains of V. cholerae, which are in serogroups O1 and O139. […] Toxigenic strains harbor the bacteriophage CTXφ, which encodes cholera toxin. […] Cholera is associated with people whose incomes are below federal poverty thresholds and lack of access to safe food, water, and adequate sanitation. […] Cholera occurs primarily in settings where there is inadequate access to clean water and sanitation; it occurs endemically as well as epidemically. […] Each year, there are an estimated 3 million cases of diarrheal illness and approximately 100,000 deaths worldwide caused by Vibrio cholerae. […] The infectious dose of V. cholerae required to cause cholera is thought to be relatively high; an inoculum of 10^8 V. cholerae or higher resulted in severe infection among healthy volunteers.
  • #50 Causes of Cholera – LIFEWAY medical diagnostics
    https://lifewaydiagnostic.com/causes-of-cholera/
    Cholera is an acute infectious disease caused by the bacterium Vibrio cholerae. It is primarily transmitted through the consumption of contaminated water or food, leading to severe, watery diarrhea that can rapidly result in dehydration and, if left untreated, death. […] The current cholera outbreak can be attributed to several interconnected factors: […] Inadequate access to clean water and poor sanitation systems are the primary drivers of cholera transmission. […] Natural disasters, such as floods and earthquakes, can disrupt water and sanitation systems, creating conditions ripe for cholera outbreaks. […] Cholera disproportionately affects impoverished communities with limited access to basic healthcare, clean water, and proper sanitation facilities. […] Changing environmental conditions, such as rising temperatures and extreme weather events, can contribute to the proliferation of Vibrio cholera bacteria and the expansion of choleras geographic range. […] Addressing the underlying water, sanitation, and hygiene issues is key to the long-term prevention of cholera.
  • #51
    https://continentalhospitals.com/diseases/cholera/
    Cholera is an acute diarrheal disease caused by the bacterium Vibrio cholerae. […] Cholera infection can lead to severe dehydration and electrolyte imbalances, resulting in rapid and potentially fatal fluid loss. […] Contaminated Water: Ingesting water contaminated with human feces containing the cholera bacterium is a common mode of transmission. […] Poor Sanitation: Inadequate sewage disposal and lack of access to clean drinking water contribute to the spread of cholera. […] Unhygienic Food Handling: Consuming raw or undercooked seafood, fruits, and vegetables irrigated with contaminated water can transmit the bacterium. […] Crowded Living Conditions: Overcrowded and unsanitary living environments facilitate the rapid spread of cholera among communities. […] Natural Disasters: Cholera outbreaks often occur in the aftermath of natural disasters, such as floods or earthquakes, which disrupt sanitation infrastructure and contaminate water sources.
  • #52
    https://continentalhospitals.com/diseases/cholera/
    Drinking or using water contaminated with Vibrio cholerae bacteria is the primary mode of transmission. […] Lack of adequate sanitation facilities increases the risk of cholera transmission. […] Cholera outbreaks are more common in areas with warm temperatures, flooding, or natural disasters, which can contaminate water sources. […] Limited access to healthcare facilities for prompt diagnosis and treatment exacerbates the severity of cholera outbreaks. […] Cholera is usually spread through contaminated water or food. Consuming water or food contaminated with the Vibrio cholerae bacterium is the most common way of getting infected. Poor sanitation and hygiene practices contribute significantly to its spread. […] Cholera remains a significant health concern in many parts of the world, especially in areas with poor sanitation and limited access to clean water.
  • #53 Cholera | The deadly disease explained | British Red Cross
    https://www.redcross.org.uk/stories/health-and-social-care/health/cholera-the-deadly-disease-explained
    Cholera is a bacterial infection that’s spread when people consume contaminated food or water it is nearly always waterborne. […] Cholera is typically most prevalent in communities with poor infrastructure or during humanitarian emergencies, such as earthquakes, where there is a lack of clean water, poor hygiene and limited access to healthcare. […] Typically, cholera is spread through the consumption of food or water contaminated with the bacteria, Vibrio cholerae. […] This means the disease can spread rapidly in areas without adequate water treatment, facilities or hygiene. […] Cholera has a short incubation period, between two hours and five days, before symptoms begin. […] Its important to note that even if people do not display symptoms, the bacterium, Vibrio cholerae, stays in their faeces for up to two weeks. […] The main causes of cholera are contaminated water or food, so maintaining personal hygiene and access to uncontaminated food and water is paramount. […] In Yemen, for example, conflict has destroyed essential infrastructure, and poor conditions mean that cholera has taken hold.
  • #54 Cholera – Wikipedia
    https://en.wikipedia.org/wiki/Cholera
    About 100 million bacteria must typically be ingested to cause cholera in a normal healthy adult. […] Individuals’ susceptibility to cholera is also affected by their blood type, with those with type O blood being the most susceptible. […] The cholera toxin (CTX or CT) is an oligomeric complex made up of six protein subunits: a single copy of the A subunit (part A), and five copies of the B subunit (part B), connected by a disulfide bond. […] The gene encoding the cholera toxin was introduced into Vibrio cholerae by horizontal gene transfer.
  • #55 Cholera: Epidemiology, clinical features, and diagnosis – UpToDate
    https://www.uptodate.com/contents/cholera-epidemiology-clinical-features-and-diagnosis
    Cholera is a life-threatening diarrheal illness caused by cholera toxin-producing strains of Vibrio cholerae. […] The disease cholera is caused by cholera toxin-producing (toxigenic) strains of V. cholerae, which are in serogroups O1 and O139. […] Toxigenic strains harbor the bacteriophage CTXφ, which encodes cholera toxin. […] Cholera is associated with people whose incomes are below federal poverty thresholds and lack of access to safe food, water, and adequate sanitation. […] Cholera occurs primarily in settings where there is inadequate access to clean water and sanitation; it occurs endemically as well as epidemically. […] Each year, there are an estimated 3 million cases of diarrheal illness and approximately 100,000 deaths worldwide caused by Vibrio cholerae. […] The infectious dose of V. cholerae required to cause cholera is thought to be relatively high; an inoculum of 10^8 V. cholerae or higher resulted in severe infection among healthy volunteers.
  • #56 Cholera – Infectious Diseases – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/infectious-diseases/gram-negative-bacilli/cholera
    Cholera is an acute infection of the small bowel caused by the gram-negative bacterium Vibrio cholerae. The causative organism, V. cholerae, is a short, curved, motile, aerobic, gram-negative bacillus that produces enterotoxin, a protein that induces hypersecretion of an isotonic electrolyte solution by the small-bowel mucosa. Cholera epidemics are caused only by V. cholerae serogroups O1 and O139. Cholera is spread by ingestion of water, shellfish, or other foods contaminated by the excrement of people with symptomatic or asymptomatic infection. […] Infection is typically through contaminated water or shellfish. […] Humans are the only known natural host for V. cholerae. […] These organisms do not invade the intestinal wall; thus, few or no white blood cells are found in stool. […] Susceptibility to infection varies and is greater for people with blood type O. […] Because vibrios are sensitive to gastric acid, hypochlorhydria and achlorhydria are predisposing factors, including in patients taking gastric acid-suppressing medications. […] People living in endemic areas gradually acquire a natural immunity.
  • #57
    https://www.atsu.edu/faculty/chamberlain/website/lectures/tritzid/infgas.htm
    V. cholerae is very acid sensitive and the majority of ingested organisms are killed by stomach acidity; it takes ingestion of 108-1010 cells to cause disease. Those few organisms that survive stomach and upper intestinal acidity attach to the microvilli of the glycocalyx of epithelial cells of the jejunum and ileum. There they multiply and liberate cholera enterotoxin, mucinase and endotoxin. They do not invade the mucosa. All signs, symptoms and metabolic derangements in cholera result from the rapid loss of liquid from the gut. […] The increased electrolyte secretion is caused, in the absence of morphologic damage to the gut mucosa, by a protein enterotoxin coded for by a chromosomal gene. The enterotoxin has a molecular mass of 84,000 daltons and consists of a binding (B) moiety and an activating (A) moiety.
  • #58 Cholera, Vibrio cholerae O1 and O139, and Other Pathogenic Vibrios – Medical Microbiology – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK8407/
    Cholera appears to exhibit three major epidemiologic patterns: heavily endemic, neoepidemic (newly invaded, cholera-receptive areas), and, in developed countries with good sanitation, occasional limited outbreaks. […] Like smallpox and typhoid, cholera under natural circumstances appears to affect only humans; therefore, Vibrio cholerae as an etiologic entity could conceivably disappear with the last human infection.
  • #59 Cholera, Vibrio cholerae O1 and O139, and Other Pathogenic Vibrios – Medical Microbiology – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK8407/
    Cholera appears to exhibit three major epidemiologic patterns: heavily endemic, neoepidemic (newly invaded, cholera-receptive areas), and, in developed countries with good sanitation, occasional limited outbreaks. […] Like smallpox and typhoid, cholera under natural circumstances appears to affect only humans; therefore, Vibrio cholerae as an etiologic entity could conceivably disappear with the last human infection.
  • #60 Cholera, Vibrio cholerae O1 and O139, and Other Pathogenic Vibrios – Medical Microbiology – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK8407/
    Cholera appears to exhibit three major epidemiologic patterns: heavily endemic, neoepidemic (newly invaded, cholera-receptive areas), and, in developed countries with good sanitation, occasional limited outbreaks. […] Like smallpox and typhoid, cholera under natural circumstances appears to affect only humans; therefore, Vibrio cholerae as an etiologic entity could conceivably disappear with the last human infection.
  • #61 Cholera: Facts, FAQs, and how to help | World Vision
    https://www.worldvision.org/clean-water-news-stories/what-is-cholera-facts
    Cholera is an intestinal infection caused by Vibrio cholerae bacteria. Most people get it by consuming or coming in contact with contaminated water or food. Cholera may cause extreme diarrhea, which can lead to dehydration and even death. […] Cholera is most common in developing countries with poor sanitation and inadequate access to clean water. According to the WHO, cholera is now endemic in many countries, mostly in sub-Saharan Africa, South Asia, and the Americas. […] Natural disasters floods, hurricanes, and earthquakes can damage water and sanitation infrastructure, leading to contaminated water sources and poor sanitation conditions. The disruption creates ideal conditions for transmitting cholera bacteria. […] Cholera spreads through contaminated water and food. The bacterium responsible for cholera can survive in water for long periods and infect humans who consume the contaminated water or food. Poor sanitation, inadequate sewage disposal, and a lack of clean drinking water can all contribute to the spread of cholera. […] Access to clean water, sanitation, and hygiene behavior resources is critical to prevent and control cholera and other waterborne diseases.
  • #62 Cholera (for Teens) | Nemours KidsHealth
    https://kidshealth.org/en/teens/cholera.html
    Cholera is a bacterial infection of the intestines. […] People get it from drinking water or eating food that’s contaminated with a type of bacteria called Vibrio cholerae. […] Cholera is mostly found in the tropics in particular Asia, Africa, Latin America, India, and the Middle East. […] People get cholera from eating or drinking food or water that’s been contaminated with the feces (poop) of someone who has cholera. […] Cholera epidemics can also sometimes happen after a disaster (like an earthquake or flood) if people are living in tent cities or other places without running water or proper sanitation systems. […] Cholera is not likely to spread through direct contact with an infected person.
  • #63 Cholera: Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/962643-overview
    Cholera can be an endemic, epidemic, or a pandemic disease. Initiation and maintenance of epidemic and pandemic disease by V cholerae result from human infection and poor sanitation with assistance from human migration and seasonal warming of coastal waters. […] Owing to the relatively large infectious dose, transmission occurs almost exclusively via contaminated water or food. V cholerae O1 has been shown to survive in crabs boiled for 8 minutes, but not in crabs boiled for 10 minutes. Transmission via direct person-to-person contact is rare. […] Cholera has 2 main reservoirs, humans and water. V cholerae is rarely isolated from animals, and animals do not play a role in transmission of disease. […] Infection rates predictably are highest in communities in which water is not potable and personal and community hygiene standards are low.
  • #64 Cholera, Vibrio cholerae O1 and O139, and Other Pathogenic Vibrios – Medical Microbiology – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK8407/
    Cholera appears to exhibit three major epidemiologic patterns: heavily endemic, neoepidemic (newly invaded, cholera-receptive areas), and, in developed countries with good sanitation, occasional limited outbreaks. […] Like smallpox and typhoid, cholera under natural circumstances appears to affect only humans; therefore, Vibrio cholerae as an etiologic entity could conceivably disappear with the last human infection.
  • #65 Cholera: Causes, Symptoms, Treatments And More
    https://www.lybrate.com/topic/cholera
    Cholera is defined as an water-borne disease occurring due to causative bacterium, Vibrio cholera. […] Vibrio cholera named bacteria is found as basic cause behind cholera disease that naturally occurs in coastal water where they attached to tiny crustaceans called cope-pods. […] Poor sanitation conditions, reduced or nonexistent stomach acid as hypochlorhydria or achlorhydria conditions, household exposure, consumption of food contaminated with feces containing such bacteria can be considered as origin of cholera disease. […] Cholera is a disease that is caused by Vibrio cholera bacterium found in water of coastal region.
  • #66 Cholera – NICD
    https://www.nicd.ac.za/diseases-a-z-index/cholera/
    Cholera is a bacterial disease usually spread through contaminated water. Cholera causes severe diarrhoea and dehydration. Left untreated, cholera can be fatal in a matter of hours, even in previously healthy people. Most people exposed to the cholera bacterium (Vibrio cholerae) dont become ill and never know theyve been infected. Yet because they shed cholera bacteria in their stool for seven to 14 days, they can still infect others through contaminated water. […] Most symptomatic cases of cholera cause mild or moderate diarrhoea thats often hard to distinguish from diarrhoea caused by other problems.
  • #67
    https://www.who.int/health-topics/cholera
    Cholera is an acute diarrhoeal infection caused by eating or drinking food or water that is contaminated with the bacterium Vibrio cholerae. […] Cholera is an extremely serious disease that can cause severe acute watery diarrhoea with severe dehydration. […] Most people infected with Vibrio cholerae do not develop any symptoms, although the bacteria are present in their faeces for 1-10 days after infection. […] Cholera is often predictable and preventable. […] Measures for the prevention of cholera mostly consist of providing clean water and proper sanitation to populations who do not yet have access to basic services, as well as vaccination with Oral Cholera Vaccines. […] OCV are safe and effective and are just one tool in a much larger toolbox that includes sustainable safe water, sanitation, and hygiene (WASH), but serve as a critical bridge to these longer-term efforts.
  • #68 How Does Cholera Cause Diarrhea? | Passport Health
    https://www.passporthealthusa.com/2022/01/how-does-cholera-cause-diarrhea/
    Cholera causes severe diarrhea in many cases. […] Caused by the bacterium Vibrio cholerae, cholera is an acute infectious disease. […] The bacteria start to produce toxic proteins which disrupt your small intestines regular functions and cause the small intestine to start to secrete fluid. […] The severity of the disease differs from strain to strain. But, they can all cause the body to secrete enormous amounts of water, leading to watery diarrhea and rapid loss of fluids and electrolytes.
  • #69
    https://www.who.int/news-room/fact-sheets/detail/cholera
    Cholera is an acute diarrheal infection caused by consuming food or water contaminated with the bacterium Vibrio cholerae. […] Cholera is linked to limited access to safe water, basic sanitation facilities and poor hygiene practices. […] Only two serogroups, O1 and O139, cause cholera outbreaks. […] Cholera outbreaks occur regularly in some countries. […] The long-term solution for cholera control lies in economic development and universal access to safe drinking water, basic sanitation and good hygiene practices. […] Cholera is an easily treatable disease. […] Community engagement is essential for effectively communicating the potential risks and symptoms of cholera, precautions to take to avoid cholera, when and where to report cases, and the importance of seeking immediate treatment if symptoms appear.
  • #70 Cholera: Causes, Symptoms, Treatment & Prevention
    https://my.clevelandclinic.org/health/diseases/16636-cholera
    Cholera is a disease you get from bacteria (Vibrio cholerae) in contaminated shellfish or water. […] Cholera can cause sudden, severe diarrhea that causes you to lose fluids quickly. It can be fatal if you get dehydrated. […] The bacteria Vibrio cholerae (V. cholerae) causes cholera. V. cholerae live in warm, mildly salty (brackish) water. When you drink water or eat food contaminated with V. cholerae, the bacteria stick to the walls of your small intestine. There, they release toxins that cause diarrhea. […] Outbreaks of cholera are more likely to happen in areas without running water, toileting facilities or ways to sanitize drinking and cooking water. […] Cholera is dangerous because of the risk of dehydration and losing electrolytes. This can cause complications that can quickly be fatal, including: Hypovolemic shock, Heart rhythm issues, Organ failure. […] With treatment managing fluids to prevent dehydration the mortality (death) rate of cholera is less than 1%. Without treatment, its over 50%.
  • #71 Cholera | Cause, Symptoms, Treatment, & Prevention | Britannica
    https://www.britannica.com/science/cholera
    The toxin increases the activity of an enzyme that regulates a cellular pumping mechanism that controls the movement of water and electrolytes between the intestine and the circulatory system. […] All of the clinical manifestations of cholera can be attributed to the extreme loss of water and salts. […] The rapid loss of fluid from the bowel can, if untreated, lead to death sometimes within hours in more than 50 percent of those stricken. […] A safe and clean supply of water is the key to cholera prevention. […] Methods have been developed to test and monitor environmental water supplies for the presence of V. cholerae. […] Another important intervention is the hygienic disposal of human waste. […] The first time that a vaccine against cholera was used in humans was in 1885, when an injectable agent containing a weakened form of V. cholerae was used to limit the disease’s spread during an outbreak in Valencia, Spain.
  • #72
    https://www.who.int/news-room/fact-sheets/detail/cholera
    Cholera is an acute diarrheal infection caused by consuming food or water contaminated with the bacterium Vibrio cholerae. […] Cholera is linked to limited access to safe water, basic sanitation facilities and poor hygiene practices. […] Only two serogroups, O1 and O139, cause cholera outbreaks. […] Cholera outbreaks occur regularly in some countries. […] The long-term solution for cholera control lies in economic development and universal access to safe drinking water, basic sanitation and good hygiene practices. […] Cholera is an easily treatable disease. […] Community engagement is essential for effectively communicating the potential risks and symptoms of cholera, precautions to take to avoid cholera, when and where to report cases, and the importance of seeking immediate treatment if symptoms appear.
  • #73
    https://www.who.int/news-room/fact-sheets/detail/cholera
    Cholera is an acute diarrheal infection caused by consuming food or water contaminated with the bacterium Vibrio cholerae. […] Cholera is linked to limited access to safe water, basic sanitation facilities and poor hygiene practices. […] Only two serogroups, O1 and O139, cause cholera outbreaks. […] Cholera outbreaks occur regularly in some countries. […] The long-term solution for cholera control lies in economic development and universal access to safe drinking water, basic sanitation and good hygiene practices. […] Cholera is an easily treatable disease. […] Community engagement is essential for effectively communicating the potential risks and symptoms of cholera, precautions to take to avoid cholera, when and where to report cases, and the importance of seeking immediate treatment if symptoms appear.
  • #74 Cholera: a public health threat that still causes devastating outbreaks – News from the Institut Pasteur
    https://www.pasteur.fr/en/cholera-public-health-threat-still-causes-devastating-outbreaks?language=fr
    These findings show that cholera was not only introduced into Africa in 1970 before subsequently taking up residence there, but is repeatedly introduced on a regular basis. […] The areas of Africa most susceptible to the introduction of cholera will have to be targeted more specifically in order to stem the cholera waves before they sweep the rest of the continent. […] All of these studies demonstrate the added value of whole-genome sequencing of V. cholerae strains for cholera surveillance, prevention and control. […] The world is currently witnessing its seventh cholera pandemic. […] The seventh pandemic began in South Asia in 1961, reaching Africa in 1971 and America in 1991. […] The events currently unfolding in Yemen have tragically proved it right.