cholera [key] or Asiatic cholera, acute infectious disease caused by strains of the bacterium Vibrio cholerae that have been infected by bacteriophages. The bacteria, which are found in fecal-contaminated food and water and in raw or undercooked seafood, produce a toxin that affects the intestines causing diarrhea, vomiting, and severe fluid and electrolyte loss. This overwhelming dehydration is the outstanding characteristic of the disease and is the main cause of death. Cholera has a short incubation period (two or three days) and runs a quick course. In untreated cases the death rate is high, averaging 50%, and as high as 90% in epidemics, but with effective treatment the death rate is less than 1%. The intravenous and oral replacement of body fluids and essential electrolytes and the restoration of kidney function are more important in therapy than the administration of antibacterial drugs. In regions of Asia, Africa, and South America where public sanitation is poor the disease is still endemic or epidemic; vaccination is recommended for people living in those areas. Although a cholera vaccine was developed in the late 1800s, an inexpensive oral vaccine that could be easily given in countries where cholera is most common did not become widely available until the 2010s. A theory of evolutionary biologists holds that the cystic fibrosis gene, a common but lethal recessive gene carried by approximately one in twenty Caucasians, affords those carriers partial protection against cholera.
See C. E. Rosenberg, The Cholera Years (1962).
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