Cholera disease spreads because of contamination of water and food and is closely associated with poor sanitation and lack of clean drinking water. The global disease burden is around 3–5 million cases and 100 000– 130 000 deaths per year. In recent time the frequency of cholera epidemics has increased. The disease is caused by Vibrio cholerae a rod-shaped waterborne bacterium. The toxins released by bacterium causes loss of intravascular and extravascular fluids and essential electrolytes in the small intestines.
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Cholera disease is generally characterized as acute, profuse watery diarrhea of one or a few days’ duration. In extreme condition the patients may suffer severe dehydration within 3–4 hours. Rehydration is the mainstay of treatment of Cholera or antibiotics are indicated for severe cases only.
According to reports published by W.H.O Cholera control should be the main priority in the endemic areas. Right now there are only two types of oral cholera vaccines available. These oral vaccines should be used in conjunction with other preventive measure in areas where the disease is endemic. The vaccination provides an immediate short-term response while to completely overcome the disease other interventions such as availability of clean water and proper sanitation should be put into place.
To control endemic cholera vaccination should be targeted at individuals with higher risk, the best way to counter cholera can be periodic mass vaccination campaigns, for example such as pre-school and school aged children, HIV-infected individuals and pregnant women. Older age individuals may also be taken into consideration for cholera vaccination. Currently protection induced by current cholera vaccines is 2 years, therefore initial vaccination of 2 dose should be followed by a booster dose after every 2 years.
In recent times W.H.O. and its partners are considering newer ways to complement the traditional methods. The oral cholera vaccines have proven to be effective against the disease, the evidence provided by the use of cholera vaccines has paved way for investigation for mass vaccination for protection against cholera disease. As of now there are three types of oral cholera vaccines available Crucell, Dukoral and ShanChol, which are approved by W.H.O. Out of these three vaccines one is monovalent and the other two are bivalent vaccines. Several other oral cholera vaccines are under development. Currently the demand for cholera vaccines is uncertain as it depends on the immunization strategy which may vary total demand requirement.
The W.H.O strongly recommends monitoring for confirmed cases of cholera disease must be integrated in already existing surveillance programs so that the impact of the disease and vaccination could be monitored.
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