Materiały źródłowe

• #1

  https://www.who.int/news-room/fact-sheets/detail/cholera

  Cholera is a severe diarrheal disease that can be fatal within hours if not treated. Quick access to treatment is crucial. […] Most people with cholera have mild or moderate diarrhoea and can be treated with oral rehydration solution (ORS). However, the disease can progress rapidly, so starting treatment quickly is vital to save lives. Patients with severe disease need intravenous fluids, ORS and antibiotics. […] Cholera can cause severe acute watery diarrhoea, which can be fatal within hours if untreated. Most people infected with V. cholerae do not develop symptoms but can spread the bacteria through their faeces for 110 days. Symptoms appear 12 hours to 5 days after infection. […] The number of cholera cases reported to WHO has continued to rise in recent years. In 2023, 535 321 cases and 4007 deaths were reported to WHO from 45 countries.

• #2

  https://www.who.int/news-room/fact-sheets/detail/cholera

  Cholera is an easily treatable disease. Most people can be treated successfully with prompt ORS administration. Severely dehydrated patients are at risk of dying from dehydration and need rapid intravenous fluids. […] Community access to ORS is essential during a cholera outbreak. […] The case fatality rate in treatment centres should remain below 1%. […] The Global Task Force on Cholera Control (GTFCC) is a partnership of governmental and nongovernmental organizations, UN agencies and academic institutions with a common mission to reduce the global cholera burden. […] In 2017, the GTFCC published the Ending cholera: a global roadmap to 2030 strategy. It aims to reduce cholera deaths by 90% and eliminate cholera in as many as 20 countries by 2030 through early detection and containment of outbreaks through rapid multisectoral response. […] WHO supports countries in all pillars of cholera control including strengthening epidemiological surveillance, reinforcing laboratory capacity, improving access to and quality of treatment.

• #3 Climate Change and Cholera: A Review Exploring the Association Between Storm Severity and Global Human Vibrio spp. Incidence. | Published in Georgetown Medical Review

  https://gmr.scholasticahq.com/article/116783-climate-change-and-cholera-a-review-exploring-the-association-between-storm-severity-and-global-human-_vibrio-spp-_-incidence

  The bacterial family Vibrionaceae, specifically the genus Vibrio, is one such pathogen class that is of rising concern to epidemiologists, as the recent incidence of Vibrio spp. infections has significantly increased. […] Each of these infection routes has the potential for systemic spread and life-threatening complications if proper medical intervention is not pursued, with global estimates for the fatality rate of V. vulnificus at 1 in 5 and for V. cholerae at 1 in 4. […] The WHO emphasizes the importance of improving public health surveillance systems globally through international coordination between countries resulting in the creation of standardized data and metadata sets to improve global cholera reporting practices. […] The WHO has also implemented two vibriosis preventative strategies: Infection Prevention and Control (IPC) and Water, Sanitation, and Hygiene (WASH).

• #4 Exploring the burden of cholera in the WHO African region: patterns and trends from 2000 to 2023 cholera outbreak data | BMJ Global Health

  https://gh.bmj.com/content/10/1/e016491

  Cholera outbreaks remain persistent in the WHO African region, with an increased trend in recent years. […] The case fatality ratio of 2.3% is suggestive of issues in case management. […] The study results confirmed correlations between WASH indicators and cholera outbreaks. […] Insufficient access to WASH services remains the main predisposing factor for cholera in the WHO African region. […] The analysis reveals that slow progress in the development of good water, sanitation, and hygiene (WASH) infrastructure and the associated challenges remain the key factors for cholera outbreaks in the African region. […] The failure in ensuring access to safe water and adequate sanitation, even during cholera outbreaks, can explain the long duration to control epidemics. […] Our analysis confirms correlations and relationships between WASH indicators and the occurrence of cholera outbreaks. Risks factors include drinking directly from unprotected water sources, limited hygiene facilities, lack of soap and/or water, and open defaecation.

• #5 Cholera: Technical guidelines and resources – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/haiti-humanitarian-crisis-grade-3/cholera-technical-guidelines-and-resources

  Given the re-emergence of cholera in Haiti, PAHO/WHO recommends that Member States strengthen and maintain surveillance for cholera for the early detection of suspected cases and to provide adequate treatment to prevent its spread. Early and adequate treatment limits the case-fatality rate (CFR) of hospitalized patients to less than 1%. […] Cholera is a disease that responds satisfactorily to medical treatment. The first treatment goal is to replace fluids that have been lost by diarrhea and vomiting. Up to 80% of cases can be treated through early administration of oral rehydration salts (WHO/UNICEF oral rehydration salts standard sachet). […] With appropriate treatment the fatality rate is less than 1%. […] In order to provide timely access to treatment, cholera treatment centers should be established in affected populations. These centers should be located at strategic points to maximize the number of affected individuals that can be treated outside of a hospital setting and based on management protocols defined by and agreed to by all parties.

• #6 About Cholera | Cholera | CDC

  https://www.cdc.gov/cholera/about/index.html

  Cholera can cause severe diarrhea, dehydration, and even death if the disease goes untreated. […] With early and proper treatment, even severely ill patients can survive cholera. […] Treatment for cholera can include: Rehydration therapy, Antibiotics, Zinc supplementation for children. […] 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.

• #7

  https://www.cdc.gov/Mmwr/preview/mmwrhtml/00014993.htm

  Cholera can be a severe, life-threatening illness but is highly preventable and easily treated; however, few health-care practitioners in the United States have experience identifying and treating cholera. […] With clinical awareness of signs and symptoms of cholera, and knowledge of appropriate treatment, cholera should not pose a major risk to health in the United States. […] Cholera should be suspected in a patient with severe watery diarrhea, vomiting, and dehydration. […] Cholera is diagnosed by isolation of toxigenic V. cholerae serotype O1 from feces. […] Patients suspected of having cholera should be treated aggressively while awaiting culture results. […] Antimicrobial drugs are a useful adjunctive therapy, decreasing the duration of both diarrhea and bacterial shedding and diminishing the volume of fluid replacement needed for treatment.

• #8 Near real-time forecasting for cholera decision making in Haiti after Hurricane Matthew | PLOS Computational Biology

  https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1006127

  Computational models of cholera transmission can provide objective insights into the course of an ongoing epidemic and aid decision making on allocation of health care resources. […] Here, we report the efforts of a team from academia, field research and humanitarian organizations to model in near real-time the Haitian cholera outbreak after Hurricane Matthew in October 2016, to assess risk and to quantitatively estimate the efficacy of a then ongoing vaccination campaign. […] The experience gained by this modeling effort shows that state-of-the-art computational modeling and data-assimilation methods can produce informative near real-time projections of cholera incidence. […] Future efforts should thus draw together multi-disciplinary teams to ensure model outputs are appropriately based, interpreted and communicated.

• #9 Near real-time forecasting for cholera decision making in Haiti after Hurricane Matthew | PLOS Computational Biology

  https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1006127&rev=1

  Computational models of cholera transmission can provide objective insights into the course of an ongoing epidemic and aid decision making on allocation of health care resources. […] Here, we report the efforts of a team from academia, field research and humanitarian organizations to model in near real-time the Haitian cholera outbreak after Hurricane Matthew in October 2016, to assess risk and to quantitatively estimate the efficacy of a then ongoing vaccination campaign. […] The experience gained by this modeling effort shows that state-of-the-art computational modeling and data-assimilation methods can produce informative near real-time projections of cholera incidence. […] Future efforts should thus draw together multi-disciplinary teams to ensure model outputs are appropriately based, interpreted and communicated.

• #10 Prediction and control of cholera outbreak: Study case of Cameroon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11099323/

  A second monitoring of control led to a further reduction of around 60% of incidences the following year, showing how impulse control could be an effective means of eradicating cholera. […] The cholera outbreak that started on 18 May 2018 in Cameroon is persisting. […] The cholera outbreak continue to improve. […] The future trends reveals that an outbreak appeared from July to November 2023 with the number of cases reported monthly peaked in October 2023. […] The basic reproduction number noted R0, a central concept in the study of the spread of infectious diseases, is the number of secondary infections caused by a single infective in a population consisting essentially only of susceptible individuals. […] The thresholds R_0 and R0 play an important role on the cholera outbreak within a human community.

• #11 Prediction and control of cholera outbreak: Study case of Cameroon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11099323/

  The epidemiological consequence of the global asymptotic stability of the DFE is that the community-wide implementation of control interventions that can bring (and maintain) R0 to a value less than unity will lead to an effective control (or elimination) of cholera within a human community. […] Thus, to avoid or prevent cholera outbreaks, we need to estimate the thresholds R_0 and R0 which contain the bounds of transmission rates that cannot be measure directly. […] The current paper investigates the problem of the prediction and control of cholera outbreaks in Cameroon. […] The novelty and relevance of this work are precisely to estimate the number of undetected cases of cholera and cholera asymptomatic cases, which compromise the control strategies implemented by health systems in sub-Saharan Africa.

• #12 Prediction and control of cholera outbreak: Study case of Cameroon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11099323/

  This paper deals with the problem of the prediction and control of cholera outbreak using real data of Cameroon. […] We present the basic properties of the model and compute two explicit threshold parameters R0 and R_0 that bound the effective reproduction number R0, from below and above, that is R_0R0R0. […] We prove that cholera tends to disappear when R01, while when R_01, cholera persists uniformly within the population. […] We use this result to estimate the upper and lower bound of the effective reproduction number and reconstructed active asymptomatic and symptomatic cholera cases in Cameroon, and give a short-term forecasts of cholera in Cameroon until 2024. […] An impulsive control strategy is incorporated in the model with the aim to avoid or prevent the cholera outbreak.

• #13 A Review of the Environmental Trigger and Transmission Components for Prediction of Cholera

  https://www.mdpi.com/2414-6366/6/3/147

  The fundamental theory of the SEIR model is presented as the simultaneous presence of four entities (i.e., S, E, I, and R) required for a cholera outbreak. […] The robustness of an SEIR-based TrM relies heavily on the extent to which the module is capable of capturing the interactions. […] However, in some cases, rigorous mathematical complexity may impart problems in evaluating the success of intervention strategies and in assessing the effectiveness of behavioral changes in the human population. […] The integration of environmental variables into SEIR models will therefore be expected to yield better performance. […] Predictive models for cholera risk assessment will be critical in the future to safeguard public health.

• #14 NASA Investment in Cholera Forecasts Helps Save Lives in Yemen – NASA

  https://www.nasa.gov/news-release/nasa-investment-in-cholera-forecasts-helps-save-lives-in-yemen/

  For the first time ever, measurements from NASA Earth-observing research satellites are being used to help combat a potential outbreak of life-threatening cholera. […] Starting this spring, the British government and international aid groups in Yemen began using these new cholera forecasts to target their work in reducing cholera risk. […] The results to date suggest the forecast model has the potential to fundamentally change how the international community addresses cholera. […] The NASA forecast tool divides the entire country of Yemen into regions about the size of a typical U.S. county, and predicts the risk of cholera outbreaks in each region. […] In 2017, the model achieved 92 percent accuracy in predicting the regions where cholera was most likely to occur and spread in Yemen that year, even identifying inland areas that are not usually susceptible to the disease but suffered outbreaks.

• #15 PREDICTIVE MODELING OF CHOLERA OUTBREAKS IN BANGLADESH

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5061460/

  Despite seasonal cholera outbreaks in Bangladesh, little is known about the relationship between environmental conditions and cholera cases. […] We seek to develop a predictive model for cholera outbreaks in Bangladesh based on environmental predictors. […] We demonstrate that our model can successfully predict an increase in the number of infected individuals in the population weeks before the observed number of cholera cases increases, which could allow for early notification of an epidemic and timely allocation of resources. […] If the timing and size of a seasonal epidemic could be predicted reliably, vaccines and other resources could be allocated effectively to curb the impact of the disease. […] We want to measure the effect of the environmental covariates while accounting for disease dynamics via mechanistic models of disease transmission.

• #16 PREDICTIVE MODELING OF CHOLERA OUTBREAKS IN BANGLADESH

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5061460/

  We test the ability of our model to make short-term predictions during different time intervals in the data observation period and find that the pattern of predictive distribution dynamics matches the pattern of changes in the reported number of cases. […] The predicted hidden states show a noticeable increase in the fraction of infected individuals weeks before the observed number of cholera cases increases, which could allow for early notification of an epidemic and timely allocation of resources. […] Estimates of It are low, but not negligible, compared to estimates of (t), suggesting that most of the transmission is coming from environmental sources.

• #17 A Model to Predict When a Cholera Outbreak Might Hit the Congo – Eos

  https://eos.org/research-spotlights/model-predict-cholera-outbreak-might-hit-congo

  In 2011, as many as 600,000 people in 58 countries contracted cholera, with thousands succumbing to the disease. […] In a new modeling study, Finger et al. have determined the set of environmental conditions most likely to trigger a cholera epidemic in the area around Lake Kivu, a region in eastern Congo that is home to 1.8 million people and that sees recurrent outbreaks of the disease. […] The model that best fit the cholera data considered the state of El Niño–Southern Oscillation, the amount of precipitation, and a simplified parameterization of human mobility. Because these environmental conditions could possibly be predicted in advance, tracking these parameters could potentially give health managers much-needed warning time to prepare for an outbreak.

• #18 Near real-time forecasting for cholera decision making in Haiti after Hurricane Matthew | PLOS Computational Biology

  https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1006127&rev=1

  Following the passage of Hurricane Matthew on cholera-struck Haiti in October 2016, a large Oral cholera vaccine campaign targeting approximately 760,000 individuals was planned to minimize the risk of cholera transmission after the heavy hurricane rainfall. […] Our projections highlighted that the departments of Grande Anse and Sud were at risk of a second epidemic wave, thus supporting the planned vaccination campaign therein. […] The first cholera projection, from October 29 (Fig 3) up to December 31 2016, provided a quantitative estimation of the spatial and temporal features of the cholera outbreak and their uncertainty expressed in terms of 90% predictive intervals. […] The highest cumulative incidence was predicted to occur in the departments of Grande Anse and Sud, which proved the most damaged after the Hurricane.

• #19 Near real-time forecasting for cholera decision making in Haiti after Hurricane Matthew | PLOS Computational Biology

  https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1006127&rev=1

  The model predicts a significantly reduced risk of cholera after implementation of the vaccination campaign in all scenarios. […] Sequential assimilation of epidemiological data is fundamental to update the model in near real-time and track the epidemic dynamics. […] Supporting high quality surveillance and data sharing among partners is an important part of both short and long-term strategies to improve the cholera prevention and control efforts. […] As Haiti is unlikely to be cholera-free for years to come, refined versions of this model can continue to be used to forecast future risk and evaluate the potential impacts of different control strategies.

• #20 Near real-time forecasting for cholera decision making in Haiti after Hurricane Matthew | PLOS Computational Biology

  https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1006127

  Our projections highlighted that the departments of Grande Anse and Sud were at risk of a second epidemic wave, thus supporting the planned vaccination campaign therein. […] The model suggested that the OCV campaign was indeed an effective response to mitigate the risk of a second epidemic peak in the damaged departments of Grande Anse and Sud. […] Our results also suggested a limited impact of the OCV campaign in the rest of the country, implying that other intervention strategies would be required towards a global cholera control in Haiti. […] The model predicts a significantly reduced risk of cholera after implementation of the vaccination campaign in all scenarios. […] Sequential assimilation of epidemiological data is fundamental to update the model in near real-time and track the epidemic dynamics. […] As Haiti is unlikely to be cholera-free for years to come, refined versions of this model can continue to be used to forecast future risk and evaluate the potential impacts of different control strategies.

• #21 Quantifying the population-level impact of expanded antibiotic treatment for cholera outbreak management | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.11.04.24316579v1.full-text

  Since 2021, there has been a resurgence in the number of cholera cases, countries affected, and the case fatality risk. […] However, it has been suggested that the reduction in transmissibility from antibiotic treatment may result in circumstances under which treating mild or moderate cases with antibiotics may have population-level benefits. […] We found that expanding antibiotic treatment could significantly reduce the final outbreak size under certain outbreak characteristics. […] Under these different transmission scenarios, treating non-severe symptomatic infections with antibiotics decreased cholera transmission and, in some cases, the total number of antibiotic doses used. […] While expanding antibiotic eligibility could enhance outbreak control in some settings, careful consideration of antibiotic resistance risks is necessary in high-transmission contexts.

• #22 Quantifying the population-level impact of expanded antibiotic treatment for cholera outbreak management | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.11.04.24316579v1.full-text

  Our findings show how treating non-severe cholera cases with antibiotics can help control outbreaks and highlight the critical role of linking these cases to healthcare in achieving impact. […] The effectiveness of expanding antibiotic treatment criteria improves as the proportion of non-severely symptomatic infections seeking care increases. […] In the majority of outbreaks with low to intermediate transmission rates, such as those seen in most cholera outbreaks, reducing transmission can substantially lower the proportion of the population infected, supporting the theoretical findings that expanded antibiotic access can enhance outbreak control. […] A key distinction emerges between low and high Re settings. […] These results suggest that treating non-severe cholera cases may be effective in low Re settings but may carry a risk of antibiotic resistance in high-transmission contexts, underscoring the importance of tailoring treatment strategies to the specific outbreak context. […] Our study builds on phenomenological findings which suggest that treating non-severely symptomatic infections can reduce the number of antibiotic doses needed and may therefore lower the selective pressure for cholera to develop resistance.

• #23 Cholera past and future in Nigeria: are the Global Task Force on Cholera Control’s 2030 targets achievable? | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.12.06.22283154v2.full-text

  Understanding and continually assessing the achievability of global health targets is key to reducing disease burden and mortality. The Global Task Force on Cholera Control (GTFCC) Roadmap aims to reduce cholera deaths by 90% and eliminate the disease in twenty countries by 2030. […] The projections suggest that significant reductions in cholera cases could be achieved by 2030, particularly in the more developed southern states, but increases in cases remain a possibility. Meeting the 2030 target, nationally, currently looks unlikely and we propose a new 2050 target focusing on reducing regional inequities, while still advocating for cholera elimination being achieved as soon as possible. […] The 2030 targets could potentially be reached by 2030 in some parts of Nigeria, but more effort is needed to reach these targets at a national level, particularly through access and incentives to cholera testing, sanitation expansion, poverty alleviation and urban planning.

• #24 Cholera past and future in Nigeria: are the Global Task Force on Cholera Control’s 2030 targets achievable? | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.12.06.22283154v2.full-text

  Based on the work presented here, the achievability of the GTFCC targets at the current pace of cholera control and development appears unlikely to be met by 2030 in Nigeria. Despite this, there has been significant progress in terms of health and development in Nigeria and the southern states appear far more likely to meet these goals. A new proposed 2050 target, building on the GTFCC Roadmap and expanding on the three axes will now be delineated, while still advocating that the targets are reached as soon as possible.

• #25 Exploring the burden of cholera in the WHO African region: patterns and trends from 2000 to 2023 cholera outbreak data | BMJ Global Health

  https://gh.bmj.com/content/10/1/e016491

  The findings of this study call for more commitment to cholera in the region. Access to WASH remains the main driver for cholera outbreaks in the region, calling on political leaders and governments to invest more in WASH structures and services. […] Insufficient access to safe WASH remains the main predisposing factor for cholera in the WHO African region.

• #26 Evaluation of Household Water Treatment Technologies for Cholera Eradication in Sub-Saharan Africa: Epidemiological and Economic Perspectives

  https://www.mdpi.com/2071-1050/16/4/1422

  Cholera has been a global pandemic in past centuries, and its persistent emergence and spread pose a significant public health challenge globally. […] Despite efforts to contain the disease, recurrent cholera outbreaks in sub-Saharan Africa remain a major health threat. […] We find that—if universally adopted—the HWT technologies evaluated here offer comparable and effective microbiological potential for eradicating cholera disease in sub-Saharan Africa but are potentially not affordable for low-income households that reside in cholera hotspots. […] This finding provides substantial insights on the efficacy and affordability of these household water treatment technologies—insights which can inform stakeholder decisions on the applicability of this intervention in eradicating cholera.

• #27 Climate Change and Cholera: A Review Exploring the Association Between Storm Severity and Global Human Vibrio spp. Incidence. | Published in Georgetown Medical Review

  https://gmr.scholasticahq.com/article/116783-climate-change-and-cholera-a-review-exploring-the-association-between-storm-severity-and-global-human-_vibrio-spp-_-incidence

  Current global meteorological evidence suggests that climate change is a direct contributor to the increased severity of weather events, such as hurricanes and typhoons, putting billions of people at increased risk of physical harm, property damage, and destructive flooding. […] Vibrio spp. infections, specifically species V. vulnificus, V. parahaemolyticus, and V. cholerae, have shown significant upticks in the number of global cases, with some species increasing in incidence by more than 8-fold in the last 40 years. […] Given the environmental connection between tropical cyclones and the incidence of vibriosis, this review details recent studies that addressed the potential correlation between warmer global temperature as a result of climate change and increased human Vibrio disease incidence, while looking ahead towards mitigation strategies to face new global challenges. Increased incidence of vibriosis has already begun to have deleterious effects on the tourism and seafood industries, as well as public health and coastal recreational activities.

• #28 Comparison of analysis methods to classify cholera hotspots in Ethiopia from 2015 to 2021 | Scientific Reports

  https://www.nature.com/articles/s41598-024-56299-5

  Cholera continues to represent a major public health concern in Ethiopia. The current study aimed to classify cholera hotspots in Ethiopia at the woreda level (equivalent to district level) applying the three methods and comparing the results to optimize the hotspot targeting strategy. A cholera hotspot is a geographically limited area where environmental, cultural and/or socioeconomic conditions facilitate the transmission of the disease, and where cholera persists or reappears regularly. As these areas play a central role in the spread of cholera outbreaks, multisectoral interventions should target these areas to prevent and control cholera outbreaks, prioritizing the most at-risk hotspots to most efficiently use limited resources. The current study aimed to identify and classify cholera hotspots in Ethiopia at the woreda level applying the three main classification methods. The results of the three methods were compared, highlighting the pros and cons of each approach. Overall, high-priority cholera hotspots were mainly located along major routes between Addis Ababa and the Kenya and Somalia borders, throughout Tigray Region, around Lake Tana (in Amhara Region), and in Afar Region along the Ethiopia-Djibouti road. The results of the classification methods were then compared to identify the best approach for Ethiopia to implement targeted strategies to achieve the objective of cholera elimination. A cholera hotspot is defined as an area where cholera persists or reappears regularly and thus plays a critical role in outbreak diffusion to unaffected areas.

• #29 Association of post-diagnostic use of cholera vaccine with survival outcome in breast cancer patients | British Journal of Cancer

  https://www.nature.com/articles/s41416-020-01108-9

  Post-diagnostic use of cholera vaccine is associated with a favourable survival rate in breast cancer patients; this provides evidence for repurposing it against breast cancer. […] Vaccinated patients showed favourable overall survival (hazard ratio (HR): 0.54, 95% confidence interval (CI): 0.37-0.79) and disease-specific survival (HR: 0.53, 95% CI: 0.33-0.84), compared to their unvaccinated counterpart. […] Based on this nationwide study, we found that post-diagnostic use of cholera vaccine in breast cancer patients was associated with better overall and disease-specific survival. This association was still significant after considering competing risks and 1-year lag of exposure. This study suggests that cholera vaccine may be a good candidate for drug repurposing for breast cancer.

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