Cholera

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Abstract
Cholera, once thought of as conquered by medical science, is now increasing as a threat in many areas of the world where populations are dense and sanitation inadequate. The past decade has seen an increase in the number of persons affected, and in the geographic extent of the disease. There has been a resurgence of interest in scientific research on the treatment and prevention of cholera. In this symposium, important recent advances are reviewed by investigators who have participated in these developments. Fluid and electrolyte disturbances in clinical cholera explain the mortality from the condition, but these can be satisfactorily managed so that good treatment, every patient should survive. With antibiotics, the duration of illness is minimized. Bacteriologic study promises to reveal the toxic substance by which the cholera vibrio produces diarrhea. The effect of this toxin on the host requires further investigation from both anatomic and functional points of view. The value of prophylactic cholera immunization, a procedure long accepted on faith, has recently been shown for the first time in a controlled field trial. Although it can reduce the incidence of clinical cholera by approximately 80%, cholera vaccine as presently formulated may cause adverse side effects, probably protects for only a limited period, and may have no value in eliminating the carrier state. If cholera is to be eradicated, further research and improved technology will be required, particularly in preventive methods. Continuing study of the pathophysiology of cholera may yield information of value, not only in improving cholera treatment, but in furthering understanding of gastrointestinal physiology and of other intestinal and metabolic diseases.