As the surge of cholera continues worldwide and vaccines remain scarce, experts are increasingly concerned about the global risk posed by the disease.
Cholera, a bacterial illness transmitted through contaminated food and water, causes severe diarrhea and dehydration. Its incidence has been on the rise globally since 2021, with a significant number of cases reported in Asia, Africa, and Latin America, according to Dr. Renuga Vivekanandan, M.D., assistant dean and professor at the Creighton University School of Medicine in Omaha, Nebraska.
The countries most affected include the Democratic Republic of the Congo, Ethiopia, Haiti, Somalia, Sudan, Syria, Zambia, and Zimbabwe, according to UNICEF.
Although cholera was prevalent in the United States in the 1800s, the disease has largely been eliminated thanks to water treatment systems, according to the CDC. However, there have been rare cases of individuals in the U.S. contracting cholera from consuming raw or undercooked shellfish from the Gulf of Mexico, the agency noted.
"In the U.S., the number of cases has remained very small and is usually due to travel exposure," Vivekanandan added.
Cholera is primarily spread through contaminated water or food. It can spread quickly in areas with inadequate water and sewage treatment, although it is not typically transmitted from person to person.
UNICEF attributes the increase in cholera cases to persistent gaps in access to safe water and sanitation, exacerbated by factors such as climate change, displacement due to disasters, and poor sanitary conditions.
Around 10% of those infected with cholera develop severe symptoms, including watery diarrhea, vomiting, and leg cramps, according to the CDC. Severe cases can lead to shock and dehydration, and without treatment, the disease can be fatal.
The most effective treatment for cholera is immediate rehydration therapy, which involves replacing fluids and salts lost through diarrhea. In severe cases, intravenous fluids may be necessary.
There is a single-dose cholera vaccine called Vaxchora for individuals between the ages of 2 and 64 traveling to areas with active cholera transmission. However, there has been a shortage of cholera vaccines, with more doses requested for outbreak response between 2021 and 2023 than in the entire previous decade.
To reduce the global burden of cholera, Vivekanandan emphasized the need for increased investment in resources and partnerships with pharmaceutical companies to produce more vaccines. He also advised travelers to review CDC travel guidance and practice good hygiene practices.
In conclusion, addressing cholera requires a multi-pronged approach, including surveillance, water and sanitation improvements, social mobilization, treatment, and access to vaccines for high-risk communities.