Cholera

Abstract

Cholera is a severe secretory diarrhoeal illness caused by strains of the O1 and O139 serogroups of Vibrio cholerae. Millions of cases occur annually both endemically and epidemically with approximately 100 000 of those resulting in death. V. cholerae is a natural inhabitant of marine ecosystems, often found to be associated with higher organisms; infection of humans is through ingestion. Increased concentrations of V. cholerae in coastal waters during summer months, coupled with natural disasters that compromise clean water and sanitation infrastructures, often trigger epidemic cholera. The excessive watery diarrhoea associated with this disease is due to the action of cholera toxin. Cholera is effectively treated with oral rehydration therapy. The V. cholerae genome is composed of two circular chromosomes and contains laterally acquired virulence genes as part of lysogenic phages and pathogenicity islands. Pathogenesis of V. cholerae involves a number of virulence factors and is subject to complex regulation.

Key Concepts

  • Cholera is an acute secretory diarrhoeal disease caused by the bacterium Vibrio cholerae.
  • Since recording began, six cholera pandemics occurred between 1817 and 1923; the current seventh cholera pandemic began in 1961 in Indonesia.
  • Cholera occurs both endemically and epidemically.
  • V. cholerae is a natural inhabitant of marine systems around the world.
  • Cholera toxin causes deregulation of adenylate cyclase in intestinal cells, which results in a massive efflux of water and electrolytes.
  • Early rehydration therapy to restore the extensive water loss and correct electrolyte abnormalities is the foundation for effective cholera treatment.
  • Of the over 200 serogroups of V. cholerae, only serogroups 01 and 139 are capable of causing epidemic cholera.
  • Two circular chromosomes of approximately 3 Mb and 1 Mb in size comprise the V. cholerae genome.
  • Some important virulenceā€related genes are found within horizontally acquired genetic elements including lysogenic phages and pathogenicity islands.

Keywords: cholera; Vibrio cholerae; pathogen; biofilm; toxin; genome

Figure 1. Life cycle of Vibrio cholerae depicting (a) the persistence of the bacterium in its natural aquatic environment and (b) its occasional transmission to and dissemination from its human host.
Figure 2. Summary of the mechanism of action of cholera toxin.
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Further Reading

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Lambert, Bliss, and Pettis, Gregg S(Nov 2017) Cholera. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0027200]