[Cholera]

Cholera remains a great epidemic disease. The spread of the current pandemic due to Vibrio cholerae O1, the discovery of a permanent aquatic reservoir due to dormant state of vibrio, the occurrence in 1992 of the new pathogenic serotype O139 in India, and increasing antibiotic resistance are clear demonstration that this old disease is far from conquered. Clinical manifestations are due to the stimulation of enterocytic cAMP by vibrio's enterotoxin. Treatment by appropriate early rehydration is highly effective. During major outbreaks it requires "military logistics". Hygiene and chlorine remain the best prophylaxis; WHO's recommendations on the use of the new oral vaccines, effective against O1-strains, will probably evolve as the results of ongoing trials will become available.