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Chapter 29 : The Future of Cholera: Persistence, Change, and an Expanding Research Agenda

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The Future of Cholera: Persistence, Change, and an Expanding Research Agenda, Page 1 of 2

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Abstract:

The history of cholera provides a framework for assessing the potential for eradicating the disease. Although large cholera epidemics may become less likely to occur as effective control measures are put into place, persistence of cholera as an epidemic disease in some regions of the world and its periodic epidemic emergence from natural reservoirs is likely for the foreseeable future. The public health management of cholera requires a coordinated laboratory effort. In many countries, epidemic cholera has served as the focus for improving surveillance activities in general. The two groups of toxigenic El Tor O1 best documented to be capable of long-term environmental persistence are both consistently serotype Inaba, raising the possibility that this serotype is better suited to persistence than is the Ogawa serotype. Strategies of control that put intense selective pressure on the organism during an ongoing epidemic may lead to other evolutionary developments. Defining the ecologic determinants of persistence of toxigenic O1 in the environment will require clarification of the potential roles of copepods and other plankton in providing a niche for O1 and of the mechanism by which shellfish become contaminated in sewage-free environments. Research on cholera vaccines had been accelerated by the emergence of cholera in Latin America. Eradication of choleras is unlikely, because it has environmental reservoirs that will probably continue to cause occasional cases of cholera indefinitely.

Citation: Tauxe R, Blake P, Olsvik Ø, Wachsmuth I. 1994. The Future of Cholera: Persistence, Change, and an Expanding Research Agenda, p 443-453. In Wachsmuth I, Blake P, Olsvik Ø (ed), and Cholera. ASM Press, Washington, DC. doi: 10.1128/9781555818364.ch29
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