5. Cholera

Cholera is a water-borne, diarrhoeal disease caused by the bacterium Vibrio cholerae. For illness to occur, humans must consume vast amounts of the bacteria and cholera must possess a cluster of genes involved in creating the toxin co-regulated pilus. The gene for cholera enterotoxin must also be expressed. Treatment for cholera involves giving victims oral rehydration and antibiotics as a secondary defence. ‘Cholera’ explains that cholera gave rise to the foundation of epidemiology and Koch’s postulates, which state the requirements for identifying a particular organism as the causative agent of a disease. It also describes the ways in which cholera evolves antibiotic resistance, the interactions between Vibrio cholerae and the viruses that prey upon it, and possible reasons for the seasonality of epidemics.

Vibrio cholerae non-O1 non-O139 infection in an immunocompromised patient returning from Spain, July 2009

We describe a severe gastroenteritis with non-O1, non-O139 Vibrio cholerae in an immunocompromised patient returning from a holiday in Spain in July 2009. Predisposing factors and possible cholera enterotoxin production could explain the unusually grave symptomatology. The patient recovered after doxycyclin treatment.