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Cholera - Wikipedia

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<button aria-controls="toc-Cause-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Cause subsection</span> </button> <ul id="toc-Cause-sublist" class="vector-toc-list"> <li id="toc-Transmission" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Transmission"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Transmission</span> </div> </a> <ul id="toc-Transmission-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Susceptibility" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Susceptibility"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Susceptibility</span> </div> </a> <ul id="toc-Susceptibility-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Mechanism" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Mechanism"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Mechanism</span> </div> </a> <button aria-controls="toc-Mechanism-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Mechanism subsection</span> </button> <ul id="toc-Mechanism-sublist" class="vector-toc-list"> <li id="toc-Genetic_structure" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Genetic_structure"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Genetic structure</span> </div> </a> <ul id="toc-Genetic_structure-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Antibiotic_resistance" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Antibiotic_resistance"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Antibiotic resistance</span> </div> </a> <ul id="toc-Antibiotic_resistance-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Diagnosis</span> </div> </a> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Prevention</span> </div> </a> <button aria-controls="toc-Prevention-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Prevention subsection</span> </button> <ul id="toc-Prevention-sublist" class="vector-toc-list"> <li id="toc-Water,_sanitation_and_hygiene" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Water,_sanitation_and_hygiene"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.1</span> <span>Water, sanitation and hygiene</span> </div> </a> <ul id="toc-Water,_sanitation_and_hygiene-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surveillance" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surveillance"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.2</span> <span>Surveillance</span> </div> </a> <ul id="toc-Surveillance-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Vaccination" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Vaccination"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.3</span> <span>Vaccination</span> </div> </a> <ul id="toc-Vaccination-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Sari_filtration" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Sari_filtration"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.4</span> <span>Sari filtration</span> </div> </a> <ul id="toc-Sari_filtration-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Treatment</span> </div> </a> <button aria-controls="toc-Treatment-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Treatment subsection</span> </button> <ul id="toc-Treatment-sublist" class="vector-toc-list"> <li id="toc-Fluids" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Fluids"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.1</span> <span>Fluids</span> </div> </a> <ul id="toc-Fluids-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Electrolytes" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Electrolytes"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2</span> <span>Electrolytes</span> </div> </a> <ul id="toc-Electrolytes-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Antibiotics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Antibiotics"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.3</span> <span>Antibiotics</span> </div> </a> <ul id="toc-Antibiotics-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Zinc_supplementation" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Zinc_supplementation"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.4</span> <span>Zinc supplementation</span> </div> </a> <ul id="toc-Zinc_supplementation-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Prognosis</span> </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Epidemiology</span> </div> </a> <button aria-controls="toc-Epidemiology-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Epidemiology subsection</span> </button> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> <li id="toc-History_of_outbreaks" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#History_of_outbreaks"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.1</span> <span>History of outbreaks</span> </div> </a> <ul id="toc-History_of_outbreaks-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.2</span> <span>Research</span> </div> </a> <ul id="toc-Research-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Global_Strategy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Global_Strategy"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.3</span> <span>Global Strategy</span> </div> </a> <ul id="toc-Global_Strategy-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>Society and culture</span> </div> </a> <button aria-controls="toc-Society_and_culture-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Society and culture subsection</span> </button> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> <li id="toc-Health_policy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Health_policy"> <div class="vector-toc-text"> <span class="vector-toc-numb">9.1</span> <span>Health policy</span> </div> </a> <ul id="toc-Health_policy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Notable_cases" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Notable_cases"> <div class="vector-toc-text"> <span class="vector-toc-numb">9.2</span> <span>Notable cases</span> </div> </a> <ul id="toc-Notable_cases-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-In_popular_culture" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#In_popular_culture"> <div class="vector-toc-text"> <span class="vector-toc-numb">9.3</span> <span>In popular culture</span> </div> </a> <ul id="toc-In_popular_culture-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Country_examples" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Country_examples"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Country examples</span> </div> </a> <button aria-controls="toc-Country_examples-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Country examples subsection</span> </button> <ul id="toc-Country_examples-sublist" class="vector-toc-list"> <li id="toc-Zambia" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Zambia"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.1</span> <span>Zambia</span> </div> </a> <ul id="toc-Zambia-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-India" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#India"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.2</span> <span>India</span> </div> </a> <ul id="toc-India-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Democratic_Republic_of_Congo" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Democratic_Republic_of_Congo"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.3</span> <span>Democratic Republic of Congo</span> </div> </a> <ul id="toc-Democratic_Republic_of_Congo-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Explanatory_notes" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Explanatory_notes"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>Explanatory notes</span> </div> </a> <ul id="toc-Explanatory_notes-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">12</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">13</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">14</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Cholera</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 137 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-137" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">137 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ace mw-list-item"><a href="https://ace.wikipedia.org/wiki/Kolera" title="Kolera – Acehnese" lang="ace" hreflang="ace" data-title="Kolera" data-language-autonym="Acèh" data-language-local-name="Acehnese" class="interlanguage-link-target"><span>Acèh</span></a></li><li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Cholera" title="Cholera – Afrikaans" lang="af" hreflang="af" data-title="Cholera" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target"><span>Afrikaans</span></a></li><li class="interlanguage-link interwiki-als mw-list-item"><a href="https://als.wikipedia.org/wiki/Cholera" title="Cholera – Alemannic" lang="gsw" hreflang="gsw" data-title="Cholera" data-language-autonym="Alemannisch" data-language-local-name="Alemannic" class="interlanguage-link-target"><span>Alemannisch</span></a></li><li class="interlanguage-link interwiki-am mw-list-item"><a href="https://am.wikipedia.org/wiki/%E1%8A%AE%E1%88%8C%E1%88%AB" title="ኮሌራ – Amharic" lang="am" hreflang="am" data-title="ኮሌራ" data-language-autonym="አማርኛ" data-language-local-name="Amharic" class="interlanguage-link-target"><span>አማርኛ</span></a></li><li class="interlanguage-link interwiki-anp mw-list-item"><a href="https://anp.wikipedia.org/wiki/%E0%A4%B5%E0%A4%BF%E0%A4%B8%E0%A5%82%E0%A4%9A%E0%A4%BF%E0%A4%95%E0%A4%BE" title="विसूचिका – Angika" lang="anp" hreflang="anp" data-title="विसूचिका" data-language-autonym="अंगिका" data-language-local-name="Angika" class="interlanguage-link-target"><span>अंगिका</span></a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%83%D9%88%D9%84%D9%8A%D8%B1%D8%A7" title="كوليرا – Arabic" lang="ar" hreflang="ar" data-title="كوليرا" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-an mw-list-item"><a href="https://an.wikipedia.org/wiki/Colera" title="Colera – Aragonese" lang="an" hreflang="an" data-title="Colera" data-language-autonym="Aragonés" data-language-local-name="Aragonese" class="interlanguage-link-target"><span>Aragonés</span></a></li><li class="interlanguage-link interwiki-hyw mw-list-item"><a href="https://hyw.wikipedia.org/wiki/%D4%BA%D5%A1%D5%B6%D5%BF%D5%A1%D5%AD%D5%BF" title="Ժանտախտ – Western Armenian" lang="hyw" hreflang="hyw" data-title="Ժանտախտ" data-language-autonym="Արեւմտահայերէն" data-language-local-name="Western Armenian" class="interlanguage-link-target"><span>Արեւմտահայերէն</span></a></li><li class="interlanguage-link interwiki-as mw-list-item"><a href="https://as.wikipedia.org/wiki/%E0%A6%95%E0%A6%B2%E0%A7%87%E0%A7%B0%E0%A6%BE" title="কলেৰা – Assamese" lang="as" hreflang="as" data-title="কলেৰা" data-language-autonym="অসমীয়া" data-language-local-name="Assamese" class="interlanguage-link-target"><span>অসমীয়া</span></a></li><li class="interlanguage-link interwiki-ast mw-list-item"><a href="https://ast.wikipedia.org/wiki/C%C3%B3lera" title="Cólera – Asturian" lang="ast" hreflang="ast" data-title="Cólera" data-language-autonym="Asturianu" data-language-local-name="Asturian" class="interlanguage-link-target"><span>Asturianu</span></a></li><li class="interlanguage-link interwiki-av mw-list-item"><a href="https://av.wikipedia.org/wiki/%D0%9A%D1%8A%D0%B0%D0%B2%D1%83%D0%B4%D0%B0" title="Къавуда – Avaric" lang="av" hreflang="av" data-title="Къавуда" data-language-autonym="Авар" data-language-local-name="Avaric" class="interlanguage-link-target"><span>Авар</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/V%C9%99ba" title="Vəba – Azerbaijani" lang="az" hreflang="az" data-title="Vəba" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D9%88%D8%A8%D8%A7" title="وبا – South Azerbaijani" lang="azb" hreflang="azb" data-title="وبا" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target"><span>تۆرکجه</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%95%E0%A6%B2%E0%A7%87%E0%A6%B0%E0%A6%BE" title="কলেরা – Bangla" lang="bn" hreflang="bn" data-title="কলেরা" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-zh-min-nan mw-list-item"><a href="https://zh-min-nan.wikipedia.org/wiki/L%C3%A0u-th%C3%B2%CD%98-soa" title="Làu-thò͘-soa – Minnan" lang="nan" hreflang="nan" data-title="Làu-thò͘-soa" data-language-autonym="閩南語 / Bân-lâm-gú" data-language-local-name="Minnan" class="interlanguage-link-target"><span>閩南語 / Bân-lâm-gú</span></a></li><li class="interlanguage-link interwiki-ba mw-list-item"><a href="https://ba.wikipedia.org/wiki/%D0%A5%D0%BE%D0%BB%D0%B5%D1%80%D0%B0" title="Холера – Bashkir" lang="ba" hreflang="ba" data-title="Холера" data-language-autonym="Башҡортса" data-language-local-name="Bashkir" class="interlanguage-link-target"><span>Башҡортса</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%A5%D0%B0%D0%BB%D0%B5%D1%80%D0%B0" title="Халера – Belarusian" lang="be" hreflang="be" data-title="Халера" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%A5%D0%B0%D0%BB%D0%B5%D1%80%D0%B0" title="Халера – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Халера" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target"><span>Беларуская (тарашкевіца)</span></a></li><li class="interlanguage-link interwiki-bcl mw-list-item"><a href="https://bcl.wikipedia.org/wiki/Kolera" title="Kolera – Central Bikol" lang="bcl" hreflang="bcl" data-title="Kolera" data-language-autonym="Bikol Central" data-language-local-name="Central Bikol" class="interlanguage-link-target"><span>Bikol Central</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%A5%D0%BE%D0%BB%D0%B5%D1%80%D0%B0" title="Холера – Bulgarian" lang="bg" hreflang="bg" data-title="Холера" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-bo mw-list-item"><a href="https://bo.wikipedia.org/wiki/%E0%BD%A6%E0%BE%90%E0%BE%B1%E0%BD%B4%E0%BD%82%E0%BC%8B%E0%BD%A4%E0%BD%A3%E0%BC%8B%E0%BD%A0%E0%BD%82%E0%BD%BC%E0%BD%A6%E0%BC%8B%E0%BD%93%E0%BD%91%E0%BC%8D" title="སྐྱུག་ཤལ་འགོས་ནད། – Tibetan" lang="bo" hreflang="bo" data-title="སྐྱུག་ཤལ་འགོས་ནད།" data-language-autonym="བོད་ཡིག" data-language-local-name="Tibetan" class="interlanguage-link-target"><span>བོད་ཡིག</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Kolera" title="Kolera – Bosnian" lang="bs" hreflang="bs" data-title="Kolera" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-br mw-list-item"><a href="https://br.wikipedia.org/wiki/Kolera" title="Kolera – Breton" lang="br" hreflang="br" data-title="Kolera" data-language-autonym="Brezhoneg" data-language-local-name="Breton" class="interlanguage-link-target"><span>Brezhoneg</span></a></li><li class="interlanguage-link interwiki-bxr mw-list-item"><a href="https://bxr.wikipedia.org/wiki/%D0%A5%D0%BE%D0%BB%D0%B5%D1%80%D1%8D" title="Холерэ – Russia Buriat" lang="bxr" hreflang="bxr" data-title="Холерэ" data-language-autonym="Буряад" data-language-local-name="Russia Buriat" class="interlanguage-link-target"><span>Буряад</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/C%C3%B2lera" title="Còlera – Catalan" lang="ca" hreflang="ca" data-title="Còlera" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Cholera" title="Cholera – Czech" lang="cs" hreflang="cs" data-title="Cholera" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-cy mw-list-item"><a href="https://cy.wikipedia.org/wiki/Colera" title="Colera – Welsh" lang="cy" hreflang="cy" data-title="Colera" data-language-autonym="Cymraeg" data-language-local-name="Welsh" class="interlanguage-link-target"><span>Cymraeg</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Kolera" title="Kolera – Danish" lang="da" hreflang="da" data-title="Kolera" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-ary mw-list-item"><a href="https://ary.wikipedia.org/wiki/%D9%83%D9%88%D9%84%D9%8A%D8%B1%D8%A7" title="كوليرا – Moroccan Arabic" lang="ary" hreflang="ary" data-title="كوليرا" data-language-autonym="الدارجة" data-language-local-name="Moroccan Arabic" class="interlanguage-link-target"><span>الدارجة</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Cholera" title="Cholera – German" lang="de" hreflang="de" data-title="Cholera" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%86%DE%AE%DE%8D%DE%AC%DE%83%DE%A7" title="ކޮލެރާ – Divehi" lang="dv" hreflang="dv" data-title="ކޮލެރާ" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target"><span>ދިވެހިބަސް</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Koolera" title="Koolera – Estonian" lang="et" hreflang="et" data-title="Koolera" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%A7%CE%BF%CE%BB%CE%AD%CF%81%CE%B1" title="Χολέρα – Greek" lang="el" hreflang="el" data-title="Χολέρα" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-eml mw-list-item"><a href="https://eml.wikipedia.org/wiki/Col%C3%A9ro" title="Coléro – Emiliano-Romagnolo" lang="egl" hreflang="egl" data-title="Coléro" data-language-autonym="Emiliàn e rumagnòl" data-language-local-name="Emiliano-Romagnolo" class="interlanguage-link-target"><span>Emiliàn e rumagnòl</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/C%C3%B3lera" title="Cólera – Spanish" lang="es" hreflang="es" data-title="Cólera" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/%C4%A4olero" title="Ĥolero – Esperanto" lang="eo" hreflang="eo" data-title="Ĥolero" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Kolera" title="Kolera – Basque" lang="eu" hreflang="eu" data-title="Kolera" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%88%D8%A8%D8%A7" title="وبا – Persian" lang="fa" hreflang="fa" data-title="وبا" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-hif mw-list-item"><a href="https://hif.wikipedia.org/wiki/Haeja" title="Haeja – Fiji Hindi" lang="hif" hreflang="hif" data-title="Haeja" data-language-autonym="Fiji Hindi" data-language-local-name="Fiji Hindi" class="interlanguage-link-target"><span>Fiji Hindi</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Chol%C3%A9ra" title="Choléra – French" lang="fr" hreflang="fr" data-title="Choléra" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-fy mw-list-item"><a href="https://fy.wikipedia.org/wiki/Goalera" title="Goalera – Western Frisian" lang="fy" hreflang="fy" data-title="Goalera" data-language-autonym="Frysk" data-language-local-name="Western Frisian" class="interlanguage-link-target"><span>Frysk</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Calar" title="Calar – Irish" lang="ga" hreflang="ga" data-title="Calar" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/C%C3%B3lera" title="Cólera – Galician" lang="gl" hreflang="gl" data-title="Cólera" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-hak mw-list-item"><a href="https://hak.wikipedia.org/wiki/Kh%C3%B3-lie%CC%8Dt-l%C3%A0" title="Khó-lie̍t-là – Hakka Chinese" lang="hak" hreflang="hak" data-title="Khó-lie̍t-là" data-language-autonym="客家語 / Hak-kâ-ngî" data-language-local-name="Hakka Chinese" class="interlanguage-link-target"><span>客家語 / Hak-kâ-ngî</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%BD%9C%EB%A0%88%EB%9D%BC" title="콜레라 – Korean" lang="ko" hreflang="ko" data-title="콜레라" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%BD%D5%B8%D5%AC%D5%A5%D6%80%D5%A1" title="Խոլերա – Armenian" lang="hy" hreflang="hy" data-title="Խոլերա" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%B9%E0%A5%88%E0%A4%9C%E0%A4%BE" title="हैजा – Hindi" lang="hi" hreflang="hi" data-title="हैजा" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Kolera" title="Kolera – Croatian" lang="hr" hreflang="hr" data-title="Kolera" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Kolero" title="Kolero – Ido" lang="io" hreflang="io" data-title="Kolero" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target"><span>Ido</span></a></li><li class="interlanguage-link interwiki-ilo mw-list-item"><a href="https://ilo.wikipedia.org/wiki/Kolera" title="Kolera – Iloko" lang="ilo" hreflang="ilo" data-title="Kolera" data-language-autonym="Ilokano" data-language-local-name="Iloko" class="interlanguage-link-target"><span>Ilokano</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Kolera" title="Kolera – Indonesian" lang="id" hreflang="id" data-title="Kolera" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/K%C3%B3lera" title="Kólera – Icelandic" lang="is" hreflang="is" data-title="Kólera" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target"><span>Íslenska</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Colera" title="Colera – Italian" lang="it" hreflang="it" data-title="Colera" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%9B%D7%95%D7%9C%D7%A8%D7%94" title="כולרה – Hebrew" lang="he" hreflang="he" data-title="כולרה" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-jv mw-list-item"><a href="https://jv.wikipedia.org/wiki/Kolera" title="Kolera – Javanese" lang="jv" hreflang="jv" data-title="Kolera" data-language-autonym="Jawa" data-language-local-name="Javanese" class="interlanguage-link-target"><span>Jawa</span></a></li><li class="interlanguage-link interwiki-kn mw-list-item"><a href="https://kn.wikipedia.org/wiki/%E0%B2%95%E0%B2%BE%E0%B2%B2%E0%B3%86%E0%B2%B0%E0%B2%BE" title="ಕಾಲೆರಾ – Kannada" lang="kn" hreflang="kn" data-title="ಕಾಲೆರಾ" data-language-autonym="ಕನ್ನಡ" data-language-local-name="Kannada" class="interlanguage-link-target"><span>ಕನ್ನಡ</span></a></li><li class="interlanguage-link interwiki-krc mw-list-item"><a href="https://krc.wikipedia.org/wiki/%D0%A5%D0%BE%D0%BB%D0%B5%D1%80%D0%B0" title="Холера – Karachay-Balkar" lang="krc" hreflang="krc" data-title="Холера" data-language-autonym="Къарачай-малкъар" data-language-local-name="Karachay-Balkar" class="interlanguage-link-target"><span>Къарачай-малкъар</span></a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%A5%E1%83%9D%E1%83%9A%E1%83%94%E1%83%A0%E1%83%90" title="ქოლერა – Georgian" lang="ka" hreflang="ka" data-title="ქოლერა" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target"><span>ქართული</span></a></li><li class="interlanguage-link interwiki-ks mw-list-item"><a href="https://ks.wikipedia.org/wiki/%DA%A9%D8%A7%D9%84%D8%B1%D8%A7" title="کالرا – Kashmiri" lang="ks" hreflang="ks" data-title="کالرا" data-language-autonym="कॉशुर / کٲشُر" data-language-local-name="Kashmiri" class="interlanguage-link-target"><span>कॉशुर / کٲشُر</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%A2%D1%8B%D1%80%D1%8B%D1%81%D2%9B%D0%B0%D2%9B" title="Тырысқақ – Kazakh" lang="kk" hreflang="kk" data-title="Тырысқақ" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Kipindupindu" title="Kipindupindu – Swahili" lang="sw" hreflang="sw" data-title="Kipindupindu" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target"><span>Kiswahili</span></a></li><li class="interlanguage-link interwiki-ht mw-list-item"><a href="https://ht.wikipedia.org/wiki/Kolera" title="Kolera – Haitian Creole" lang="ht" hreflang="ht" data-title="Kolera" data-language-autonym="Kreyòl ayisyen" data-language-local-name="Haitian Creole" class="interlanguage-link-target"><span>Kreyòl ayisyen</span></a></li><li class="interlanguage-link interwiki-ku mw-list-item"><a href="https://ku.wikipedia.org/wiki/Kolera" title="Kolera – Kurdish" lang="ku" hreflang="ku" data-title="Kolera" data-language-autonym="Kurdî" data-language-local-name="Kurdish" class="interlanguage-link-target"><span>Kurdî</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%A5%D0%BE%D0%BB%D0%B5%D1%80%D0%B0" title="Холера – Kyrgyz" lang="ky" hreflang="ky" data-title="Холера" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Cholera" title="Cholera – Latin" lang="la" hreflang="la" data-title="Cholera" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target"><span>Latina</span></a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Holera" title="Holera – Latvian" lang="lv" hreflang="lv" data-title="Holera" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target"><span>Latviešu</span></a></li><li class="interlanguage-link interwiki-lb mw-list-item"><a href="https://lb.wikipedia.org/wiki/Cholera" title="Cholera – Luxembourgish" lang="lb" hreflang="lb" data-title="Cholera" data-language-autonym="Lëtzebuergesch" data-language-local-name="Luxembourgish" class="interlanguage-link-target"><span>Lëtzebuergesch</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Cholera" title="Cholera – Lithuanian" lang="lt" hreflang="lt" data-title="Cholera" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-li mw-list-item"><a href="https://li.wikipedia.org/wiki/Cholera" title="Cholera – Limburgish" lang="li" hreflang="li" data-title="Cholera" data-language-autonym="Limburgs" data-language-local-name="Limburgish" class="interlanguage-link-target"><span>Limburgs</span></a></li><li class="interlanguage-link interwiki-lg mw-list-item"><a href="https://lg.wikipedia.org/wiki/Kolera_ndwadde" title="Kolera ndwadde – Ganda" lang="lg" hreflang="lg" data-title="Kolera ndwadde" data-language-autonym="Luganda" data-language-local-name="Ganda" class="interlanguage-link-target"><span>Luganda</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Kolera" title="Kolera – Hungarian" lang="hu" hreflang="hu" data-title="Kolera" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-mai mw-list-item"><a href="https://mai.wikipedia.org/wiki/%E0%A4%B9%E0%A5%88%E0%A4%9C%E0%A4%BE" title="हैजा – Maithili" lang="mai" hreflang="mai" data-title="हैजा" data-language-autonym="मैथिली" data-language-local-name="Maithili" class="interlanguage-link-target"><span>मैथिली</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%9A%D0%BE%D0%BB%D0%B5%D1%80%D0%B0" title="Колера – Macedonian" lang="mk" hreflang="mk" data-title="Колера" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%95%E0%B5%8B%E0%B4%B3%E0%B4%B1" title="കോളറ – Malayalam" lang="ml" hreflang="ml" data-title="കോളറ" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-mt mw-list-item"><a href="https://mt.wikipedia.org/wiki/Kolera" title="Kolera – Maltese" lang="mt" hreflang="mt" data-title="Kolera" data-language-autonym="Malti" data-language-local-name="Maltese" class="interlanguage-link-target"><span>Malti</span></a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%AA%E0%A4%9F%E0%A4%95%E0%A5%80" title="पटकी – Marathi" lang="mr" hreflang="mr" data-title="पटकी" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target"><span>मराठी</span></a></li><li class="interlanguage-link interwiki-arz mw-list-item"><a href="https://arz.wikipedia.org/wiki/%D9%83%D9%88%D9%84%D9%8A%D8%B1%D8%A7" title="كوليرا – Egyptian Arabic" lang="arz" hreflang="arz" data-title="كوليرا" data-language-autonym="مصرى" data-language-local-name="Egyptian Arabic" class="interlanguage-link-target"><span>مصرى</span></a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Taun" title="Taun – Malay" lang="ms" hreflang="ms" data-title="Taun" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target"><span>Bahasa Melayu</span></a></li><li class="interlanguage-link interwiki-cdo mw-list-item"><a href="https://cdo.wikipedia.org/wiki/B%C3%A2ng-t%C3%B3-si%C3%A1" title="Bâng-tó-siá – Mindong" lang="cdo" hreflang="cdo" data-title="Bâng-tó-siá" data-language-autonym="閩東語 / Mìng-dĕ̤ng-ngṳ̄" data-language-local-name="Mindong" class="interlanguage-link-target"><span>閩東語 / Mìng-dĕ̤ng-ngṳ̄</span></a></li><li class="interlanguage-link interwiki-my mw-list-item"><a href="https://my.wikipedia.org/wiki/%E1%80%80%E1%80%AC%E1%80%9C%E1%80%9D%E1%80%99%E1%80%BA%E1%80%B8%E1%80%9B%E1%80%B1%E1%80%AC%E1%80%82%E1%80%AB" title="ကာလဝမ်းရောဂါ – Burmese" lang="my" hreflang="my" data-title="ကာလဝမ်းရောဂါ" data-language-autonym="မြန်မာဘာသာ" data-language-local-name="Burmese" class="interlanguage-link-target"><span>မြန်မာဘာသာ</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Cholera" title="Cholera – Dutch" lang="nl" hreflang="nl" data-title="Cholera" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ne mw-list-item"><a href="https://ne.wikipedia.org/wiki/%E0%A4%B9%E0%A5%88%E0%A4%9C%E0%A4%BE" title="हैजा – Nepali" lang="ne" hreflang="ne" data-title="हैजा" data-language-autonym="नेपाली" data-language-local-name="Nepali" class="interlanguage-link-target"><span>नेपाली</span></a></li><li class="interlanguage-link interwiki-new mw-list-item"><a href="https://new.wikipedia.org/wiki/%E0%A4%95%E0%A5%8B%E0%A4%B2%E0%A5%87%E0%A4%B0%E0%A4%BE" title="कोलेरा – Newari" lang="new" hreflang="new" data-title="कोलेरा" data-language-autonym="नेपाल भाषा" data-language-local-name="Newari" class="interlanguage-link-target"><span>नेपाल भाषा</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%82%B3%E3%83%AC%E3%83%A9" title="コレラ – Japanese" lang="ja" hreflang="ja" data-title="コレラ" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Kolera" title="Kolera – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Kolera" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Kolera" title="Kolera – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Kolera" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target"><span>Norsk nynorsk</span></a></li><li class="interlanguage-link interwiki-oc mw-list-item"><a href="https://oc.wikipedia.org/wiki/Col%C3%A8ra" title="Colèra – Occitan" lang="oc" hreflang="oc" data-title="Colèra" data-language-autonym="Occitan" data-language-local-name="Occitan" class="interlanguage-link-target"><span>Occitan</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%95%E0%AC%B2%E0%AD%87%E0%AC%B0%E0%AC%BE" title="କଲେରା – Odia" lang="or" hreflang="or" data-title="କଲେରା" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-om mw-list-item"><a href="https://om.wikipedia.org/wiki/Xeensa" title="Xeensa – Oromo" lang="om" hreflang="om" data-title="Xeensa" data-language-autonym="Oromoo" data-language-local-name="Oromo" class="interlanguage-link-target"><span>Oromoo</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Vabo" title="Vabo – Uzbek" lang="uz" hreflang="uz" data-title="Vabo" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pa mw-list-item"><a href="https://pa.wikipedia.org/wiki/%E0%A8%B9%E0%A9%88%E0%A8%9C%E0%A8%BC%E0%A8%BE" title="ਹੈਜ਼ਾ – Punjabi" lang="pa" hreflang="pa" data-title="ਹੈਜ਼ਾ" data-language-autonym="ਪੰਜਾਬੀ" data-language-local-name="Punjabi" class="interlanguage-link-target"><span>ਪੰਜਾਬੀ</span></a></li><li class="interlanguage-link interwiki-pnb mw-list-item"><a href="https://pnb.wikipedia.org/wiki/%DB%81%DB%8C%D8%B6%DB%81" title="ہیضہ – Western Punjabi" lang="pnb" hreflang="pnb" data-title="ہیضہ" data-language-autonym="پنجابی" data-language-local-name="Western Punjabi" class="interlanguage-link-target"><span>پنجابی</span></a></li><li class="interlanguage-link interwiki-ps mw-list-item"><a href="https://ps.wikipedia.org/wiki/%DA%A9%D9%88%D9%84%D8%B1%D8%A7" title="کولرا – Pashto" lang="ps" hreflang="ps" data-title="کولرا" data-language-autonym="پښتو" data-language-local-name="Pashto" class="interlanguage-link-target"><span>پښتو</span></a></li><li class="interlanguage-link interwiki-jam mw-list-item"><a href="https://jam.wikipedia.org/wiki/Kalara" title="Kalara – Jamaican Creole English" lang="jam" hreflang="jam" data-title="Kalara" data-language-autonym="Patois" data-language-local-name="Jamaican Creole English" class="interlanguage-link-target"><span>Patois</span></a></li><li class="interlanguage-link interwiki-pms mw-list-item"><a href="https://pms.wikipedia.org/wiki/Colera" title="Colera – Piedmontese" lang="pms" hreflang="pms" data-title="Colera" data-language-autonym="Piemontèis" data-language-local-name="Piedmontese" class="interlanguage-link-target"><span>Piemontèis</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Cholera" title="Cholera – Polish" lang="pl" hreflang="pl" data-title="Cholera" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/C%C3%B3lera" title="Cólera – Portuguese" lang="pt" hreflang="pt" data-title="Cólera" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Holer%C4%83" title="Holeră – Romanian" lang="ro" hreflang="ro" data-title="Holeră" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-qu mw-list-item"><a href="https://qu.wikipedia.org/wiki/Q%27icha_unquy" title="Q&#039;icha unquy – Quechua" lang="qu" hreflang="qu" data-title="Q&#039;icha unquy" data-language-autonym="Runa Simi" data-language-local-name="Quechua" class="interlanguage-link-target"><span>Runa Simi</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A5%D0%BE%D0%BB%D0%B5%D1%80%D0%B0" title="Холера – Russian" lang="ru" hreflang="ru" data-title="Холера" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sah mw-list-item"><a href="https://sah.wikipedia.org/wiki/%D0%A5%D0%BE%D0%BB%D0%B5%D1%80%D0%B0" title="Холера – Yakut" lang="sah" hreflang="sah" data-title="Холера" data-language-autonym="Саха тыла" data-language-local-name="Yakut" class="interlanguage-link-target"><span>Саха тыла</span></a></li><li class="interlanguage-link interwiki-sa mw-list-item"><a href="https://sa.wikipedia.org/wiki/%E0%A4%B5%E0%A4%BF%E0%A4%B8%E0%A5%82%E0%A4%9A%E0%A4%BF%E0%A4%95%E0%A4%BE" title="विसूचिका – Sanskrit" lang="sa" hreflang="sa" data-title="विसूचिका" data-language-autonym="संस्कृतम्" data-language-local-name="Sanskrit" class="interlanguage-link-target"><span>संस्कृतम्</span></a></li><li class="interlanguage-link interwiki-sat mw-list-item"><a href="https://sat.wikipedia.org/wiki/%E1%B1%A6%E1%B1%9F.%E1%B1%AD%E1%B1%A1%E1%B1%9F" title="ᱦᱟ.ᱭᱡᱟ – Santali" lang="sat" hreflang="sat" data-title="ᱦᱟ.ᱭᱡᱟ" data-language-autonym="ᱥᱟᱱᱛᱟᱲᱤ" data-language-local-name="Santali" class="interlanguage-link-target"><span>ᱥᱟᱱᱛᱟᱲᱤ</span></a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Kolera" title="Kolera – Albanian" lang="sq" hreflang="sq" data-title="Kolera" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target"><span>Shqip</span></a></li><li class="interlanguage-link interwiki-scn mw-list-item"><a href="https://scn.wikipedia.org/wiki/Culera" title="Culera – Sicilian" lang="scn" hreflang="scn" data-title="Culera" data-language-autonym="Sicilianu" data-language-local-name="Sicilian" class="interlanguage-link-target"><span>Sicilianu</span></a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B6%9A%E0%B7%9C%E0%B6%BD%E0%B6%BB%E0%B7%8F%E0%B7%80" title="කොලරාව – Sinhala" lang="si" hreflang="si" data-title="කොලරාව" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target"><span>සිංහල</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Cholera" title="Cholera – Simple English" lang="en-simple" hreflang="en-simple" data-title="Cholera" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sd mw-list-item"><a href="https://sd.wikipedia.org/wiki/%DA%BE%D9%8A%D8%B6%D9%88_%D9%8A%D8%A7_%DA%AA%D9%88%D9%84%D9%8A%D8%B1%D8%A7" title="ھيضو يا ڪوليرا – Sindhi" lang="sd" hreflang="sd" data-title="ھيضو يا ڪوليرا" data-language-autonym="سنڌي" data-language-local-name="Sindhi" class="interlanguage-link-target"><span>سنڌي</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Cholera" title="Cholera – Slovak" lang="sk" hreflang="sk" data-title="Cholera" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Kolera" title="Kolera – Slovenian" lang="sl" hreflang="sl" data-title="Kolera" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%DA%A9%DB%86%D9%84%DB%8E%D8%B1%D8%A7" title="کۆلێرا – Central Kurdish" lang="ckb" hreflang="ckb" data-title="کۆلێرا" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target"><span>کوردی</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%9A%D0%BE%D0%BB%D0%B5%D1%80%D0%B0" title="Колера – Serbian" lang="sr" hreflang="sr" data-title="Колера" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Kolera" title="Kolera – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Kolera" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-su mw-list-item"><a href="https://su.wikipedia.org/wiki/Kol%C3%A9ra" title="Koléra – Sundanese" lang="su" hreflang="su" data-title="Koléra" data-language-autonym="Sunda" data-language-local-name="Sundanese" class="interlanguage-link-target"><span>Sunda</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Kolera" title="Kolera – Finnish" lang="fi" hreflang="fi" data-title="Kolera" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Kolera" title="Kolera – Swedish" lang="sv" hreflang="sv" data-title="Kolera" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Kolera" title="Kolera – Tagalog" lang="tl" hreflang="tl" data-title="Kolera" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%B5%E0%AE%BE%E0%AE%A8%E0%AF%8D%E0%AE%A4%E0%AE%BF%E0%AE%AA%E0%AF%87%E0%AE%A4%E0%AE%BF" title="வாந்திபேதி – Tamil" lang="ta" hreflang="ta" data-title="வாந்திபேதி" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%92%D0%B0%D0%B1%D0%B0" title="Ваба – Tatar" lang="tt" hreflang="tt" data-title="Ваба" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target"><span>Татарча / tatarça</span></a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%95%E0%B0%B2%E0%B0%B0%E0%B0%BE" title="కలరా – Telugu" lang="te" hreflang="te" data-title="కలరా" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target"><span>తెలుగు</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%AD%E0%B8%AB%E0%B8%B4%E0%B8%A7%E0%B8%B2%E0%B8%95%E0%B8%81%E0%B9%82%E0%B8%A3%E0%B8%84" title="อหิวาตกโรค – Thai" lang="th" hreflang="th" data-title="อหิวาตกโรค" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-din mw-list-item"><a href="https://din.wikipedia.org/wiki/Y%C3%A4cpou" title="Yäcpou – Dinka" lang="din" hreflang="din" data-title="Yäcpou" data-language-autonym="Thuɔŋjäŋ" data-language-local-name="Dinka" class="interlanguage-link-target"><span>Thuɔŋjäŋ</span></a></li><li class="interlanguage-link interwiki-tg mw-list-item"><a href="https://tg.wikipedia.org/wiki/%D0%91%D0%B5%D0%BC%D0%BE%D1%80%D0%B8%D0%B8_%D0%B2%D0%B0%D0%B1%D0%BE" title="Бемории вабо – Tajik" lang="tg" hreflang="tg" data-title="Бемории вабо" data-language-autonym="Тоҷикӣ" data-language-local-name="Tajik" class="interlanguage-link-target"><span>Тоҷикӣ</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Kolera" title="Kolera – Turkish" lang="tr" hreflang="tr" data-title="Kolera" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-tw mw-list-item"><a href="https://tw.wikipedia.org/wiki/Ayamtunini/K%C9%94lera" title="Ayamtunini/Kɔlera – Twi" lang="tw" hreflang="tw" data-title="Ayamtunini/Kɔlera" data-language-autonym="Twi" data-language-local-name="Twi" class="interlanguage-link-target"><span>Twi</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%A5%D0%BE%D0%BB%D0%B5%D1%80%D0%B0" title="Холера – Ukrainian" lang="uk" hreflang="uk" data-title="Холера" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%DB%81%DB%8C%D8%B6%DB%81" title="ہیضہ – Urdu" lang="ur" hreflang="ur" data-title="ہیضہ" data-language-autonym="اردو" data-language-local-name="Urdu" class="interlanguage-link-target"><span>اردو</span></a></li><li class="interlanguage-link interwiki-za mw-list-item"><a href="https://za.wikipedia.org/wiki/Binghsiqrueg" title="Binghsiqrueg – Zhuang" lang="za" hreflang="za" data-title="Binghsiqrueg" data-language-autonym="Vahcuengh" data-language-local-name="Zhuang" class="interlanguage-link-target"><span>Vahcuengh</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/B%E1%BB%87nh_t%E1%BA%A3" title="Bệnh tả – Vietnamese" lang="vi" hreflang="vi" data-title="Bệnh tả" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-fiu-vro mw-list-item"><a href="https://fiu-vro.wikipedia.org/wiki/Hall%C3%B5r" title="Hallõr – Võro" lang="vro" hreflang="vro" data-title="Hallõr" data-language-autonym="Võro" data-language-local-name="Võro" class="interlanguage-link-target"><span>Võro</span></a></li><li class="interlanguage-link interwiki-wa mw-list-item"><a href="https://wa.wikipedia.org/wiki/Colera" title="Colera – Walloon" lang="wa" hreflang="wa" data-title="Colera" data-language-autonym="Walon" data-language-local-name="Walloon" class="interlanguage-link-target"><span>Walon</span></a></li><li class="interlanguage-link interwiki-war mw-list-item"><a href="https://war.wikipedia.org/wiki/Kolera" title="Kolera – Waray" lang="war" hreflang="war" data-title="Kolera" data-language-autonym="Winaray" data-language-local-name="Waray" class="interlanguage-link-target"><span>Winaray</span></a></li><li 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class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/1/1b/Semi-protection-shackle.svg/30px-Semi-protection-shackle.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/1/1b/Semi-protection-shackle.svg/40px-Semi-protection-shackle.svg.png 2x" data-file-width="512" data-file-height="512" /></a></span></div></div> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Bacterial infection of the small intestine</div> <p class="mw-empty-elt"> </p> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">This article is about the bacterial disease. For the dish, see <a href="/wiki/Cholera_(food)" title="Cholera (food)">Cholera (food)</a>.</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Not to be confused with <a href="/wiki/Vibriosis" title="Vibriosis">Vibriosis</a>, a milder disease that can be caused by non-cholera toxin producing <a href="/wiki/Vibrio_cholerae" title="Vibrio cholerae">Vibrio cholerae</a> bacteria.</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Cholera</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Asiatic cholera, epidemic cholera<sup id="cite_ref-textbook_1-0" class="reference"><a href="#cite_note-textbook-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Adult_cholera_patient.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2b/Adult_cholera_patient.jpg/220px-Adult_cholera_patient.jpg" decoding="async" width="220" height="146" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2b/Adult_cholera_patient.jpg/330px-Adult_cholera_patient.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2b/Adult_cholera_patient.jpg/440px-Adult_cholera_patient.jpg 2x" data-file-width="700" data-file-height="463" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">A person with severe <a href="/wiki/Dehydration" title="Dehydration">dehydration</a> due to cholera, causing sunken eyes and wrinkled hands and skin.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Infectious_disease_(medical_specialty)" class="mw-redirect" title="Infectious disease (medical specialty)">Infectious disease</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">Large amounts of watery <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a>, <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, <a href="/wiki/Muscle_cramps" class="mw-redirect" title="Muscle cramps">muscle cramps</a><sup id="cite_ref-WHO2010_2-0" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-CDC2015Pro_3-0" class="reference"><a href="#cite_note-CDC2015Pro-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data"><a href="/wiki/Dehydration" title="Dehydration">Dehydration</a>, <a href="/wiki/Electrolyte_imbalance" title="Electrolyte imbalance">electrolyte imbalance</a><sup id="cite_ref-WHO2010_2-1" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">2 hours to 5 days after exposure<sup id="cite_ref-CDC2015Pro_3-1" class="reference"><a href="#cite_note-CDC2015Pro-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">A few days<sup id="cite_ref-WHO2010_2-2" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data"><i><a href="/wiki/Vibrio_cholerae" title="Vibrio cholerae">Vibrio cholerae</a></i> spread by <a href="/wiki/Fecal-oral_route" class="mw-redirect" title="Fecal-oral route">fecal-oral route</a><sup id="cite_ref-WHO2010_2-3" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Fink2016_4-0" class="reference"><a href="#cite_note-Fink2016-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data">Poor <a href="/wiki/Sanitation" title="Sanitation">sanitation</a>, not enough clean <a href="/wiki/Drinking_water" title="Drinking water">drinking water</a>, <a href="/wiki/Poverty" title="Poverty">poverty</a><sup id="cite_ref-WHO2010_2-4" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data"><a href="/wiki/Stool_test" title="Stool test">Stool test</a><sup id="cite_ref-WHO2010_2-5" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Prevention</th><td class="infobox-data">Improved sanitation, <a href="/wiki/Drinking_water" title="Drinking water">clean water</a>, <a href="/wiki/Hand_washing" title="Hand washing">hand washing</a>, <a href="/wiki/Cholera_vaccine" title="Cholera vaccine">cholera vaccines</a><sup id="cite_ref-WHO2010_2-6" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Lancet2012_5-0" class="reference"><a href="#cite_note-Lancet2012-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><a href="/wiki/Oral_rehydration_therapy" title="Oral rehydration therapy">Oral rehydration therapy</a>, <a href="/wiki/Zinc_supplementation" class="mw-redirect" title="Zinc supplementation">zinc supplementation</a>, <a href="/wiki/Intravenous_fluids" class="mw-redirect" title="Intravenous fluids">intravenous fluids</a>, <a href="/wiki/Antibiotics" class="mw-redirect" title="Antibiotics">antibiotics</a><sup id="cite_ref-WHO2010_2-7" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-CDC2014Zinc_6-0" class="reference"><a href="#cite_note-CDC2014Zinc-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data">Less than 1% mortality rate with proper treatment, untreated mortality rate 50–60%</td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">3–5&#160;million people a year<sup id="cite_ref-WHO2010_2-8" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Deaths</th><td class="infobox-data">28,800 (2015)<sup id="cite_ref-GBD2015De_7-0" class="reference"><a href="#cite_note-GBD2015De-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup></td></tr></tbody></table> <p><b>Cholera</b> (<span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˈ/: primary stress follows">ˈ</span><span title="&#39;k&#39; in &#39;kind&#39;">k</span><span title="/ɒ/: &#39;o&#39; in &#39;body&#39;">ɒ</span><span title="&#39;l&#39; in &#39;lie&#39;">l</span><span title="/ər/: &#39;er&#39; in &#39;letter&#39;">ər</span><span title="/ə/: &#39;a&#39; in &#39;about&#39;">ə</span></span>/</a></span></span>) is an <a href="/wiki/Infection" title="Infection">infection</a> of the <a href="/wiki/Small_intestine" title="Small intestine">small intestine</a> by some <a href="/wiki/Strain_(biology)" title="Strain (biology)">strains</a> of the <a href="/wiki/Bacteria" title="Bacteria">bacterium</a> <i><a href="/wiki/Vibrio_cholerae" title="Vibrio cholerae">Vibrio cholerae</a></i>.<sup id="cite_ref-Fink2016_4-1" class="reference"><a href="#cite_note-Fink2016-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-CDC2015Pro_3-2" class="reference"><a href="#cite_note-CDC2015Pro-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> Symptoms may range from none, to mild, to severe.<sup id="cite_ref-CDC2015Pro_3-3" class="reference"><a href="#cite_note-CDC2015Pro-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> The classic symptom is large amounts of watery <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a> lasting a few days.<sup id="cite_ref-WHO2010_2-9" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Vomiting" title="Vomiting">Vomiting</a> and <a href="/wiki/Muscle_cramps" class="mw-redirect" title="Muscle cramps">muscle cramps</a> may also occur.<sup id="cite_ref-CDC2015Pro_3-4" class="reference"><a href="#cite_note-CDC2015Pro-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> Diarrhea can be so severe that it leads within hours to severe <a href="/wiki/Dehydration" title="Dehydration">dehydration</a> and <a href="/wiki/Electrolyte_imbalance" title="Electrolyte imbalance">electrolyte imbalance</a>.<sup id="cite_ref-WHO2010_2-10" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> This may result in <a href="/wiki/Enophthalmia" title="Enophthalmia">sunken eyes</a>, cold skin, decreased skin elasticity, and wrinkling of the hands and feet.<sup id="cite_ref-Lancet2012_5-1" class="reference"><a href="#cite_note-Lancet2012-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> Dehydration can cause the skin to turn <a href="/wiki/Cyanosis" title="Cyanosis">bluish</a>.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> Symptoms start two hours to five days after exposure.<sup id="cite_ref-CDC2015Pro_3-5" class="reference"><a href="#cite_note-CDC2015Pro-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> </p><p>Cholera is caused by a number of <a href="/wiki/Serotype" title="Serotype">types</a> of <i>Vibrio cholerae</i>, with some types producing more severe disease than others.<sup id="cite_ref-WHO2010_2-11" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> It is spread mostly by <a href="/wiki/Waterborne_diseases" class="mw-redirect" title="Waterborne diseases">unsafe water</a> and <a href="/wiki/Foodborne_illness" title="Foodborne illness">unsafe food</a> that has been contaminated with <a href="/wiki/Human_feces" title="Human feces">human feces</a> containing the bacteria.<sup id="cite_ref-WHO2010_2-12" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Undercooked <a href="/wiki/Shellfish" title="Shellfish">shellfish</a> is a common source.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup> Humans are the only known host for the <a href="/wiki/Bacteria" title="Bacteria">bacteria</a>.<sup id="cite_ref-WHO2010_2-13" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Risk_factors" class="mw-redirect" title="Risk factors">Risk factors</a> for the disease include poor <a href="/wiki/Sanitation" title="Sanitation">sanitation</a>, insufficient clean <a href="/wiki/Drinking_water" title="Drinking water">drinking water</a>, and <a href="/wiki/Poverty" title="Poverty">poverty</a>.<sup id="cite_ref-WHO2010_2-14" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Cholera can be diagnosed by a <a href="/wiki/Stool_test" title="Stool test">stool test</a>,<sup id="cite_ref-WHO2010_2-15" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> or a rapid <a href="/wiki/Dipstick#Testing_dipstick" title="Dipstick">dipstick test</a>, although the dipstick test is less accurate.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup> </p><p>Prevention methods against cholera include improved sanitation and access to <a href="/wiki/Drinking_water" title="Drinking water">clean water</a>.<sup id="cite_ref-Lancet2012_5-2" class="reference"><a href="#cite_note-Lancet2012-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Cholera_vaccine" title="Cholera vaccine">Cholera vaccines</a> that are given by mouth provide reasonable protection for about six months, and confer the added benefit of protecting against another type of diarrhea caused by <i><a href="/wiki/Escherichia_coli" title="Escherichia coli">E.&#160;coli</a></i>.<sup id="cite_ref-WHO2010_2-16" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> In 2017, the <a href="/wiki/US_Food_and_Drug_Administration" class="mw-redirect" title="US Food and Drug Administration">US Food and Drug Administration</a> (FDA) approved a single-dose, live, oral cholera vaccine called <a href="/wiki/Cholera_vaccine" title="Cholera vaccine">Vaxchora</a> for adults aged 18–64 who are travelling to an area of active cholera transmission.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> It offers limited protection to young children. People who survive an episode of cholera have long-lasting immunity for at least three years (the period tested).<sup id="cite_ref-immunity_12-0" class="reference"><a href="#cite_note-immunity-12"><span class="cite-bracket">&#91;</span>12<span class="cite-bracket">&#93;</span></a></sup> </p><p>The primary treatment for affected individuals is <a href="/wiki/Oral_rehydration_therapy" title="Oral rehydration therapy">oral rehydration salts</a> (ORS), the replacement of fluids and electrolytes by using slightly sweet and salty solutions.<sup id="cite_ref-WHO2010_2-17" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Rice-based solutions are preferred.<sup id="cite_ref-WHO2010_2-18" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> In children, <a href="/wiki/Zinc_supplementation" class="mw-redirect" title="Zinc supplementation">zinc supplementation</a> has also been found to improve outcomes.<sup id="cite_ref-CDC2014Zinc_6-1" class="reference"><a href="#cite_note-CDC2014Zinc-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> In severe cases, <a href="/wiki/Intravenous_fluid" class="mw-redirect" title="Intravenous fluid">intravenous fluids</a>, such as <a href="/wiki/Ringer%27s_lactate" class="mw-redirect" title="Ringer&#39;s lactate">Ringer's lactate</a>, may be required, and <a href="/wiki/Antibiotic" title="Antibiotic">antibiotics</a> may be beneficial.<sup id="cite_ref-WHO2010_2-19" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> The choice of antibiotic is aided by <a href="/wiki/Antibiotic_sensitivity_testing" title="Antibiotic sensitivity testing">antibiotic sensitivity testing</a>.<sup id="cite_ref-CDC2015Pro_3-6" class="reference"><a href="#cite_note-CDC2015Pro-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> </p><p>Cholera continues to affect an estimated 3–5&#160;million people worldwide and causes 28,800–130,000&#160;deaths a year.<sup id="cite_ref-WHO2010_2-20" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-GBD2015De_7-1" class="reference"><a href="#cite_note-GBD2015De-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup> To date, seven <a href="/wiki/Cholera_pandemic" class="mw-redirect" title="Cholera pandemic">cholera pandemics</a> have occurred, with the most recent beginning in 1961, and continuing today.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> The illness is rare in <a href="/wiki/High-income_country" class="mw-redirect" title="High-income country">high-income countries</a>, and affects children most severely.<sup id="cite_ref-WHO2010_2-21" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">&#91;</span>14<span class="cite-bracket">&#93;</span></a></sup> Cholera occurs as both <a href="/wiki/Epidemic" title="Epidemic">outbreaks</a> and <a href="/wiki/Endemic" class="mw-redirect" title="Endemic">chronically in certain areas</a>.<sup id="cite_ref-WHO2010_2-22" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Areas with an ongoing risk of disease include <a href="/wiki/Africa" title="Africa">Africa</a> and <a href="/wiki/Southeast_Asia" title="Southeast Asia">Southeast Asia</a>.<sup id="cite_ref-WHO2010_2-23" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> The risk of death among those affected is usually less than 5%, given improved treatment, but may be as high as 50% without such access to treatment.<sup id="cite_ref-WHO2010_2-24" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Descriptions of cholera are found as early as the 5th century BC in <a href="/wiki/Sanskrit" title="Sanskrit">Sanskrit</a>.<sup id="cite_ref-Lancet2012_5-3" class="reference"><a href="#cite_note-Lancet2012-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> In Europe, cholera was a term initially used to describe any kind of gastroenteritis, and was not used for this disease until the early 19th century.<sup id="cite_ref-rosenberg_15-0" class="reference"><a href="#cite_note-rosenberg-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> The study of cholera in England by <a href="/wiki/John_Snow_(physician)" class="mw-redirect" title="John Snow (physician)">John Snow</a> between 1849 and 1854 led to significant advances in the field of <a href="/wiki/Epidemiology" title="Epidemiology">epidemiology</a> because of his insights about transmission via contaminated water, and a map of the same was the first recorded incidence of epidemiological tracking.<sup id="cite_ref-Lancet2012_5-4" class="reference"><a href="#cite_note-Lancet2012-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> </p> <figure class="mw-default-size" typeof="mw:File/Thumb"><span><video id="mwe_player_0" poster="//upload.wikimedia.org/wikipedia/commons/thumb/0/06/En.Wikipedia-VideoWiki-Cholera.webm/290px-seek%3D79-En.Wikipedia-VideoWiki-Cholera.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="290" height="163" data-durationhint="191" data-mwtitle="En.Wikipedia-VideoWiki-Cholera.webm" data-mwprovider="wikimediacommons" resource="/wiki/File:En.Wikipedia-VideoWiki-Cholera.webm"><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/0/06/En.Wikipedia-VideoWiki-Cholera.webm/En.Wikipedia-VideoWiki-Cholera.webm.480p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="480p.vp9.webm" data-width="854" data-height="480" /><source src="//upload.wikimedia.org/wikipedia/commons/0/06/En.Wikipedia-VideoWiki-Cholera.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-width="1280" data-height="720" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/0/06/En.Wikipedia-VideoWiki-Cholera.webm/En.Wikipedia-VideoWiki-Cholera.webm.720p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="720p.vp9.webm" data-width="1280" data-height="720" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/0/06/En.Wikipedia-VideoWiki-Cholera.webm/En.Wikipedia-VideoWiki-Cholera.webm.144p.mjpeg.mov" type="video/quicktime" data-transcodekey="144p.mjpeg.mov" data-width="256" data-height="144" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/0/06/En.Wikipedia-VideoWiki-Cholera.webm/En.Wikipedia-VideoWiki-Cholera.webm.240p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="240p.vp9.webm" data-width="426" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/0/06/En.Wikipedia-VideoWiki-Cholera.webm/En.Wikipedia-VideoWiki-Cholera.webm.360p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="360p.vp9.webm" data-width="640" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/0/06/En.Wikipedia-VideoWiki-Cholera.webm/En.Wikipedia-VideoWiki-Cholera.webm.360p.webm" type="video/webm; codecs=&quot;vp8, vorbis&quot;" data-transcodekey="360p.webm" data-width="640" data-height="360" /><track src="https://commons.wikimedia.org/w/api.php?action=timedtext&amp;title=File%3AEn.Wikipedia-VideoWiki-Cholera.webm&amp;lang=en&amp;trackformat=vtt&amp;origin=%2A" kind="subtitles" type="text/vtt" srclang="en" label="English ‪(en)‬" data-dir="ltr" /></video></span><figcaption>Video summary of this article with VideoWiki (<a href="/wiki/Wikipedia:VideoWiki/Cholera" title="Wikipedia:VideoWiki/Cholera">script</a>)</figcaption></figure> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Cholera_feces.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/ee/Cholera_feces.jpg/220px-Cholera_feces.jpg" decoding="async" width="220" height="222" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/ee/Cholera_feces.jpg/330px-Cholera_feces.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/ee/Cholera_feces.jpg/440px-Cholera_feces.jpg 2x" data-file-width="693" data-file-height="698" /></a><figcaption>Typical cholera diarrhea that looks like "rice water"</figcaption></figure> <p>The primary symptoms of cholera are profuse <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a> and <a href="/wiki/Vomiting" title="Vomiting">vomiting</a> of clear fluid.<sup id="cite_ref-Lancet2004_17-0" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> These symptoms usually start suddenly, half a day to five days after ingestion of the bacteria.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">&#91;</span>18<span class="cite-bracket">&#93;</span></a></sup> The diarrhea is frequently described as "rice water" in nature and may have a fishy odor.<sup id="cite_ref-Lancet2004_17-1" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> An untreated person with cholera may produce 10 to 20 litres (3 to 5&#160;US&#160;gal) of diarrhea a day.<sup id="cite_ref-Lancet2004_17-2" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Severe cholera, without treatment, kills about half of affected individuals.<sup id="cite_ref-Lancet2004_17-3" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> If the severe diarrhea is not treated, it can result in life-threatening <a href="/wiki/Dehydration" title="Dehydration">dehydration</a> and <a href="/wiki/Electrolyte" title="Electrolyte">electrolyte</a> imbalances.<sup id="cite_ref-Lancet2004_17-4" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Estimates of the ratio of <a href="/wiki/Asymptomatic" title="Asymptomatic">asymptomatic</a> to symptomatic infections have ranged from 3 to 100.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> Cholera has been nicknamed the "blue death"<sup id="cite_ref-Greenough_20-0" class="reference"><a href="#cite_note-Greenough-20"><span class="cite-bracket">&#91;</span>20<span class="cite-bracket">&#93;</span></a></sup> because a person's skin may turn <a href="/wiki/Cyanosis" title="Cyanosis">bluish-gray</a> from extreme loss of fluids.<sup id="cite_ref-McE2009_21-0" class="reference"><a href="#cite_note-McE2009-21"><span class="cite-bracket">&#91;</span>21<span class="cite-bracket">&#93;</span></a></sup> </p><p>Fever is rare and should raise suspicion for secondary infection. Patients can be lethargic and might have sunken eyes, dry mouth, cold clammy skin, or wrinkled hands and feet. <a href="/wiki/Kussmaul_breathing" title="Kussmaul breathing">Kussmaul breathing</a>, a deep and labored breathing pattern, can occur because of <a href="/wiki/Acidosis" title="Acidosis">acidosis</a> from <a href="/wiki/Human_feces" title="Human feces">stool</a> <a href="/wiki/Bicarbonate" title="Bicarbonate">bicarbonate</a> losses and <a href="/wiki/Lactic_acidosis" title="Lactic acidosis">lactic acidosis</a> associated with poor <a href="/wiki/Perfusion" title="Perfusion">perfusion</a>. <a href="/wiki/Blood_pressure" title="Blood pressure">Blood pressure</a> drops due to dehydration, peripheral pulse is rapid and thready, and urine output decreases with time. Muscle cramping and weakness, altered consciousness, <a href="/wiki/Seizures" class="mw-redirect" title="Seizures">seizures</a>, or even <a href="/wiki/Coma" title="Coma">coma</a> due to <a href="/wiki/Electrolyte_imbalance" title="Electrolyte imbalance">electrolyte imbalances</a> are common, especially in children.<sup id="cite_ref-Lancet2004_17-5" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Cause">Cause</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Vibrio_cholerae" title="Vibrio cholerae">Vibrio cholerae</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Cholera_bacteria_SEM.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/9d/Cholera_bacteria_SEM.jpg/220px-Cholera_bacteria_SEM.jpg" decoding="async" width="220" height="172" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/9d/Cholera_bacteria_SEM.jpg/330px-Cholera_bacteria_SEM.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/9d/Cholera_bacteria_SEM.jpg/440px-Cholera_bacteria_SEM.jpg 2x" data-file-width="1228" data-file-height="960" /></a><figcaption><a href="/wiki/Scanning_electron_microscope" title="Scanning electron microscope">Scanning electron microscope</a> image of <i>Vibrio cholerae</i></figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Vibrio_cholerae.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f6/Vibrio_cholerae.jpg/220px-Vibrio_cholerae.jpg" decoding="async" width="220" height="179" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f6/Vibrio_cholerae.jpg/330px-Vibrio_cholerae.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f6/Vibrio_cholerae.jpg/440px-Vibrio_cholerae.jpg 2x" data-file-width="1762" data-file-height="1437" /></a><figcaption><i><a href="/wiki/Vibrio_cholerae" title="Vibrio cholerae">Vibrio cholerae</a></i>, the bacterium that causes cholera</figcaption></figure> <div class="mw-heading mw-heading3"><h3 id="Transmission">Transmission</h3></div> <p>Cholera bacteria have been found in <a href="/wiki/Shellfish" title="Shellfish">shellfish</a> and <a href="/wiki/Plankton" title="Plankton">plankton</a>.<sup id="cite_ref-Lancet2004_17-6" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> </p><p><a href="/wiki/Transmission_(medicine)" class="mw-redirect" title="Transmission (medicine)">Transmission</a> is usually through the <a href="/wiki/Fecal-oral_route" class="mw-redirect" title="Fecal-oral route">fecal-oral route</a> of contaminated food or water caused by poor <a href="/wiki/Sanitation" title="Sanitation">sanitation</a>.<sup id="cite_ref-WHO2010_2-25" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Most cholera cases in <a href="/wiki/Developed_country" title="Developed country">developed countries</a> are a result of transmission by food, while in <a href="/wiki/Developing_country" title="Developing country">developing countries</a> it is more often water.<sup id="cite_ref-Lancet2004_17-7" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Food transmission can occur when people harvest seafood such as <a href="/wiki/Oyster" title="Oyster">oysters</a> in waters infected with <a href="/wiki/Sewage" title="Sewage">sewage</a>, as <i>Vibrio cholerae</i> accumulates in <a href="/wiki/Plankton" title="Plankton">planktonic</a> <a href="/wiki/Copepod" title="Copepod">crustaceans</a> and the oysters eat the <a href="/wiki/Zooplankton" title="Zooplankton">zooplankton</a>.<sup id="cite_ref-bakerinstitute.org_22-0" class="reference"><a href="#cite_note-bakerinstitute.org-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup> </p><p>People infected with cholera often have diarrhea, and disease transmission may occur if this highly liquid stool, colloquially referred to as "rice-water", contaminates water used by others.<sup id="cite_ref-Sherris_23-0" class="reference"><a href="#cite_note-Sherris-23"><span class="cite-bracket">&#91;</span>23<span class="cite-bracket">&#93;</span></a></sup> A single diarrheal event can cause a one-million fold increase in numbers of <i>V. cholerae</i> in the environment.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> The source of the contamination is typically other people with cholera when their untreated diarrheal discharge is allowed to get into waterways, <a href="/wiki/Groundwater" title="Groundwater">groundwater</a> or <a href="/wiki/Drinking_water" title="Drinking water">drinking water</a> supplies. Drinking any contaminated water and eating any foods washed in the water, as well as <a href="/wiki/Shellfish" title="Shellfish">shellfish</a> living in the affected <a href="/wiki/Waterway" title="Waterway">waterway</a>, can cause a person to contract an infection. Cholera is rarely <a href="/wiki/Contagious_disease" title="Contagious disease">spread directly from person to person</a>.<sup id="cite_ref-CDC_2020_25-0" class="reference"><a href="#cite_note-CDC_2020-25"><span class="cite-bracket">&#91;</span>25<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">&#91;</span>note 1<span class="cite-bracket">&#93;</span></a></sup> </p><p><i>V. cholerae</i> also exists outside the human body in natural water sources, either by itself or through interacting with <a href="/wiki/Phytoplankton" title="Phytoplankton">phytoplankton</a>, <a href="/wiki/Zooplankton" title="Zooplankton">zooplankton</a>, or <a href="/wiki/Biotic_material" title="Biotic material">biotic</a> and <a href="/wiki/Abiotic" class="mw-redirect" title="Abiotic">abiotic</a> detritus.<sup id="cite_ref-NEJOct2009review_27-0" class="reference"><a href="#cite_note-NEJOct2009review-27"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup> Drinking such water can also result in the disease, even without prior contamination through fecal matter. Selective pressures exist however in the aquatic environment that may reduce the virulence of <i>V. cholerae</i>.<sup id="cite_ref-NEJOct2009review_27-1" class="reference"><a href="#cite_note-NEJOct2009review-27"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup> Specifically, animal models indicate that the transcriptional profile of the pathogen changes as it prepares to enter an aquatic environment.<sup id="cite_ref-NEJOct2009review_27-2" class="reference"><a href="#cite_note-NEJOct2009review-27"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup> This transcriptional change results in a loss of ability of <i>V. cholerae</i> to be cultured on standard media, a phenotype referred to as '<a href="/wiki/Viable_but_non-culturable" class="mw-redirect" title="Viable but non-culturable">viable but non-culturable</a>' (VBNC) or more conservatively '<a href="/w/index.php?title=Active_but_non-culturable&amp;action=edit&amp;redlink=1" class="new" title="Active but non-culturable (page does not exist)">active but non-culturable</a>' (ABNC).<sup id="cite_ref-NEJOct2009review_27-3" class="reference"><a href="#cite_note-NEJOct2009review-27"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup> One study indicates that the culturability of <i>V. cholerae</i> drops 90% within 24 hours of entering the water, and furthermore that this loss in culturability is associated with a loss in virulence.<sup id="cite_ref-NEJOct2009review_27-4" class="reference"><a href="#cite_note-NEJOct2009review-27"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-NEJOct2008plos_28-0" class="reference"><a href="#cite_note-NEJOct2008plos-28"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> </p><p>Both toxic and non-toxic strains exist. Non-toxic strains can acquire <a href="/wiki/Toxicity" title="Toxicity">toxicity</a> through a <a href="/wiki/Temperateness_(virology)" title="Temperateness (virology)">temperate</a> <a href="/wiki/Bacteriophage" title="Bacteriophage">bacteriophage</a>.<sup id="cite_ref-Archivist_1997_29-0" class="reference"><a href="#cite_note-Archivist_1997-29"><span class="cite-bracket">&#91;</span>28<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Susceptibility">Susceptibility</h3></div> <p>About 100<span class="nowrap">&#160;</span>million bacteria must typically be ingested to cause cholera in a normal healthy adult.<sup id="cite_ref-Lancet2004_17-8" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> This dose, however, is less in those with lowered <a href="/wiki/Gastric_acid" title="Gastric acid">gastric acidity</a> (for instance those using <a href="/wiki/Proton_pump_inhibitors" class="mw-redirect" title="Proton pump inhibitors">proton pump inhibitors</a>).<sup id="cite_ref-Lancet2004_17-9" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Children are also more susceptible, with two- to four-year-olds having the highest rates of infection.<sup id="cite_ref-Lancet2004_17-10" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Individuals' susceptibility to cholera is also affected by their <a href="/wiki/Blood_type" title="Blood type">blood type</a>, with those with <a href="/wiki/Type_O_blood" class="mw-redirect" title="Type O blood">type O blood</a> being the most susceptible.<sup id="cite_ref-Lancet2004_17-11" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Persons with <a href="/wiki/Immunodeficiency" title="Immunodeficiency">lowered immunity</a>, such as persons with <a href="/wiki/HIV/AIDS" title="HIV/AIDS">AIDS</a> or <a href="/wiki/Malnutrition" title="Malnutrition">malnourished</a> children, are more likely to develop a severe case if they become infected.<sup id="cite_ref-WHOpreventionandcontrolofoutbreaks_30-0" class="reference"><a href="#cite_note-WHOpreventionandcontrolofoutbreaks-30"><span class="cite-bracket">&#91;</span>29<span class="cite-bracket">&#93;</span></a></sup> Any individual, even a healthy adult in middle age, can undergo a severe case, and each person's case should be measured by the loss of fluids, preferably in consultation with a professional <a href="/wiki/Health_care_provider" title="Health care provider">health care provider</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (December 2013)">medical citation needed</span></a></i>&#93;</sup> </p><p>The <a href="/wiki/Cystic_fibrosis" title="Cystic fibrosis">cystic fibrosis</a> genetic <a href="/wiki/Mutation" title="Mutation">mutation</a> known as <a href="/wiki/Delta-F508" class="mw-redirect" title="Delta-F508">delta-F508</a> in humans has been said to maintain a selective <a href="/wiki/Heterozygous_advantage" class="mw-redirect" title="Heterozygous advantage">heterozygous advantage</a>: <a href="/wiki/Heterozygous" class="mw-redirect" title="Heterozygous">heterozygous</a> carriers of the mutation (who are not affected by cystic fibrosis) are more resistant to <i>V. cholerae</i> infections.<sup id="cite_ref-Bertranpetit_1996_31-0" class="reference"><a href="#cite_note-Bertranpetit_1996-31"><span class="cite-bracket">&#91;</span>30<span class="cite-bracket">&#93;</span></a></sup> In this model, the genetic deficiency in the <a href="/wiki/Cystic_fibrosis_transmembrane_conductance_regulator" title="Cystic fibrosis transmembrane conductance regulator">cystic fibrosis transmembrane conductance regulator</a> channel proteins interferes with bacteria binding to the <a href="/wiki/Intestinal_epithelium" title="Intestinal epithelium">intestinal epithelium</a>, thus reducing the effects of an infection. </p> <div class="mw-heading mw-heading2"><h2 id="Mechanism">Mechanism</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Cholera_role_of_biofilm_in_intestinal_colonization.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/9a/Cholera_role_of_biofilm_in_intestinal_colonization.jpg/310px-Cholera_role_of_biofilm_in_intestinal_colonization.jpg" decoding="async" width="310" height="154" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/9a/Cholera_role_of_biofilm_in_intestinal_colonization.jpg/465px-Cholera_role_of_biofilm_in_intestinal_colonization.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/9a/Cholera_role_of_biofilm_in_intestinal_colonization.jpg/620px-Cholera_role_of_biofilm_in_intestinal_colonization.jpg 2x" data-file-width="1607" data-file-height="799" /></a><figcaption>The role of <a href="/wiki/Biofilm" title="Biofilm">biofilm</a> in the intestinal colonization of <i>Vibrio cholerae</i></figcaption></figure> <p>When consumed, most bacteria do not survive the <a href="/wiki/Gastric_acid" title="Gastric acid">acidic</a> conditions of the <a href="/wiki/Stomach" title="Stomach">human stomach</a>.<sup id="cite_ref-BliskaAlmagro-Moreno2015_32-0" class="reference"><a href="#cite_note-BliskaAlmagro-Moreno2015-32"><span class="cite-bracket">&#91;</span>31<span class="cite-bracket">&#93;</span></a></sup> The few surviving bacteria conserve their energy and stored <a href="/wiki/Nutrient" title="Nutrient">nutrients</a> during the passage through the stomach by shutting down <a href="/wiki/Protein" title="Protein">protein</a> production. When the surviving bacteria exit the stomach and reach the <a href="/wiki/Small_intestine" title="Small intestine">small intestine</a>, they must propel themselves through the thick <a href="/wiki/Mucus#Digestive_system" title="Mucus">mucus</a> that lines the small intestine to reach the intestinal walls where they can attach and thrive.<sup id="cite_ref-BliskaAlmagro-Moreno2015_32-1" class="reference"><a href="#cite_note-BliskaAlmagro-Moreno2015-32"><span class="cite-bracket">&#91;</span>31<span class="cite-bracket">&#93;</span></a></sup> </p><p>Once the cholera bacteria reach the intestinal wall, they no longer need the <a href="/wiki/Flagellum" title="Flagellum">flagella</a> to move. The bacteria stop producing the protein <a href="/wiki/Flagellin" title="Flagellin">flagellin</a> to conserve energy and nutrients by changing the mix of proteins that they express in response to the changed chemical surroundings. On reaching the intestinal wall, <i>V. cholerae</i> start producing the <a href="/wiki/Exotoxin" title="Exotoxin">toxic proteins</a> that give the infected person a watery diarrhea. This carries the multiplying new generations of <i>V. cholerae</i> bacteria out into the drinking water of the next host if proper sanitation measures are not in place.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">&#91;</span>32<span class="cite-bracket">&#93;</span></a></sup> </p><p>The <a href="/wiki/Cholera_toxin" title="Cholera toxin">cholera toxin</a> (CTX or CT) is an <a href="/wiki/Oligomer" title="Oligomer">oligomeric</a> complex made up of six <a href="/wiki/Protein_subunit" title="Protein subunit">protein subunits</a>: a single copy of the A subunit (part A), and five copies of the B subunit (part B), connected by a <a href="/wiki/Disulfide_bond" class="mw-redirect" title="Disulfide bond">disulfide bond</a>. The five B subunits form a five-membered ring that binds to <a href="/wiki/GM1" title="GM1">GM1</a> <a href="/wiki/Ganglioside" title="Ganglioside">gangliosides</a> on the surface of the intestinal epithelium cells. The A1 portion of the A subunit is an enzyme that <a href="/wiki/ADP-ribosylation" title="ADP-ribosylation">ADP-ribosylates</a> <a href="/wiki/G_protein" title="G protein">G proteins</a>, while the A2 chain fits into the central pore of the B subunit ring. Upon binding, the complex is taken into the cell via receptor-mediated <a href="/wiki/Endocytosis" title="Endocytosis">endocytosis</a>. Once inside the cell, the disulfide bond is reduced, and the A1 subunit is freed to bind with a human partner protein called <a href="/wiki/ADP-ribosylation_factor_6" class="mw-redirect" title="ADP-ribosylation factor 6">ADP-ribosylation factor 6</a> (Arf6).<sup id="cite_ref-O_34-0" class="reference"><a href="#cite_note-O-34"><span class="cite-bracket">&#91;</span>33<span class="cite-bracket">&#93;</span></a></sup> Binding exposes its active site, allowing it to permanently ribosylate the <a href="/wiki/Gs_alpha_subunit" title="Gs alpha subunit">Gs alpha subunit</a> of the <a href="/wiki/Heterotrimeric_G_protein" title="Heterotrimeric G protein">heterotrimeric G protein</a>. This results in constitutive <a href="/wiki/Cyclic_adenosine_monophosphate" title="Cyclic adenosine monophosphate">cAMP</a> production, which in turn leads to the secretion of water, sodium, potassium, and bicarbonate into the lumen of the small intestine and rapid dehydration. The gene encoding the cholera toxin was introduced into <i>V. cholerae</i> by <a href="/wiki/Horizontal_gene_transfer" title="Horizontal gene transfer">horizontal gene transfer</a>. Virulent strains of <i>V. cholerae</i> carry a variant of a <a href="/wiki/Temperateness_(virology)" title="Temperateness (virology)">temperate</a> <a href="/wiki/Bacteriophage" title="Bacteriophage">bacteriophage</a> called <a href="/wiki/CTX%CF%86_Bacteriophage" class="mw-redirect" title="CTXφ Bacteriophage">CTXφ</a>. </p><p>Microbiologists have studied the <a href="/wiki/Gene_expression" title="Gene expression">genetic mechanisms</a> by which the <i>V. cholerae</i> bacteria turn off the production of some proteins and turn on the production of other proteins as they respond to the series of chemical environments they encounter, passing through the stomach, through the mucous layer of the small intestine, and on to the intestinal wall.<sup id="cite_ref-DiRita_35-0" class="reference"><a href="#cite_note-DiRita-35"><span class="cite-bracket">&#91;</span>34<span class="cite-bracket">&#93;</span></a></sup> Of particular interest have been the genetic mechanisms by which cholera bacteria turn on the protein production of the toxins that interact with host cell mechanisms to pump <a href="/wiki/Chloride" title="Chloride">chloride</a> ions into the small intestine, creating an ionic pressure which prevents sodium ions from entering the cell. The chloride and sodium ions create a salt-water environment in the small intestines, which through osmosis can pull up to six liters of water per day through the intestinal cells, creating the massive amounts of diarrhea. The host can become rapidly dehydrated unless treated properly.<sup id="cite_ref-who.int_36-0" class="reference"><a href="#cite_note-who.int-36"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup> </p><p>By inserting separate, successive sections of <i>V. cholerae</i> DNA into the DNA of other bacteria, such as <i><a href="/wiki/Escherichia_coli" title="Escherichia coli">E. coli</a></i> that would not naturally produce the protein toxins, researchers have investigated the mechanisms by which <i>V. cholerae</i> responds to the changing chemical environments of the stomach, mucous layers, and intestinal wall. Researchers have discovered a complex cascade of regulatory proteins controls expression of <i>V. cholerae</i> <a href="/wiki/Virulence" title="Virulence">virulence</a> determinants.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">&#91;</span>36<span class="cite-bracket">&#93;</span></a></sup> In responding to the chemical environment at the intestinal wall, the <i>V. cholerae</i> bacteria produce the TcpP/TcpH proteins, which, together with the ToxR/ToxS proteins, activate the expression of the ToxT regulatory protein. ToxT then directly activates expression of <a href="/wiki/Virulence" title="Virulence">virulence</a> genes that produce the toxins, causing diarrhea in the infected person and allowing the bacteria to colonize the intestine.<sup id="cite_ref-DiRita_35-1" class="reference"><a href="#cite_note-DiRita-35"><span class="cite-bracket">&#91;</span>34<span class="cite-bracket">&#93;</span></a></sup> Current<sup class="noprint Inline-Template" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers"><span title="The time period mentioned near this tag is ambiguous. (August 2017)">when?</span></a></i>&#93;</sup> research aims at discovering "the signal that makes the cholera bacteria stop swimming and start to colonize (that is, adhere to the cells of) the small intestine."<sup id="cite_ref-DiRita_35-2" class="reference"><a href="#cite_note-DiRita-35"><span class="cite-bracket">&#91;</span>34<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Genetic_structure">Genetic structure</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Vibrio_cholerae" title="Vibrio cholerae">Vibrio cholerae</a></div> <p><a href="/wiki/Amplified_fragment_length_polymorphism" title="Amplified fragment length polymorphism">Amplified fragment length polymorphism</a> <a href="/wiki/DNA_profiling" title="DNA profiling">fingerprinting</a> of the pandemic <a href="/wiki/Genetic_isolate" title="Genetic isolate">isolates</a> of <i>V. cholerae</i> has revealed variation in the genetic structure. Two <a href="/wiki/Gene_cluster" title="Gene cluster">clusters</a> have been identified: Cluster I and Cluster II. For the most part, Cluster I consists of strains from the 1960s and 1970s, while Cluster II largely contains strains from the 1980s and 1990s, based on the change in the clone structure. This grouping of strains is best seen in the strains from the African continent.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Antibiotic_resistance">Antibiotic resistance</h3></div> <p>In many areas of the world, <a href="/wiki/Antibiotic_resistance" class="mw-redirect" title="Antibiotic resistance">antibiotic resistance</a> is increasing within cholera bacteria. In <a href="/wiki/Bangladesh" title="Bangladesh">Bangladesh</a>, for example, most cases are resistant to <a href="/wiki/Tetracycline" title="Tetracycline">tetracycline</a>, <a href="/wiki/Trimethoprim-sulfamethoxazole" class="mw-redirect" title="Trimethoprim-sulfamethoxazole">trimethoprim-sulfamethoxazole</a>, and <a href="/wiki/Erythromycin" title="Erythromycin">erythromycin</a>.<sup id="cite_ref-NEJM2006_39-0" class="reference"><a href="#cite_note-NEJM2006-39"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> Rapid diagnostic <a href="/wiki/Assay" title="Assay">assay</a> methods are available for the identification of <a href="/wiki/Multiple_drug_resistance" title="Multiple drug resistance">multi-drug resistant</a> cases.<sup id="cite_ref-Mackay_40-0" class="reference"><a href="#cite_note-Mackay-40"><span class="cite-bracket">&#91;</span>39<span class="cite-bracket">&#93;</span></a></sup> New generation antimicrobials have been discovered which are effective against cholera bacteria in <i>in vitro</i> studies.<sup id="cite_ref-Ramamurthy_41-0" class="reference"><a href="#cite_note-Ramamurthy-41"><span class="cite-bracket">&#91;</span>40<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2></div> <p>A rapid <a href="/wiki/Dipstick" title="Dipstick">dipstick</a> test is available to determine the presence of <i>V. cholerae</i>.<sup id="cite_ref-NEJM2006_39-1" class="reference"><a href="#cite_note-NEJM2006-39"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> In those samples that test positive, further testing should be done to determine antibiotic resistance.<sup id="cite_ref-NEJM2006_39-2" class="reference"><a href="#cite_note-NEJM2006-39"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> In <a href="/wiki/Epidemic" title="Epidemic">epidemic</a> situations, a clinical diagnosis may be made by taking a <a href="/wiki/Medical_history" title="Medical history">patient history</a> and doing a brief examination. Treatment via hydration and over-the-counter hydration solutions can be started without or before confirmation by laboratory analysis, especially where cholera is a common problem.<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">&#91;</span>41<span class="cite-bracket">&#93;</span></a></sup> </p><p>Stool and swab samples collected in the acute stage of the disease, before antibiotics have been administered, are the most useful specimens for laboratory diagnosis. If an epidemic of cholera is suspected, the most common causative agent is <i>V. cholerae</i> O1. If <i>V. cholerae</i> <a href="/wiki/Serotype" title="Serotype">serogroup</a> O1 is not isolated, the laboratory should test for <i>V. cholerae</i> O139. However, if neither of these organisms is isolated, it is necessary to send stool specimens to a reference laboratory.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (August 2020)">citation needed</span></a></i>&#93;</sup> </p><p>Infection with <i>V. cholerae</i> O139 should be reported and handled in the same manner as that caused by <i>V. cholerae</i> O1. The associated diarrheal illness should be referred to as cholera and must be reported in the United States.<sup id="cite_ref-CDC_Diag_43-0" class="reference"><a href="#cite_note-CDC_Diag-43"><span class="cite-bracket">&#91;</span>42<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:It_doesn%27t_hurt,_but_it_tickles._A_U.S._Navy_hospital_corpsman,_member_of_a_USAID_military_health_team,_inoculates_a_flo_-_NARA_-_541855.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/61/It_doesn%27t_hurt%2C_but_it_tickles._A_U.S._Navy_hospital_corpsman%2C_member_of_a_USAID_military_health_team%2C_inoculates_a_flo_-_NARA_-_541855.jpg/290px-It_doesn%27t_hurt%2C_but_it_tickles._A_U.S._Navy_hospital_corpsman%2C_member_of_a_USAID_military_health_team%2C_inoculates_a_flo_-_NARA_-_541855.jpg" decoding="async" width="290" height="239" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/61/It_doesn%27t_hurt%2C_but_it_tickles._A_U.S._Navy_hospital_corpsman%2C_member_of_a_USAID_military_health_team%2C_inoculates_a_flo_-_NARA_-_541855.jpg/435px-It_doesn%27t_hurt%2C_but_it_tickles._A_U.S._Navy_hospital_corpsman%2C_member_of_a_USAID_military_health_team%2C_inoculates_a_flo_-_NARA_-_541855.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/61/It_doesn%27t_hurt%2C_but_it_tickles._A_U.S._Navy_hospital_corpsman%2C_member_of_a_USAID_military_health_team%2C_inoculates_a_flo_-_NARA_-_541855.jpg/580px-It_doesn%27t_hurt%2C_but_it_tickles._A_U.S._Navy_hospital_corpsman%2C_member_of_a_USAID_military_health_team%2C_inoculates_a_flo_-_NARA_-_541855.jpg 2x" data-file-width="2890" data-file-height="2382" /></a><figcaption>Preventive inoculation against cholera in 1966</figcaption></figure> <p>The <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> (WHO) recommends focusing on prevention, preparedness, and response to combat the spread of cholera.<sup id="cite_ref-who.int_36-1" class="reference"><a href="#cite_note-who.int-36"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup> They also stress the importance of an effective surveillance system.<sup id="cite_ref-who.int_36-2" class="reference"><a href="#cite_note-who.int-36"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup> Governments can play a role in all of these areas. </p> <div class="mw-heading mw-heading3"><h3 id="Water,_sanitation_and_hygiene"><span id="Water.2C_sanitation_and_hygiene"></span>Water, sanitation and hygiene</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/WASH#Health_aspects" title="WASH">WASH §&#160;Health aspects</a></div> <p>Although cholera may be life-threatening, prevention of the disease is normally straightforward if proper <a href="/wiki/Sanitation" title="Sanitation">sanitation</a> practices are followed. In <a href="/wiki/Developed_countries" class="mw-redirect" title="Developed countries">developed countries</a>, due to their nearly universal advanced <a href="/wiki/Water_treatment" title="Water treatment">water treatment</a> and sanitation practices, cholera is rare. For example, the last major outbreak of cholera in the United States occurred in 1910–1911.<sup id="cite_ref-moltke1_44-0" class="reference"><a href="#cite_note-moltke1-44"><span class="cite-bracket">&#91;</span>43<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-moltke2_45-0" class="reference"><a href="#cite_note-moltke2-45"><span class="cite-bracket">&#91;</span>44<span class="cite-bracket">&#93;</span></a></sup> Cholera is mainly a risk in <a href="/wiki/Developing_country" title="Developing country">developing countries</a> in those areas where access to <a href="/wiki/WASH" title="WASH">WASH (water, sanitation and hygiene)</a> infrastructure is still inadequate. </p><p>Effective sanitation practices, if instituted and adhered to in time, are usually sufficient to stop an epidemic. There are several points along the cholera transmission path at which its spread may be halted:<sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">&#91;</span>45<span class="cite-bracket">&#93;</span></a></sup> </p> <ul><li>Sterilization: Proper disposal and treatment of all materials that may have come into contact with the feces of other people with cholera (e.g., clothing, bedding, etc.) are essential. These should be <a href="/wiki/Disinfection" class="mw-redirect" title="Disinfection">sanitized</a> by washing in hot water, using <a href="/wiki/Chlorine" title="Chlorine">chlorine</a> <a href="/wiki/Bleach" title="Bleach">bleach</a> if possible. Hands that touch cholera patients or their clothing, bedding, etc., should be thoroughly cleaned and disinfected with chlorinated water or other effective antimicrobial agents.</li> <li><a href="/wiki/Sewage" title="Sewage">Sewage</a> and <a href="/wiki/Fecal_sludge_management" title="Fecal sludge management">fecal sludge management</a>: In cholera-affected areas, sewage and fecal sludge need to be treated and managed carefully in order to stop the spread of this disease via <a href="/wiki/Human_excreta" class="mw-redirect" title="Human excreta">human excreta</a>. Provision of <a href="/wiki/Sanitation" title="Sanitation">sanitation</a> and <a href="/wiki/Hygiene" title="Hygiene">hygiene</a> is an important preventative measure.<sup id="cite_ref-who.int_36-3" class="reference"><a href="#cite_note-who.int-36"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Open_defecation" title="Open defecation">Open defecation</a>, release of untreated sewage, or dumping of fecal sludge from <a href="/wiki/Pit_latrine" title="Pit latrine">pit latrines</a> or <a href="/wiki/Septic_tank" title="Septic tank">septic tanks</a> into the environment need to be prevented.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">&#91;</span>46<span class="cite-bracket">&#93;</span></a></sup> In many cholera affected zones, there is a low degree of <a href="/wiki/Sewage_treatment" title="Sewage treatment">sewage treatment</a>.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">&#91;</span>47<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">&#91;</span>48<span class="cite-bracket">&#93;</span></a></sup> Therefore, the implementation of <a href="/wiki/Dry_toilet" title="Dry toilet">dry toilets</a> that do not contribute to <a href="/wiki/Water_pollution" title="Water pollution">water pollution</a>, as they do not flush with water, may be an interesting alternative to <a href="/wiki/Flush_toilet" title="Flush toilet">flush toilets</a>.<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">&#91;</span>49<span class="cite-bracket">&#93;</span></a></sup></li> <li>Sources: Warnings about possible cholera contamination should be posted around contaminated water sources with directions on how to <a href="/wiki/Decontamination" title="Decontamination">decontaminate</a> the water (boiling, chlorination etc.) for possible use.</li> <li><a href="/wiki/Water_purification" title="Water purification">Water purification</a>: All water used for drinking, washing, or cooking should be sterilized by either boiling, <a href="/wiki/Water_chlorination" title="Water chlorination">chlorination</a>, ozone water treatment, ultraviolet light sterilization (e.g., by <a href="/wiki/Solar_water_disinfection" title="Solar water disinfection">solar water disinfection</a>), or antimicrobial filtration in any area where cholera may be present. Chlorination and boiling are often the least expensive and most effective means of halting transmission. <a href="/wiki/Cloth_filter" title="Cloth filter">Cloth filters</a> or <a href="#Sari_filtration">sari filtration</a>, though very basic, have significantly reduced the occurrence of cholera when used in poor villages in <a href="/wiki/Bangladesh" title="Bangladesh">Bangladesh</a> that rely on untreated surface water. Better antimicrobial filters, like those present in advanced individual water treatment hiking kits, are most effective. Public health education and adherence to appropriate sanitation practices are of primary importance to help prevent and control transmission of cholera and other diseases.</li></ul> <p><a href="/wiki/Hand_washing" title="Hand washing">Handwashing</a> with soap or ash after using a <a href="/wiki/Toilet" title="Toilet">toilet</a> and before handling food or eating is also recommended for cholera prevention by WHO Africa.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">&#91;</span>50<span class="cite-bracket">&#93;</span></a></sup> </p> <ul class="gallery mw-gallery-traditional center"> <li class="gallerybox" style="width: 260px"> <div class="thumb" style="width: 255px; height: 230px;"><span typeof="mw:File"><a href="/wiki/File:Unsafe_disposal_of_faecal_sludge_or_sewage_in_Haiti_(6458176073).jpg" class="mw-file-description" title="Dumping of sewage or fecal sludge from a UN camp into a lake in the surroundings of Port-au-Prince is thought to have contributed to the spread of cholera after the Haiti earthquake in 2010, killing thousands."><img alt="Dumping of sewage or fecal sludge from a UN camp into a lake in the surroundings of Port-au-Prince is thought to have contributed to the spread of cholera after the Haiti earthquake in 2010, killing thousands." src="//upload.wikimedia.org/wikipedia/commons/thumb/6/61/Unsafe_disposal_of_faecal_sludge_or_sewage_in_Haiti_%286458176073%29.jpg/225px-Unsafe_disposal_of_faecal_sludge_or_sewage_in_Haiti_%286458176073%29.jpg" decoding="async" width="225" height="169" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/61/Unsafe_disposal_of_faecal_sludge_or_sewage_in_Haiti_%286458176073%29.jpg/338px-Unsafe_disposal_of_faecal_sludge_or_sewage_in_Haiti_%286458176073%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/61/Unsafe_disposal_of_faecal_sludge_or_sewage_in_Haiti_%286458176073%29.jpg/450px-Unsafe_disposal_of_faecal_sludge_or_sewage_in_Haiti_%286458176073%29.jpg 2x" data-file-width="640" data-file-height="480" /></a></span></div> <div class="gallerytext">Dumping of <a href="/wiki/Sewage" title="Sewage">sewage</a> or <a href="/wiki/Fecal_sludge_management" title="Fecal sludge management">fecal sludge</a> from a UN camp into a lake in the surroundings of <a href="/wiki/Port-au-Prince" title="Port-au-Prince">Port-au-Prince</a> is thought to have contributed to the spread of <a href="/wiki/2010_Haiti_cholera_outbreak" class="mw-redirect" title="2010 Haiti cholera outbreak">cholera after the Haiti earthquake in 2010</a>, killing thousands.</div> </li> <li class="gallerybox" style="width: 260px"> <div class="thumb" style="width: 255px; height: 230px;"><span typeof="mw:File"><a href="/wiki/File:A_SOIL_EkoLakay_toilet_customer._(15921409131).jpg" class="mw-file-description" title="Example of a urine-diverting dry toilet in a cholera-affected area in Haiti. This type of toilet stops transmission of disease via the fecal-oral route due to water pollution."><img alt="Example of a urine-diverting dry toilet in a cholera-affected area in Haiti. This type of toilet stops transmission of disease via the fecal-oral route due to water pollution." src="//upload.wikimedia.org/wikipedia/commons/thumb/d/dc/A_SOIL_EkoLakay_toilet_customer._%2815921409131%29.jpg/112px-A_SOIL_EkoLakay_toilet_customer._%2815921409131%29.jpg" decoding="async" width="112" height="200" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/dc/A_SOIL_EkoLakay_toilet_customer._%2815921409131%29.jpg/169px-A_SOIL_EkoLakay_toilet_customer._%2815921409131%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/dc/A_SOIL_EkoLakay_toilet_customer._%2815921409131%29.jpg/225px-A_SOIL_EkoLakay_toilet_customer._%2815921409131%29.jpg 2x" data-file-width="1080" data-file-height="1920" /></a></span></div> <div class="gallerytext">Example of a <a href="/wiki/Urine-diverting_dry_toilet" title="Urine-diverting dry toilet">urine-diverting dry toilet</a> in a cholera-affected area in <a href="/wiki/Haiti" title="Haiti">Haiti</a>. This type of toilet stops transmission of disease via the <a href="/wiki/Fecal%E2%80%93oral_route" title="Fecal–oral route">fecal-oral route</a> due to <a href="/wiki/Water_pollution" title="Water pollution">water pollution</a>.</div> </li> <li class="gallerybox" style="width: 260px"> <div class="thumb" style="width: 255px; height: 230px;"><span typeof="mw:File"><a href="/wiki/File:Cholera_hospital_in_Dhaka.jpg" class="mw-file-description" title="Cholera hospital in Dhaka, showing typical &quot;cholera beds&quot;."><img alt="Cholera hospital in Dhaka, showing typical &quot;cholera beds&quot;." src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f8/Cholera_hospital_in_Dhaka.jpg/150px-Cholera_hospital_in_Dhaka.jpg" decoding="async" width="150" height="200" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f8/Cholera_hospital_in_Dhaka.jpg/225px-Cholera_hospital_in_Dhaka.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f8/Cholera_hospital_in_Dhaka.jpg/300px-Cholera_hospital_in_Dhaka.jpg 2x" data-file-width="600" data-file-height="800" /></a></span></div> <div class="gallerytext"><a href="/wiki/International_Centre_for_Diarrhoeal_Disease_Research,_Bangladesh" class="mw-redirect" title="International Centre for Diarrhoeal Disease Research, Bangladesh">Cholera hospital</a> in <a href="/wiki/Dhaka" title="Dhaka">Dhaka</a>, showing typical "cholera beds".</div> </li> </ul> <div class="mw-heading mw-heading3"><h3 id="Surveillance">Surveillance</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><span><video id="mwe_player_1" poster="//upload.wikimedia.org/wikipedia/commons/thumb/e/e7/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm/290px--Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="290" height="163" data-durationhint="192" data-mwtitle="Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm" data-mwprovider="wikimediacommons" resource="/wiki/File:Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm"><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/e/e7/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm.480p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="480p.vp9.webm" data-width="854" data-height="480" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/e/e7/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm.720p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="720p.vp9.webm" data-width="1280" data-height="720" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/e/e7/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm.1080p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="1080p.vp9.webm" data-width="1920" data-height="1080" /><source src="//upload.wikimedia.org/wikipedia/commons/e/e7/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm" type="video/webm; codecs=&quot;vp8, vorbis&quot;" data-width="1920" data-height="1080" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/e/e7/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm.240p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="240p.vp9.webm" data-width="426" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/e/e7/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm.360p.webm" type="video/webm; codecs=&quot;vp8, vorbis&quot;" data-transcodekey="360p.webm" data-width="640" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/e/e7/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm/Using_Precipitation_Data_to_Assess_Risk_of_Cholera_Outbreaks.webm.360p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="360p.vp9.webm" data-width="640" data-height="360" /></video></span><figcaption>A modelling approach using satellite data can enhance our ability to develop cholera risk maps in several regions of the globe.</figcaption></figure> <p>Surveillance and prompt reporting allow for containing cholera epidemics rapidly. Cholera exists as a seasonal disease in many endemic countries, occurring annually mostly during <a href="/wiki/Wet_season" title="Wet season">rainy seasons</a>. Surveillance systems can provide early alerts to outbreaks, therefore leading to coordinated response and assist in preparation of preparedness plans. Efficient surveillance systems can also improve the risk assessment for potential cholera outbreaks. Understanding the seasonality and location of outbreaks provides guidance for improving cholera control activities for the most vulnerable.<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">&#91;</span>51<span class="cite-bracket">&#93;</span></a></sup> For prevention to be effective, it is important that cases be reported to national health authorities.<sup id="cite_ref-Lancet2004_17-12" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Vaccination">Vaccination</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Cholera_vaccine" title="Cholera vaccine">Cholera vaccine</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Euvichol-plus.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b3/Euvichol-plus.jpg/220px-Euvichol-plus.jpg" decoding="async" width="220" height="232" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b3/Euvichol-plus.jpg/330px-Euvichol-plus.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b3/Euvichol-plus.jpg/440px-Euvichol-plus.jpg 2x" data-file-width="2064" data-file-height="2178" /></a><figcaption>Euvichol-plus oral vaccine for cholera</figcaption></figure> <p>Spanish physician <a href="/wiki/Jaume_Ferran_i_Clua" title="Jaume Ferran i Clua">Jaume Ferran i Clua</a> developed the first successful cholera inoculation in 1885, the first to immunize humans against a bacterial disease.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">&#91;</span>52<span class="cite-bracket">&#93;</span></a></sup> His vaccine and inoculation was rather controversial and was rejected by his peers and several investigation commissions but it ended up demonstrating its effectiveness and being recognized for it: out of the 30 thousand people he vaccinated only 54 died.<sup id="cite_ref-:0_54-0" class="reference"><a href="#cite_note-:0-54"><span class="cite-bracket">&#91;</span>53<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:1_55-0" class="reference"><a href="#cite_note-:1-55"><span class="cite-bracket">&#91;</span>54<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:2_56-0" class="reference"><a href="#cite_note-:2-56"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> Russian-Jewish bacteriologist <a href="/wiki/Waldemar_Haffkine" title="Waldemar Haffkine">Waldemar Haffkine</a> also developed a human cholera vaccine in July 1892.<sup id="cite_ref-:0_54-1" class="reference"><a href="#cite_note-:0-54"><span class="cite-bracket">&#91;</span>53<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:1_55-1" class="reference"><a href="#cite_note-:1-55"><span class="cite-bracket">&#91;</span>54<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:2_56-1" class="reference"><a href="#cite_note-:2-56"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">&#91;</span>57<span class="cite-bracket">&#93;</span></a></sup> He conducted a massive inoculation program in <a href="/wiki/British_India" class="mw-redirect" title="British India">British India</a>.<sup id="cite_ref-:2_56-2" class="reference"><a href="#cite_note-:2-56"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">&#91;</span>58<span class="cite-bracket">&#93;</span></a></sup> </p><p>Persons who survive an episode of cholera have long-lasting immunity for at least 3 years (the period tested.)<sup id="cite_ref-immunity_12-1" class="reference"><a href="#cite_note-immunity-12"><span class="cite-bracket">&#91;</span>12<span class="cite-bracket">&#93;</span></a></sup> A number of safe and effective oral vaccines for cholera are available.<sup id="cite_ref-pmid21412922_60-0" class="reference"><a href="#cite_note-pmid21412922-60"><span class="cite-bracket">&#91;</span>59<span class="cite-bracket">&#93;</span></a></sup> The World Health Organization (WHO) has three prequalified oral cholera vaccines (OCVs): Dukoral, Sanchol, and Euvichol. <a href="/wiki/Dukoral" class="mw-redirect" title="Dukoral">Dukoral</a>, an orally administered, inactivated <a href="/wiki/Whole-cell_vaccine" title="Whole-cell vaccine">whole-cell vaccine</a>, has an overall efficacy of about 52% during the first year after being given and 62% in the second year, with minimal side effects.<sup id="cite_ref-pmid21412922_60-1" class="reference"><a href="#cite_note-pmid21412922-60"><span class="cite-bracket">&#91;</span>59<span class="cite-bracket">&#93;</span></a></sup> It is available in over 60 countries. However, it is not currently<sup class="noprint Inline-Template" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers"><span title="The time period mentioned near this tag is ambiguous. (August 2017)">when?</span></a></i>&#93;</sup> recommended by the <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a> (CDC) for most people traveling from the United States to endemic countries.<sup id="cite_ref-CDC_Vacc_61-0" class="reference"><a href="#cite_note-CDC_Vacc-61"><span class="cite-bracket">&#91;</span>60<span class="cite-bracket">&#93;</span></a></sup> The vaccine that the <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">US Food and Drug Administration</a> (FDA) recommends, <a href="/wiki/Vaxchora" class="mw-redirect" title="Vaxchora">Vaxchora</a>, is an <a href="/wiki/Cholera_vaccine#Oral" title="Cholera vaccine">oral attenuated live vaccine</a>, that is effective for adults aged 18–64 as a single dose.<sup id="cite_ref-62" class="reference"><a href="#cite_note-62"><span class="cite-bracket">&#91;</span>61<span class="cite-bracket">&#93;</span></a></sup> </p><p>One injectable vaccine was found to be effective for two to three years. The protective efficacy was 28% lower in children less than five years old.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">&#91;</span>62<span class="cite-bracket">&#93;</span></a></sup> However, as of 2010<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Cholera&amp;action=edit">&#91;update&#93;</a></sup>, it has limited availability.<sup id="cite_ref-WHO2010_2-26" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Work is under way to investigate the role of mass vaccination.<sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">&#91;</span>63<span class="cite-bracket">&#93;</span></a></sup> The WHO recommends immunization of high-risk groups, such as children and people with <a href="/wiki/HIV" title="HIV">HIV</a>, in countries where this disease is <a href="/wiki/Endemism" title="Endemism">endemic</a>.<sup id="cite_ref-WHO2010_2-27" class="reference"><a href="#cite_note-WHO2010-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> If people are immunized broadly, <a href="/wiki/Herd_immunity" title="Herd immunity">herd immunity</a> results, with a decrease in the amount of contamination in the environment.<sup id="cite_ref-NEJM2006_39-3" class="reference"><a href="#cite_note-NEJM2006-39"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> </p><p>WHO recommends that oral cholera vaccination be considered in areas where the disease is endemic (with seasonal peaks), as part of the response to outbreaks, or in a humanitarian crisis during which the risk of cholera is high.<sup id="cite_ref-65" class="reference"><a href="#cite_note-65"><span class="cite-bracket">&#91;</span>64<span class="cite-bracket">&#93;</span></a></sup> Oral Cholera Vaccine (OCV) has been recognized as an adjunct tool for prevention and control of cholera. The World Health Organization (WHO) has prequalified three bivalent cholera vaccines—Dukoral (SBL Vaccines), containing a non-toxic B-subunit of cholera toxin and providing protection against V. cholerae O1; and two vaccines developed using the same transfer of technology—ShanChol (Shantha Biotec) and Euvichol (EuBiologics Co.), which have bivalent O1 and O139 oral killed cholera vaccines.<sup id="cite_ref-66" class="reference"><a href="#cite_note-66"><span class="cite-bracket">&#91;</span>65<span class="cite-bracket">&#93;</span></a></sup> Oral cholera vaccination could be deployed in a diverse range of situations from cholera-endemic areas and locations of humanitarian crises, but no clear consensus exists.<sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">&#91;</span>66<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Sari_filtration">Sari filtration</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Cloth_filter" title="Cloth filter">Cloth filter</a></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Washing_Utensils_And_Vegetables.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/1a/Washing_Utensils_And_Vegetables.png/240px-Washing_Utensils_And_Vegetables.png" decoding="async" width="240" height="170" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/1a/Washing_Utensils_And_Vegetables.png/360px-Washing_Utensils_And_Vegetables.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/1a/Washing_Utensils_And_Vegetables.png/480px-Washing_Utensils_And_Vegetables.png 2x" data-file-width="1606" data-file-height="1140" /></a><figcaption>Women at a village pond in <a href="/wiki/Matlab,_Bangladesh" class="mw-redirect" title="Matlab, Bangladesh">Matlab, Bangladesh</a> washing utensils and vegetables. The woman on the right is putting a sari filter onto a water-collecting pot (or <a href="/wiki/Kalasha" title="Kalasha">kalash</a>) to filter water for drinking.</figcaption></figure> <p>Developed for use in <a href="/wiki/Bangladesh" title="Bangladesh">Bangladesh</a>, the "sari filter" is a simple and cost-effective <a href="/wiki/Appropriate_technology" title="Appropriate technology">appropriate technology</a> method for reducing the contamination of drinking water. Used <a href="/wiki/Sari" title="Sari">sari</a> cloth is preferable but other types of used cloth can be used with some effect, though the effectiveness will vary significantly. Used cloth is more effective than new cloth, as the repeated washing reduces the space between the fibers. Water collected in this way has a greatly reduced <a href="/wiki/Pathogen" title="Pathogen">pathogen</a> count—though it will not necessarily be perfectly safe, it is an improvement for poor people with limited options.<sup id="cite_ref-Ram2010_68-0" class="reference"><a href="#cite_note-Ram2010-68"><span class="cite-bracket">&#91;</span>67<span class="cite-bracket">&#93;</span></a></sup> In Bangladesh this practice was found to decrease rates of cholera by nearly half.<sup id="cite_ref-Merr2010_69-0" class="reference"><a href="#cite_note-Merr2010-69"><span class="cite-bracket">&#91;</span>68<span class="cite-bracket">&#93;</span></a></sup> It involves folding a <i>sari</i> four to eight times.<sup id="cite_ref-Ram2010_68-1" class="reference"><a href="#cite_note-Ram2010-68"><span class="cite-bracket">&#91;</span>67<span class="cite-bracket">&#93;</span></a></sup> Between uses the cloth should be rinsed in clean water and dried in the sun to kill any bacteria on it.<sup id="cite_ref-70" class="reference"><a href="#cite_note-70"><span class="cite-bracket">&#91;</span>69<span class="cite-bracket">&#93;</span></a></sup> A <a href="/wiki/Nylon" title="Nylon">nylon</a> cloth appears to work as well but is not as affordable.<sup id="cite_ref-Merr2010_69-1" class="reference"><a href="#cite_note-Merr2010-69"><span class="cite-bracket">&#91;</span>68<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Cholera_rehydration_nurses.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/ad/Cholera_rehydration_nurses.jpg/290px-Cholera_rehydration_nurses.jpg" decoding="async" width="290" height="194" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/ad/Cholera_rehydration_nurses.jpg/435px-Cholera_rehydration_nurses.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/ad/Cholera_rehydration_nurses.jpg/580px-Cholera_rehydration_nurses.jpg 2x" data-file-width="1781" data-file-height="1192" /></a><figcaption>Cholera patient being treated by <a href="/wiki/Oral_rehydration_therapy" title="Oral rehydration therapy">oral rehydration therapy</a> in 1992</figcaption></figure> <p>Continued eating speeds the recovery of normal intestinal function. The WHO recommends this generally for cases of diarrhea no matter what the underlying cause.<sup id="cite_ref-WHOTreatmentOfDiarrhoea2005_71-0" class="reference"><a href="#cite_note-WHOTreatmentOfDiarrhoea2005-71"><span class="cite-bracket">&#91;</span>70<span class="cite-bracket">&#93;</span></a></sup> A CDC training manual specifically for cholera states: "Continue to breastfeed your baby if the baby has watery diarrhea, even when traveling to get treatment. Adults and older children should continue to eat frequently."<sup id="cite_ref-CDCCommunityHealthWorkerTrainingManual_72-0" class="reference"><a href="#cite_note-CDCCommunityHealthWorkerTrainingManual-72"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Fluids">Fluids</h3></div> <p>The most common error in caring for patients with cholera is to underestimate the speed and volume of fluids required.<sup id="cite_ref-73" class="reference"><a href="#cite_note-73"><span class="cite-bracket">&#91;</span>72<span class="cite-bracket">&#93;</span></a></sup> In most cases, cholera can be successfully treated with <a href="/wiki/Oral_rehydration_therapy" title="Oral rehydration therapy">oral rehydration therapy</a> (ORT), which is highly effective, safe, and simple to administer.<sup id="cite_ref-NEJM2006_39-4" class="reference"><a href="#cite_note-NEJM2006-39"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> Rice-based solutions are preferred to glucose-based ones due to greater efficiency.<sup id="cite_ref-NEJM2006_39-5" class="reference"><a href="#cite_note-NEJM2006-39"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> In severe cases with significant dehydration, <a href="/wiki/Intravenous" class="mw-redirect" title="Intravenous">intravenous</a> rehydration may be necessary. <a href="/wiki/Ringer%27s_lactate" class="mw-redirect" title="Ringer&#39;s lactate">Ringer's lactate</a> is the preferred solution, often with added potassium.<sup id="cite_ref-Lancet2004_17-13" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-WHOTreatmentOfDiarrhoea2005_71-1" class="reference"><a href="#cite_note-WHOTreatmentOfDiarrhoea2005-71"><span class="cite-bracket">&#91;</span>70<span class="cite-bracket">&#93;</span></a></sup> Large volumes and continued replacement until diarrhea has subsided may be needed.<sup id="cite_ref-Lancet2004_17-14" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Ten percent of a person's body weight in fluid may need to be given in the first two to four hours.<sup id="cite_ref-Lancet2004_17-15" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> This method was first tried on a mass scale during the <a href="/wiki/Bangladesh_Liberation_War" title="Bangladesh Liberation War">Bangladesh Liberation War</a>, and was found to have much success.<sup id="cite_ref-74" class="reference"><a href="#cite_note-74"><span class="cite-bracket">&#91;</span>73<span class="cite-bracket">&#93;</span></a></sup> Despite widespread beliefs, fruit juices and commercial fizzy drinks like cola are not ideal for rehydration of people with serious infections of the intestines, and their excessive sugar content may even harm water uptake.<sup id="cite_ref-75" class="reference"><a href="#cite_note-75"><span class="cite-bracket">&#91;</span>74<span class="cite-bracket">&#93;</span></a></sup> </p><p>If commercially produced oral rehydration solutions are too expensive or difficult to obtain, solutions can be made. One such recipe calls for 1 liter of boiled water, 1/2 teaspoon of salt, 6 teaspoons of sugar, and added mashed banana for potassium and to improve taste.<sup id="cite_ref-76" class="reference"><a href="#cite_note-76"><span class="cite-bracket">&#91;</span>75<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Electrolytes">Electrolytes</h3></div> <p>As there frequently is initially <a href="/wiki/Acidosis" title="Acidosis">acidosis</a>, the <a href="/wiki/Potassium" title="Potassium">potassium</a> level may be normal, even though large losses have occurred.<sup id="cite_ref-Lancet2004_17-16" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> As the dehydration is corrected, potassium levels may decrease rapidly, and thus need to be replaced.<sup id="cite_ref-Lancet2004_17-17" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> This is best done by Oral Rehydration Solution (ORS).<sup id="cite_ref-choleraoutbreaksteps_77-0" class="reference"><a href="#cite_note-choleraoutbreaksteps-77"><span class="cite-bracket">&#91;</span>76<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Antibiotics">Antibiotics</h3></div> <p><a href="/wiki/Antibiotic" title="Antibiotic">Antibiotic</a> treatments for one to three days shorten the course of the disease and reduce the severity of the symptoms.<sup id="cite_ref-Lancet2004_17-18" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Use of antibiotics also reduces fluid requirements.<sup id="cite_ref-78" class="reference"><a href="#cite_note-78"><span class="cite-bracket">&#91;</span>77<span class="cite-bracket">&#93;</span></a></sup> People will recover without them, however, if sufficient hydration is maintained.<sup id="cite_ref-NEJM2006_39-6" class="reference"><a href="#cite_note-NEJM2006-39"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> The WHO only recommends antibiotics in those with severe dehydration.<sup id="cite_ref-choleraoutbreaksteps_77-1" class="reference"><a href="#cite_note-choleraoutbreaksteps-77"><span class="cite-bracket">&#91;</span>76<span class="cite-bracket">&#93;</span></a></sup> </p><p><a href="/wiki/Doxycycline" title="Doxycycline">Doxycycline</a> is typically used first line, although some <a href="/wiki/Strain_(biology)" title="Strain (biology)">strains</a> of <i>V. cholerae</i> have shown <a href="/wiki/Antibiotic_resistance" class="mw-redirect" title="Antibiotic resistance">resistance</a>.<sup id="cite_ref-Lancet2004_17-19" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Testing for resistance during an outbreak can help determine appropriate future choices.<sup id="cite_ref-Lancet2004_17-20" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Other antibiotics proven to be effective include <a href="/wiki/Cotrimoxazole" class="mw-redirect" title="Cotrimoxazole">cotrimoxazole</a>, <a href="/wiki/Erythromycin" title="Erythromycin">erythromycin</a>, <a href="/wiki/Tetracycline" title="Tetracycline">tetracycline</a>, <a href="/wiki/Chloramphenicol" title="Chloramphenicol">chloramphenicol</a>, and <a href="/wiki/Furazolidone" title="Furazolidone">furazolidone</a>.<sup id="cite_ref-79" class="reference"><a href="#cite_note-79"><span class="cite-bracket">&#91;</span>78<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Fluoroquinolone" class="mw-redirect" title="Fluoroquinolone">Fluoroquinolones</a>, such as <a href="/wiki/Ciprofloxacin" title="Ciprofloxacin">ciprofloxacin</a>, also may be used, but resistance has been reported.<sup id="cite_ref-80" class="reference"><a href="#cite_note-80"><span class="cite-bracket">&#91;</span>79<span class="cite-bracket">&#93;</span></a></sup> </p><p>Antibiotics improve outcomes in those who are both severely and not severely dehydrated.<sup id="cite_ref-Lei2014_81-0" class="reference"><a href="#cite_note-Lei2014-81"><span class="cite-bracket">&#91;</span>80<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Azithromycin" title="Azithromycin">Azithromycin</a> and <a href="/wiki/Tetracycline" title="Tetracycline">tetracycline</a> may work better than <a href="/wiki/Doxycycline" title="Doxycycline">doxycycline</a> or <a href="/wiki/Ciprofloxacin" title="Ciprofloxacin">ciprofloxacin</a>.<sup id="cite_ref-Lei2014_81-1" class="reference"><a href="#cite_note-Lei2014-81"><span class="cite-bracket">&#91;</span>80<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Zinc_supplementation">Zinc supplementation</h3></div> <p>In Bangladesh <a href="/wiki/Zinc" title="Zinc">zinc</a> supplementation reduced the duration and severity of diarrhea in children with cholera when given with antibiotics and rehydration therapy as needed. It reduced the length of disease by eight hours and the amount of diarrhea stool by 10%.<sup id="cite_ref-CDC2013_82-0" class="reference"><a href="#cite_note-CDC2013-82"><span class="cite-bracket">&#91;</span>81<span class="cite-bracket">&#93;</span></a></sup> Supplementation appears to be also effective in both treating and preventing infectious diarrhea due to other causes among children in the developing world.<sup id="cite_ref-CDC2013_82-1" class="reference"><a href="#cite_note-CDC2013-82"><span class="cite-bracket">&#91;</span>81<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-83" class="reference"><a href="#cite_note-83"><span class="cite-bracket">&#91;</span>82<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2></div> <p>If people with cholera are treated quickly and properly, the mortality rate is less than 1%; however, with untreated cholera, the mortality rate rises to 50–60%.<sup id="cite_ref-Lancet2004_17-21" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-textbook_1-1" class="reference"><a href="#cite_note-textbook-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> </p><p>For certain genetic strains of cholera, such as the one present during the <a href="/wiki/2010_Haiti_cholera_outbreak" class="mw-redirect" title="2010 Haiti cholera outbreak">2010 epidemic in Haiti</a> and the 2004 outbreak in India, death can occur within two hours of becoming ill.<sup id="cite_ref-Knox2010_84-0" class="reference"><a href="#cite_note-Knox2010-84"><span class="cite-bracket">&#91;</span>83<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2></div> <p>Cholera affects an estimated 2.8&#160;million people worldwide, and causes approximately 95,000&#160;deaths a year (uncertainty range: 21,000–143,000) as of 2015<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Cholera&amp;action=edit">&#91;update&#93;</a></sup>.<sup id="cite_ref-85" class="reference"><a href="#cite_note-85"><span class="cite-bracket">&#91;</span>84<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Loz2012_86-0" class="reference"><a href="#cite_note-Loz2012-86"><span class="cite-bracket">&#91;</span>85<span class="cite-bracket">&#93;</span></a></sup> This occurs mainly in the developing world.<sup id="cite_ref-87" class="reference"><a href="#cite_note-87"><span class="cite-bracket">&#91;</span>86<span class="cite-bracket">&#93;</span></a></sup> </p><p>In the early 1980s, death rates are believed to have still been higher than three million a year.<sup id="cite_ref-Lancet2004_17-22" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> It is difficult to calculate exact numbers of cases, as many go unreported due to concerns that an outbreak may have a negative impact on the tourism of a country.<sup id="cite_ref-NEJM2006_39-7" class="reference"><a href="#cite_note-NEJM2006-39"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> As of 2004, cholera remained both <a href="/wiki/Epidemic" title="Epidemic">epidemic</a> and endemic in many areas of the world.<sup id="cite_ref-Lancet2004_17-23" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> </p><p>Recent major outbreaks are the <a href="/wiki/2010s_Haiti_cholera_outbreak" title="2010s Haiti cholera outbreak">2010s Haiti cholera outbreak</a> and the <a href="/wiki/2016%E2%80%932022_Yemen_cholera_outbreak" title="2016–2022 Yemen cholera outbreak">2016–2022 Yemen cholera outbreak</a>. In October 2016, an <a href="/wiki/2017_Yemen_cholera_outbreak" class="mw-redirect" title="2017 Yemen cholera outbreak">outbreak of cholera</a> began in war-ravaged <a href="/wiki/Yemen" title="Yemen">Yemen</a>.<sup id="cite_ref-88" class="reference"><a href="#cite_note-88"><span class="cite-bracket">&#91;</span>87<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/WHO" class="mw-redirect" title="WHO">WHO</a> called it "the worst cholera outbreak in the world".<sup id="cite_ref-89" class="reference"><a href="#cite_note-89"><span class="cite-bracket">&#91;</span>88<span class="cite-bracket">&#93;</span></a></sup> In 2019, 93% of the reported 923,037 cholera cases were from <a href="/wiki/Yemen" title="Yemen">Yemen</a> (with 1911 deaths reported).<sup id="cite_ref-who_report2020_90-0" class="reference"><a href="#cite_note-who_report2020-90"><span class="cite-bracket">&#91;</span>89<span class="cite-bracket">&#93;</span></a></sup> Between September 2019 and September 2020, a global total of over 450,000 cases and over 900 deaths was reported; however, the accuracy of these numbers suffer from over-reporting from countries that report suspected cases (and not laboratory confirmed cases), as well as under-reporting from countries that do not report official cases (such as Bangladesh, India and Philippines).<sup id="cite_ref-who_report2020_90-1" class="reference"><a href="#cite_note-who_report2020-90"><span class="cite-bracket">&#91;</span>89<span class="cite-bracket">&#93;</span></a></sup> </p><p>Although much is known about the mechanisms behind the spread of cholera, researchers still do not have a full understanding of what makes cholera outbreaks happen in some places and not others. Lack of treatment of human <a href="/wiki/Feces" title="Feces">feces</a> and lack of treatment of drinking water greatly facilitate its spread. Bodies of water have been found to serve as a <a href="/wiki/Natural_reservoir" title="Natural reservoir">reservoir</a> of infection, and seafood shipped long distances can spread the disease. </p><p>Cholera had disappeared from the <a href="/wiki/Americas" title="Americas">Americas</a> for most of the 20th century, but it reappeared toward the end of that century, beginning with a severe outbreak in Peru.<sup id="cite_ref-91" class="reference"><a href="#cite_note-91"><span class="cite-bracket">&#91;</span>90<span class="cite-bracket">&#93;</span></a></sup> This was followed by the <a href="/wiki/2010s_Haiti_cholera_outbreak" title="2010s Haiti cholera outbreak">2010s Haiti cholera outbreak</a><sup id="cite_ref-ecdc_cholera_92-0" class="reference"><a href="#cite_note-ecdc_cholera-92"><span class="cite-bracket">&#91;</span>91<span class="cite-bracket">&#93;</span></a></sup> and another outbreak of cholera in Haiti amid the <a href="/wiki/2018%E2%80%932023_Haitian_crisis" class="mw-redirect" title="2018–2023 Haitian crisis">2018–2023 Haitian crisis</a>.<sup id="cite_ref-93" class="reference"><a href="#cite_note-93"><span class="cite-bracket">&#91;</span>92<span class="cite-bracket">&#93;</span></a></sup> As of August 2021<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Cholera&amp;action=edit">&#91;update&#93;</a></sup> the disease is endemic in Africa and some areas of eastern and western Asia (Bangladesh, India and Yemen).<sup id="cite_ref-ecdc_cholera_92-1" class="reference"><a href="#cite_note-ecdc_cholera-92"><span class="cite-bracket">&#91;</span>91<span class="cite-bracket">&#93;</span></a></sup> Cholera is not endemic in Europe; all reported cases had a travel history to endemic areas.<sup id="cite_ref-ecdc_cholera_92-2" class="reference"><a href="#cite_note-ecdc_cholera-92"><span class="cite-bracket">&#91;</span>91<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="History_of_outbreaks">History of outbreaks</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Cholera_outbreaks_and_pandemics" class="mw-redirect" title="Cholera outbreaks and pandemics">Cholera outbreaks and pandemics</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Il_cholera_di_Palermo_del_1835.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/67/Il_cholera_di_Palermo_del_1835.jpg/290px-Il_cholera_di_Palermo_del_1835.jpg" decoding="async" width="290" height="204" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/67/Il_cholera_di_Palermo_del_1835.jpg/435px-Il_cholera_di_Palermo_del_1835.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/67/Il_cholera_di_Palermo_del_1835.jpg/580px-Il_cholera_di_Palermo_del_1835.jpg 2x" data-file-width="2736" data-file-height="1920" /></a><figcaption>Disposal of dead bodies during the cholera epidemic in <a href="/wiki/Palermo" title="Palermo">Palermo</a> in 1835</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Africa_cholera2008b.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c4/Africa_cholera2008b.jpg/290px-Africa_cholera2008b.jpg" decoding="async" width="290" height="309" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c4/Africa_cholera2008b.jpg/435px-Africa_cholera2008b.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c4/Africa_cholera2008b.jpg/580px-Africa_cholera2008b.jpg 2x" data-file-width="650" data-file-height="692" /></a><figcaption>Map of the <a href="/wiki/Zimbabwean_cholera_outbreak" class="mw-redirect" title="Zimbabwean cholera outbreak">2008–2009 cholera outbreak</a> in <a href="/wiki/Sub-Saharan_Africa" title="Sub-Saharan Africa">sub-Saharan Africa</a> showing the statistics as of 12 February 2009</figcaption></figure> <p>The word cholera is from <a href="/wiki/Greek_language" title="Greek language">Greek</a>: <span lang="el">χολέρα</span> <i>kholera</i> from χολή <i>kholē</i> "bile". Cholera likely has its origins in the <a href="/wiki/Indian_subcontinent" title="Indian subcontinent">Indian subcontinent</a> as evidenced by its prevalence in the region for centuries.<sup id="cite_ref-Lancet2004_17-24" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> </p><p>References to cholera appear in the European literature as early as 1642, from the Dutch physician <a href="/wiki/Jacobus_Bontius" title="Jacobus Bontius">Jakob de Bondt's</a> description in his De Medicina Indorum.<sup id="cite_ref-94" class="reference"><a href="#cite_note-94"><span class="cite-bracket">&#91;</span>93<span class="cite-bracket">&#93;</span></a></sup> (The "Indorum" of the title refers to the East Indies. He also gave first European descriptions of other diseases.) But at the time, the word "cholera" was historically used by European physicians to refer to any gastrointestinal upset resulting in yellow diarrhea. De Bondt thus used a common word already in regular use to describe the new disease. This was a frequent practice of the time. It was not until the 1830s that the name for severe yellow diarrhea changed in English from "cholera" to "cholera morbus" to differentiate it from what was then known as "Asiatic cholera", or that associated with origins in India and the East. </p><p>Early outbreaks in the Indian subcontinent are believed to have been the result of crowded, poor living conditions, as well as the presence of pools of <a href="/wiki/Stagnant_water" class="mw-redirect" title="Stagnant water">still water</a>, both of which provide ideal conditions for cholera to thrive.<sup id="cite_ref-Rosenberg_95-0" class="reference"><a href="#cite_note-Rosenberg-95"><span class="cite-bracket">&#91;</span>94<span class="cite-bracket">&#93;</span></a></sup> The disease first spread by travelers along <a href="/wiki/Trade_route" title="Trade route">trade routes</a> (land and sea) to <a href="/wiki/Russia" title="Russia">Russia</a> in 1817, later to the rest of <a href="/wiki/Europe" title="Europe">Europe</a>, and from Europe to <a href="/wiki/North_America" title="North America">North America</a> and the rest of the world,<sup id="cite_ref-Lancet2004_17-25" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> (hence the name "Asiatic cholera"<sup id="cite_ref-textbook_1-2" class="reference"><a href="#cite_note-textbook-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup>). Seven <a href="/wiki/Cholera_pandemic" class="mw-redirect" title="Cholera pandemic">cholera pandemics</a> have occurred since the early 19th century; the first one did not reach the Americas. The seventh <a href="/wiki/Pandemic" title="Pandemic">pandemic</a> originated in <a href="/wiki/Indonesia" title="Indonesia">Indonesia</a> in 1961.<sup id="cite_ref-96" class="reference"><a href="#cite_note-96"><span class="cite-bracket">&#91;</span>95<span class="cite-bracket">&#93;</span></a></sup> </p><p>The <a href="/wiki/First_cholera_pandemic" class="mw-redirect" title="First cholera pandemic">first cholera pandemic</a> occurred in the Bengal region of India, near Calcutta starting in 1817 through 1824. The disease dispersed from India to Southeast Asia, the Middle East, Europe, and Eastern Africa.<sup id="cite_ref-Hays_97-0" class="reference"><a href="#cite_note-Hays-97"><span class="cite-bracket">&#91;</span>96<span class="cite-bracket">&#93;</span></a></sup> The movement of British Army and Navy ships and personnel is believed to have contributed to the range of the pandemic, since the ships carried people with the disease to the shores of the Indian Ocean, from Africa to Indonesia, and north to China and Japan.<sup id="cite_ref-98" class="reference"><a href="#cite_note-98"><span class="cite-bracket">&#91;</span>97<span class="cite-bracket">&#93;</span></a></sup> </p><p>The <a href="/wiki/Second_cholera_pandemic" class="mw-redirect" title="Second cholera pandemic">second pandemic</a> lasted from 1826 to 1837 and particularly affected North America and Europe. Advancements in transport and global trade, and increased human migration, including soldiers, meant that more people were carrying the disease more widely.<sup id="cite_ref-99" class="reference"><a href="#cite_note-99"><span class="cite-bracket">&#91;</span>98<span class="cite-bracket">&#93;</span></a></sup> </p><p>The <a href="/wiki/Third_cholera_pandemic" class="mw-redirect" title="Third cholera pandemic">third pandemic</a> erupted in 1846, persisted until 1860, extended to North Africa, and reached North and South America. It was introduced to North America at <a href="/wiki/Quebec,_Canada" class="mw-redirect" title="Quebec, Canada">Quebec, Canada</a>, via Irish immigrants from the Great Famine. In this pandemic, Brazil was affected for the first time. </p><p>The <a href="/wiki/Fourth_cholera_pandemic" class="mw-redirect" title="Fourth cholera pandemic">fourth pandemic</a> lasted from 1863 to 1875, spreading from India to Naples and Spain, and reaching the United States at <a href="/wiki/New_Orleans,_Louisiana" class="mw-redirect" title="New Orleans, Louisiana">New Orleans, Louisiana</a> in 1873. It spread throughout the Mississippi River system on the continent. </p><p>The <a href="/wiki/Fifth_cholera_pandemic" class="mw-redirect" title="Fifth cholera pandemic">fifth</a> pandemic was from 1881 to 1896. It started in India and spread to Europe, Asia, and South America. The <a href="/wiki/Sixth_cholera_pandemic" class="mw-redirect" title="Sixth cholera pandemic">sixth pandemic</a> ran from 1899 to 1923. These epidemics had a lower number of fatalities because physicians and researchers had a greater understanding of the cholera bacteria. Egypt, the Arabian peninsula, Persia, India, and the Philippines were hit hardest during these epidemics. Other areas, such as Germany in 1892 (primarily the city of Hamburg, where more than 8.600 people died)<sup id="cite_ref-100" class="reference"><a href="#cite_note-100"><span class="cite-bracket">&#91;</span>99<span class="cite-bracket">&#93;</span></a></sup> and Naples from 1910 to 1911, also had severe outbreaks. </p><p>The <a href="/wiki/Seventh_cholera_pandemic" title="Seventh cholera pandemic">seventh pandemic</a> originated in 1961 in Indonesia and is marked by the emergence of a new strain, nicknamed <i>El Tor</i>, which still persists (as of 2018<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Cholera&amp;action=edit">&#91;update&#93;</a></sup><sup id="cite_ref-101" class="reference"><a href="#cite_note-101"><span class="cite-bracket">&#91;</span>100<span class="cite-bracket">&#93;</span></a></sup>) in developing countries.<sup id="cite_ref-102" class="reference"><a href="#cite_note-102"><span class="cite-bracket">&#91;</span>101<span class="cite-bracket">&#93;</span></a></sup> This pandemic had initially subsided about 1975 and was thought to have ended, but, as noted, it has persisted. There were a rise in cases in the 1990s and since. </p><p>Cholera became widespread in the 19th century.<sup id="cite_ref-103" class="reference"><a href="#cite_note-103"><span class="cite-bracket">&#91;</span>102<span class="cite-bracket">&#93;</span></a></sup> Since then it has killed tens of millions of people.<sup id="cite_ref-104" class="reference"><a href="#cite_note-104"><span class="cite-bracket">&#91;</span>103<span class="cite-bracket">&#93;</span></a></sup> In <a href="/wiki/Russian_Empire" title="Russian Empire">Russia</a> alone, between 1847 and 1851, more than one million people died from the disease.<sup id="cite_ref-105" class="reference"><a href="#cite_note-105"><span class="cite-bracket">&#91;</span>104<span class="cite-bracket">&#93;</span></a></sup> It killed 150,000 Americans during the second pandemic.<sup id="cite_ref-106" class="reference"><a href="#cite_note-106"><span class="cite-bracket">&#91;</span>105<span class="cite-bracket">&#93;</span></a></sup> Between 1900 and 1920, perhaps eight million people died of cholera in India.<sup id="cite_ref-107" class="reference"><a href="#cite_note-107"><span class="cite-bracket">&#91;</span>106<span class="cite-bracket">&#93;</span></a></sup> Cholera officially became the first <a href="/wiki/Reportable_disease" class="mw-redirect" title="Reportable disease">reportable disease</a> in the United States due to the significant effects it had on health.<sup id="cite_ref-Lancet2004_17-26" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/John_Snow_(physician)" class="mw-redirect" title="John Snow (physician)">John Snow</a>, in <a href="/wiki/England" title="England">England</a>, in 1854 was the first to identify the importance of contaminated water as its source of transmission.<sup id="cite_ref-Lancet2004_17-27" class="reference"><a href="#cite_note-Lancet2004-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Cholera is now no longer considered a pressing health threat in Europe and North America due to <a href="/wiki/Water_filtration" class="mw-redirect" title="Water filtration">filtering</a> and <a href="/wiki/Water_chlorination" title="Water chlorination">chlorination</a> of water supplies, but it still strongly affects populations in <a href="/wiki/Developing_countries" class="mw-redirect" title="Developing countries">developing countries</a>. </p><p>In the past, vessels flew a yellow <a href="/wiki/Quarantine" title="Quarantine">quarantine</a> flag if any crew members or passengers had cholera. No one aboard a vessel flying a yellow flag would be allowed ashore for an extended period, typically 30 to 40 days.<sup id="cite_ref-108" class="reference"><a href="#cite_note-108"><span class="cite-bracket">&#91;</span>107<span class="cite-bracket">&#93;</span></a></sup> </p><p>Historically many different claimed remedies have existed in folklore. Many of the older remedies were based on the <a href="/wiki/Miasma_theory" title="Miasma theory">miasma theory</a>, that the disease was transmitted by bad air. Some believed that abdominal chilling made one more susceptible, and flannel and <a href="/wiki/Cholera_belt" title="Cholera belt">cholera belts</a> were included in army kits.<sup id="cite_ref-109" class="reference"><a href="#cite_note-109"><span class="cite-bracket">&#91;</span>108<span class="cite-bracket">&#93;</span></a></sup> In the 1854–1855 outbreak in Naples, homeopathic <a href="/wiki/Camphor" title="Camphor">camphor</a> was used according to <a href="/wiki/Samuel_Hahnemann" title="Samuel Hahnemann">Hahnemann</a>.<sup id="cite_ref-110" class="reference"><a href="#cite_note-110"><span class="cite-bracket">&#91;</span>109<span class="cite-bracket">&#93;</span></a></sup>.Dr Hahnemann laid down three main remedies that would be curative in that disease; in early and simple cases <b>camphor</b>; in later stages with excessive cramping, <b>cuprum</b> or with excessive evacuations and profuse cold sweat, <b>veratrum album</b>. These are the Trio Cholera remedies used by homoeopaths around the world.<sup id="cite_ref-111" class="reference"><a href="#cite_note-111"><span class="cite-bracket">&#91;</span>110<span class="cite-bracket">&#93;</span></a></sup> T. J. Ritter's <i>Mother's Remedies</i> book lists tomato syrup as a home remedy from northern America. <a href="/wiki/Elecampane" title="Elecampane">Elecampane</a> was recommended in the United Kingdom, according to William Thomas Fernie.<sup id="cite_ref-oldtimeremedies_112-0" class="reference"><a href="#cite_note-oldtimeremedies-112"><span class="cite-bracket">&#91;</span>111<span class="cite-bracket">&#93;</span></a></sup> The first effective human vaccine was developed in 1885, and the first effective antibiotic was developed in 1948. </p><p>Cholera cases are much less frequent in developed countries where governments have helped to establish water sanitation practices and effective medical treatments.<sup id="cite_ref-113" class="reference"><a href="#cite_note-113"><span class="cite-bracket">&#91;</span>112<span class="cite-bracket">&#93;</span></a></sup> In the 19th century the United States, for example, had a severe cholera problem similar to those in some developing countries. It had three large cholera outbreaks in the 1800s, which can be attributed to <i>Vibrio cholerae</i><span class="nowrap" style="padding-left:0.1em;">&#39;s</span> spread through interior waterways such as the <a href="/wiki/Erie_Canal" title="Erie Canal">Erie Canal</a> and the extensive Mississippi River valley system, as well as the major ports along the <a href="/wiki/East_Coast_of_the_United_States" title="East Coast of the United States">Eastern Seaboard</a> and their cities upriver.<sup id="cite_ref-114" class="reference"><a href="#cite_note-114"><span class="cite-bracket">&#91;</span>113<span class="cite-bracket">&#93;</span></a></sup> The island of Manhattan in New York City touches the Atlantic Ocean, where cholera collected from river waters and ship discharges just off the coast. At this time, New York City did not have as effective a sanitation system as it developed in the later 20th century, so cholera spread through the city's water supply.<sup id="cite_ref-pmid7620035_115-0" class="reference"><a href="#cite_note-pmid7620035-115"><span class="cite-bracket">&#91;</span>114<span class="cite-bracket">&#93;</span></a></sup> </p><p>Cholera morbus is a historical term that was used to refer to <a href="/wiki/Gastroenteritis" title="Gastroenteritis">gastroenteritis</a> rather than specifically to what is now defined as the disease of cholera.<sup id="cite_ref-rosenberg_15-1" class="reference"><a href="#cite_note-rosenberg-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> </p> <ul class="gallery mw-gallery-traditional"> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Cholera.jpg" class="mw-file-description" title="Drawing of Death bringing cholera, in Le Petit Journal (1912)."><img alt="Drawing of Death bringing cholera, in Le Petit Journal (1912)." src="//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Cholera.jpg/81px-Cholera.jpg" decoding="async" width="81" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Cholera.jpg/122px-Cholera.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/65/Cholera.jpg/162px-Cholera.jpg 2x" data-file-width="3420" data-file-height="5057" /></a></span></div> <div class="gallerytext"><a href="/wiki/Drawing" title="Drawing">Drawing</a> of <a href="/wiki/Personifications_of_death" title="Personifications of death">Death</a> bringing cholera, in <i><a href="/wiki/Le_Petit_Journal_(newspaper)" title="Le Petit Journal (newspaper)">Le Petit Journal</a></i> (1912).</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Pedro_II_of_Brazil_and_ministers_of_state.JPG" class="mw-file-description" title="Emperor Pedro II of Brazil visiting people with cholera in 1855."><img alt="Emperor Pedro II of Brazil visiting people with cholera in 1855." src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4a/Pedro_II_of_Brazil_and_ministers_of_state.JPG/120px-Pedro_II_of_Brazil_and_ministers_of_state.JPG" decoding="async" width="120" height="83" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4a/Pedro_II_of_Brazil_and_ministers_of_state.JPG/180px-Pedro_II_of_Brazil_and_ministers_of_state.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4a/Pedro_II_of_Brazil_and_ministers_of_state.JPG/240px-Pedro_II_of_Brazil_and_ministers_of_state.JPG 2x" data-file-width="2976" data-file-height="2060" /></a></span></div> <div class="gallerytext">Emperor <a href="/wiki/Pedro_II_of_Brazil" title="Pedro II of Brazil">Pedro II of Brazil</a> visiting people with cholera in 1855.</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Cholera_395.1.jpg" class="mw-file-description" title="Hand bill from the New York City Board of Health, 1832—the outdated public health advice demonstrates the lack of understanding of the disease and its causative factors."><img alt="Hand bill from the New York City Board of Health, 1832—the outdated public health advice demonstrates the lack of understanding of the disease and its causative factors." src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2d/Cholera_395.1.jpg/120px-Cholera_395.1.jpg" decoding="async" width="120" height="81" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2d/Cholera_395.1.jpg/180px-Cholera_395.1.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2d/Cholera_395.1.jpg/240px-Cholera_395.1.jpg 2x" data-file-width="395" data-file-height="268" /></a></span></div> <div class="gallerytext">Hand bill from the <a href="/wiki/Metropolitan_Board_of_Health" title="Metropolitan Board of Health">New York City Board of Health</a>, 1832—the outdated public health advice demonstrates the lack of understanding of the disease and its causative factors.</div> </li> </ul> <div class="mw-heading mw-heading3"><h3 id="Research">Research</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Cholera_vaccine" title="Cholera vaccine">Cholera vaccine</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Robert_Koch_(Deutsche_Cholera-Expedition_in_%C3%84gypten_1884).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Robert_Koch_%28Deutsche_Cholera-Expedition_in_%C3%84gypten_1884%29.jpg/290px-Robert_Koch_%28Deutsche_Cholera-Expedition_in_%C3%84gypten_1884%29.jpg" decoding="async" width="290" height="247" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Robert_Koch_%28Deutsche_Cholera-Expedition_in_%C3%84gypten_1884%29.jpg/435px-Robert_Koch_%28Deutsche_Cholera-Expedition_in_%C3%84gypten_1884%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Robert_Koch_%28Deutsche_Cholera-Expedition_in_%C3%84gypten_1884%29.jpg/580px-Robert_Koch_%28Deutsche_Cholera-Expedition_in_%C3%84gypten_1884%29.jpg 2x" data-file-width="1800" data-file-height="1536" /></a><figcaption><a href="/wiki/Robert_Koch" title="Robert Koch">Robert Koch</a> (third from the right) on a cholera research expedition in <a href="/wiki/Egypt" title="Egypt">Egypt</a> in 1884, one year after he identified <i>V. cholerae</i></figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:How_to_avoid_the_Cholera_1848.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b1/How_to_avoid_the_Cholera_1848.jpg/290px-How_to_avoid_the_Cholera_1848.jpg" decoding="async" width="290" height="362" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b1/How_to_avoid_the_Cholera_1848.jpg/435px-How_to_avoid_the_Cholera_1848.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/b/b1/How_to_avoid_the_Cholera_1848.jpg 2x" data-file-width="522" data-file-height="651" /></a><figcaption><i>How to avoid the cholera</i> leaflet; <a href="/wiki/Aberystwyth" title="Aberystwyth">Aberystwyth</a>; August 1849</figcaption></figure> <p>One of the major contributions to fighting cholera was made by the physician and pioneer medical scientist <a href="/wiki/John_Snow_(physician)" class="mw-redirect" title="John Snow (physician)">John Snow</a> (1813–1858), who in 1854 found a link between cholera and contaminated drinking water.<sup id="cite_ref-Rosenberg_95-1" class="reference"><a href="#cite_note-Rosenberg-95"><span class="cite-bracket">&#91;</span>94<span class="cite-bracket">&#93;</span></a></sup> Dr. Snow proposed a microbial origin for epidemic cholera in 1849. In his major "state of the art" review of 1855, he proposed a substantially complete and correct model for the cause of the disease. In two pioneering epidemiological field studies, he was able to demonstrate human <a href="/wiki/Sewage" title="Sewage">sewage</a> contamination was the most probable disease vector in two <a href="/wiki/1854_Broad_Street_cholera_outbreak" title="1854 Broad Street cholera outbreak">major epidemics in London in 1854</a>.<sup id="cite_ref-116" class="reference"><a href="#cite_note-116"><span class="cite-bracket">&#91;</span>115<span class="cite-bracket">&#93;</span></a></sup> His model was not immediately accepted, but it was increasingly seen as plausible as medical microbiology developed over the next 30 years or so. For his work on cholera, John Snow is often regarded as the "Father of Epidemiology".<sup id="cite_ref-117" class="reference"><a href="#cite_note-117"><span class="cite-bracket">&#91;</span>116<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-118" class="reference"><a href="#cite_note-118"><span class="cite-bracket">&#91;</span>117<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-119" class="reference"><a href="#cite_note-119"><span class="cite-bracket">&#91;</span>118<span class="cite-bracket">&#93;</span></a></sup> </p><p>The bacterium was isolated in 1854 by Italian anatomist <a href="/wiki/Filippo_Pacini" title="Filippo Pacini">Filippo Pacini</a>,<sup id="cite_ref-120" class="reference"><a href="#cite_note-120"><span class="cite-bracket">&#91;</span>119<span class="cite-bracket">&#93;</span></a></sup> but its exact nature and his results were not widely known. In the same year, the <a href="/wiki/Catalonia" title="Catalonia">Catalan</a> <a href="/w/index.php?title=Joaquim_Balcells_i_Pascual&amp;action=edit&amp;redlink=1" class="new" title="Joaquim Balcells i Pascual (page does not exist)">Joaquim Balcells i Pascual</a> discovered the bacterium.<sup id="cite_ref-Real_Academia_de_la_Historia_2018_121-0" class="reference"><a href="#cite_note-Real_Academia_de_la_Historia_2018-121"><span class="cite-bracket">&#91;</span>120<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-122" class="reference"><a href="#cite_note-122"><span class="cite-bracket">&#91;</span>121<span class="cite-bracket">&#93;</span></a></sup> In 1856 <a href="/w/index.php?title=Ant%C3%B3nio_Augusto_da_Costa_Sim%C3%B5es&amp;action=edit&amp;redlink=1" class="new" title="António Augusto da Costa Simões (page does not exist)">António Augusto da Costa Simões</a> and <a href="/w/index.php?title=Jos%C3%A9_Ferreira_de_Macedo_Pinto&amp;action=edit&amp;redlink=1" class="new" title="José Ferreira de Macedo Pinto (page does not exist)">José Ferreira de Macedo Pinto</a>, two Portuguese researchers, are believed to have done the same.<sup id="cite_ref-Real_Academia_de_la_Historia_2018_121-1" class="reference"><a href="#cite_note-Real_Academia_de_la_Historia_2018-121"><span class="cite-bracket">&#91;</span>120<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-123" class="reference"><a href="#cite_note-123"><span class="cite-bracket">&#91;</span>122<span class="cite-bracket">&#93;</span></a></sup> </p><p>Between the mid-1850s and the 1900s, cities in developed nations made massive investment in clean water supply and well-separated sewage treatment infrastructures. This eliminated the threat of cholera epidemics from the major developed cities in the world. In 1883, <a href="/wiki/Robert_Koch" title="Robert Koch">Robert Koch</a> identified <i>V. cholerae</i> with a microscope as the bacillus causing the disease.<sup id="cite_ref-124" class="reference"><a href="#cite_note-124"><span class="cite-bracket">&#91;</span>123<span class="cite-bracket">&#93;</span></a></sup> </p><p><a href="/wiki/Hemendra_Nath_Chatterjee" title="Hemendra Nath Chatterjee">Hemendra Nath Chatterjee</a>, a Bengali scientist, was the first to formulate and demonstrate the effectiveness of <a href="/wiki/Oral_rehydration_salt" class="mw-redirect" title="Oral rehydration salt">oral rehydration salt</a> (ORS) to treat <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a>. In his 1953 paper, published in <i><a href="/wiki/The_Lancet" title="The Lancet">The Lancet</a></i>, he states that <a href="/wiki/Promethazine" title="Promethazine">promethazine</a> can stop <a href="/wiki/Vomiting" title="Vomiting">vomiting</a> during cholera and then oral rehydration is possible. The formulation of the fluid replacement solution was 4&#160;g of <a href="/wiki/Sodium_chloride" title="Sodium chloride">sodium chloride</a>, 25&#160;g of <a href="/wiki/Glucose" title="Glucose">glucose</a> and 1000&#160;ml of <a href="/wiki/Water" title="Water">water</a>.<sup id="cite_ref-125" class="reference"><a href="#cite_note-125"><span class="cite-bracket">&#91;</span>124<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-126" class="reference"><a href="#cite_note-126"><span class="cite-bracket">&#91;</span>125<span class="cite-bracket">&#93;</span></a></sup> </p> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Medical_Scientist_Prof._Sambhu_Nath_De.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Medical_Scientist_Prof._Sambhu_Nath_De.png/220px-Medical_Scientist_Prof._Sambhu_Nath_De.png" decoding="async" width="220" height="319" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Medical_Scientist_Prof._Sambhu_Nath_De.png/330px-Medical_Scientist_Prof._Sambhu_Nath_De.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Medical_Scientist_Prof._Sambhu_Nath_De.png/440px-Medical_Scientist_Prof._Sambhu_Nath_De.png 2x" data-file-width="509" data-file-height="737" /></a><figcaption>Prof. <a href="/wiki/Sambhu_Nath_De" title="Sambhu Nath De">Sambhu Nath De</a>, who discovered the <a href="/wiki/Cholera_toxin" title="Cholera toxin">cholera toxin</a> and successfully demonstrated the transmission of cholera pathogen by <i>bacterial enteric toxin</i></figcaption></figure> <p><a href="/wiki/Indian_people" title="Indian people">Indian</a> medical scientist <a href="/wiki/Sambhu_Nath_De" title="Sambhu Nath De">Sambhu Nath De</a> discovered the <a href="/wiki/Cholera_toxin" title="Cholera toxin">cholera toxin</a>, the <i><a href="/wiki/Animal_model" class="mw-redirect" title="Animal model">animal model</a> of cholera</i>, and successfully demonstrated the method of transmission of cholera pathogen <i>Vibrio cholerae</i>.<sup id="cite_ref-127" class="reference"><a href="#cite_note-127"><span class="cite-bracket">&#91;</span>126<span class="cite-bracket">&#93;</span></a></sup> </p><p><a href="/wiki/Robert_Allan_Phillips" title="Robert Allan Phillips">Robert Allan Phillips</a>, working at US <a href="/wiki/Naval_Medical_Research_Unit_Two" class="mw-redirect" title="Naval Medical Research Unit Two">Naval Medical Research Unit Two</a> in Southeast Asia, evaluated the pathophysiology of the disease using modern laboratory chemistry techniques. He developed a protocol for rehydration. His research led the <a href="/wiki/Lasker_Foundation" class="mw-redirect" title="Lasker Foundation">Lasker Foundation</a> to award him its prize in 1967.<sup id="cite_ref-128" class="reference"><a href="#cite_note-128"><span class="cite-bracket">&#91;</span>127<span class="cite-bracket">&#93;</span></a></sup> </p><p>More recently, in 2002, Alam, <i>et al.</i>, studied stool samples from patients at the <a href="/wiki/International_Centre_for_Diarrhoeal_Disease_Research,_Bangladesh" class="mw-redirect" title="International Centre for Diarrhoeal Disease Research, Bangladesh">International Centre for Diarrhoeal Disease</a> in <a href="/wiki/Dhaka,_Bangladesh" class="mw-redirect" title="Dhaka, Bangladesh">Dhaka, Bangladesh</a>. From the various experiments they conducted, the researchers found a correlation between the passage of <i>V. cholerae</i> through the human digestive system and an increased infectivity state. Furthermore, the researchers found the bacterium creates a hyperinfected state where <a href="/wiki/Gene" title="Gene">genes</a> that control biosynthesis of <a href="/wiki/Amino_acid" title="Amino acid">amino acids</a>, <a href="/wiki/Iron" title="Iron">iron</a> uptake systems, and formation of periplasmic nitrate reductase complexes were induced just before defecation. These induced characteristics allow the cholera vibrios to survive in the "rice water" stools, an environment of limited oxygen and iron, of patients with a cholera infection.<sup id="cite_ref-Merrell2002_129-0" class="reference"><a href="#cite_note-Merrell2002-129"><span class="cite-bracket">&#91;</span>128<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Global_Strategy">Global Strategy</h3></div> <p>In 2017, the WHO launched the "Ending Cholera: a global roadmap to 2030" strategy which aims to reduce cholera deaths by 90% by 2030.<sup id="cite_ref-who_fact_130-0" class="reference"><a href="#cite_note-who_fact-130"><span class="cite-bracket">&#91;</span>129<span class="cite-bracket">&#93;</span></a></sup> The strategy was developed by the Global Task Force on Cholera Control (GTFCC) which develops country-specific plans and monitors progress.<sup id="cite_ref-131" class="reference"><a href="#cite_note-131"><span class="cite-bracket">&#91;</span>130<span class="cite-bracket">&#93;</span></a></sup> The approach to achieve this goal combines surveillance, water sanitation, rehydration treatment and oral vaccines.<sup id="cite_ref-who_fact_130-1" class="reference"><a href="#cite_note-who_fact-130"><span class="cite-bracket">&#91;</span>129<span class="cite-bracket">&#93;</span></a></sup> Specifically, the control strategy focuses on three approaches: i) early detection and response to outbreaks to contain outbreaks, ii) stopping cholera transmission through improved sanitation and vaccines in hotspots, and iii) a global framework for cholera control through the GTFCC.<sup id="cite_ref-who_fact_130-2" class="reference"><a href="#cite_note-who_fact-130"><span class="cite-bracket">&#91;</span>129<span class="cite-bracket">&#93;</span></a></sup> </p><p>The WHO and the GTFCC do not consider global cholera <a href="/wiki/Eradication_of_infectious_diseases" title="Eradication of infectious diseases">eradication</a> a viable goal.<sup id="cite_ref-132" class="reference"><a href="#cite_note-132"><span class="cite-bracket">&#91;</span>131<span class="cite-bracket">&#93;</span></a></sup> Even though humans are the only host of cholera, the bacterium can persist in the environment without a human host.<sup id="cite_ref-Sack_133-0" class="reference"><a href="#cite_note-Sack-133"><span class="cite-bracket">&#91;</span>132<span class="cite-bracket">&#93;</span></a></sup> While global eradication is not possible, elimination of human to human transmission may be possible.<sup id="cite_ref-Sack_133-1" class="reference"><a href="#cite_note-Sack-133"><span class="cite-bracket">&#91;</span>132<span class="cite-bracket">&#93;</span></a></sup> Local elimination is possible, which has been underway most recently during the <a href="/wiki/2010s_Haiti_cholera_outbreak" title="2010s Haiti cholera outbreak">2010s Haiti cholera outbreak</a>. Haiti aims to achieve certification of elimination by 2022.<sup id="cite_ref-134" class="reference"><a href="#cite_note-134"><span class="cite-bracket">&#91;</span>133<span class="cite-bracket">&#93;</span></a></sup> </p><p>The GTFCC targets 47 countries, 13 of which have established vaccination campaigns.<sup id="cite_ref-who_report2020_90-2" class="reference"><a href="#cite_note-who_report2020-90"><span class="cite-bracket">&#91;</span>89<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2></div> <div class="mw-heading mw-heading3"><h3 id="Health_policy">Health policy</h3></div> <p>In many developing countries, cholera still reaches its victims through contaminated water sources, and countries without proper sanitation techniques have greater incidence of the disease.<sup id="cite_ref-135" class="reference"><a href="#cite_note-135"><span class="cite-bracket">&#91;</span>134<span class="cite-bracket">&#93;</span></a></sup> Governments can play a role in this. In 2008, for example, the <a href="/wiki/Zimbabwean_cholera_outbreak" class="mw-redirect" title="Zimbabwean cholera outbreak">Zimbabwean cholera outbreak</a> was due partly to the government's role, according to a report from the <a href="/wiki/James_Baker_Institute" class="mw-redirect" title="James Baker Institute">James Baker Institute</a>.<sup id="cite_ref-bakerinstitute.org_22-1" class="reference"><a href="#cite_note-bakerinstitute.org-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup> The Haitian government's inability to provide safe drinking water after the 2010 earthquake led to an increase in cholera cases as well.<sup id="cite_ref-pmid21142690_136-0" class="reference"><a href="#cite_note-pmid21142690-136"><span class="cite-bracket">&#91;</span>135<span class="cite-bracket">&#93;</span></a></sup> </p><p>Similarly, South Africa's cholera outbreak was exacerbated by the government's policy of privatizing water programs. The wealthy elite of the country were able to afford safe water while others had to use water from cholera-infected rivers.<sup id="cite_ref-pmid14758861_137-0" class="reference"><a href="#cite_note-pmid14758861-137"><span class="cite-bracket">&#91;</span>136<span class="cite-bracket">&#93;</span></a></sup> </p><p>According to <a href="/wiki/Rita_R._Colwell" title="Rita R. Colwell">Rita R. Colwell</a> of the <a href="/wiki/James_Baker_Institute" class="mw-redirect" title="James Baker Institute">James Baker Institute</a>, if cholera does begin to spread, government preparedness is crucial. A government's ability to contain the disease before it extends to other areas can prevent a high death toll and the development of an epidemic or even pandemic. Effective disease surveillance can ensure that cholera outbreaks are recognized as soon as possible and dealt with appropriately. Oftentimes, this will allow public health programs to determine and control the cause of the cases, whether it is unsanitary water or seafood that have accumulated a lot of <i>Vibrio cholerae</i> specimens.<sup id="cite_ref-bakerinstitute.org_22-2" class="reference"><a href="#cite_note-bakerinstitute.org-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup> Having an effective surveillance program contributes to a government's ability to prevent cholera from spreading. In the year 2000 in the state of Kerala in India, the Kottayam district was determined to be "Cholera-affected"; this pronouncement led to task forces that concentrated on educating citizens with 13,670 information sessions about human health.<sup id="cite_ref-John,_T._Jacob_2004_138-0" class="reference"><a href="#cite_note-John,_T._Jacob_2004-138"><span class="cite-bracket">&#91;</span>137<span class="cite-bracket">&#93;</span></a></sup> These task forces promoted the boiling of water to obtain safe water, and provided chlorine and oral rehydration salts.<sup id="cite_ref-John,_T._Jacob_2004_138-1" class="reference"><a href="#cite_note-John,_T._Jacob_2004-138"><span class="cite-bracket">&#91;</span>137<span class="cite-bracket">&#93;</span></a></sup> Ultimately, this helped to control the spread of the disease to other areas and minimize deaths. On the other hand, researchers have shown that most of the citizens infected during the 1991 cholera outbreak in Bangladesh lived in rural areas, and were not recognized by the government's surveillance program. This inhibited physicians' abilities to detect cholera cases early.<sup id="cite_ref-pmid1500643_139-0" class="reference"><a href="#cite_note-pmid1500643-139"><span class="cite-bracket">&#91;</span>138<span class="cite-bracket">&#93;</span></a></sup> </p><p>According to Colwell, the quality and inclusiveness of a country's health care system affects the control of cholera, as it did in the <a href="/wiki/Zimbabwean_cholera_outbreak" class="mw-redirect" title="Zimbabwean cholera outbreak">Zimbabwean cholera outbreak</a>.<sup id="cite_ref-bakerinstitute.org_22-3" class="reference"><a href="#cite_note-bakerinstitute.org-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup> While sanitation practices are important, when governments respond quickly and have readily available vaccines, the country will have a lower cholera death toll. Affordability of vaccines can be a problem; if the governments do not provide vaccinations, only the wealthy may be able to afford them and there will be a greater toll on the country's poor.<sup id="cite_ref-sciencedirect.com_140-0" class="reference"><a href="#cite_note-sciencedirect.com-140"><span class="cite-bracket">&#91;</span>139<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-141" class="reference"><a href="#cite_note-141"><span class="cite-bracket">&#91;</span>140<span class="cite-bracket">&#93;</span></a></sup> The speed with which government leaders respond to cholera outbreaks is important.<sup id="cite_ref-142" class="reference"><a href="#cite_note-142"><span class="cite-bracket">&#91;</span>141<span class="cite-bracket">&#93;</span></a></sup> </p><p>Besides contributing to an effective or declining public health care system and water sanitation treatments, government can have indirect effects on cholera control and the effectiveness of a response to cholera.<sup id="cite_ref-Kapp,_Clare_2009_143-0" class="reference"><a href="#cite_note-Kapp,_Clare_2009-143"><span class="cite-bracket">&#91;</span>142<span class="cite-bracket">&#93;</span></a></sup> A country's government can impact its ability to prevent disease and control its spread. A speedy government response backed by a fully functioning health care system and financial resources can prevent cholera's spread. This limits cholera's ability to cause death, or at the very least a decline in education, as children are kept out of school to minimize the risk of infection.<sup id="cite_ref-Kapp,_Clare_2009_143-1" class="reference"><a href="#cite_note-Kapp,_Clare_2009-143"><span class="cite-bracket">&#91;</span>142<span class="cite-bracket">&#93;</span></a></sup> Inversely, poor government response can lead to civil unrest and <a href="/wiki/Cholera_riots" title="Cholera riots">cholera riots</a>.<sup id="cite_ref-144" class="reference"><a href="#cite_note-144"><span class="cite-bracket">&#91;</span>143<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Notable_cases">Notable cases</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:James_Polk_restored_%26_cropped.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/46/James_Polk_restored_%26_cropped.jpg/220px-James_Polk_restored_%26_cropped.jpg" decoding="async" width="220" height="270" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/46/James_Polk_restored_%26_cropped.jpg/330px-James_Polk_restored_%26_cropped.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/46/James_Polk_restored_%26_cropped.jpg/440px-James_Polk_restored_%26_cropped.jpg 2x" data-file-width="619" data-file-height="760" /></a><figcaption>US President <a href="/wiki/James_K._Polk" title="James K. Polk">James K. Polk</a> was a famous victim of cholera</figcaption></figure> <ul><li><a href="/wiki/Pyotr_Ilyich_Tchaikovsky" title="Pyotr Ilyich Tchaikovsky">Tchaikovsky</a>'s death has traditionally been attributed to cholera, most probably contracted through drinking contaminated water several days earlier.<sup id="cite_ref-145" class="reference"><a href="#cite_note-145"><span class="cite-bracket">&#91;</span>144<span class="cite-bracket">&#93;</span></a></sup> Tchaikovsky's mother died of cholera,<sup id="cite_ref-146" class="reference"><a href="#cite_note-146"><span class="cite-bracket">&#91;</span>145<span class="cite-bracket">&#93;</span></a></sup> and his father became sick with cholera at this time but made a full recovery.<sup id="cite_ref-147" class="reference"><a href="#cite_note-147"><span class="cite-bracket">&#91;</span>146<span class="cite-bracket">&#93;</span></a></sup> Some scholars, however, including English musicologist and Tchaikovsky authority <a href="/wiki/David_Brown_(musicologist)" title="David Brown (musicologist)">David Brown</a> and biographer <a href="/wiki/Anthony_Holden" title="Anthony Holden">Anthony Holden</a>, have theorized that his death was a suicide.<sup id="cite_ref-148" class="reference"><a href="#cite_note-148"><span class="cite-bracket">&#91;</span>147<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/2010s_Haiti_cholera_outbreak" title="2010s Haiti cholera outbreak">2010s Haiti cholera outbreak</a>. Ten months after the 2010 earthquake, an <a href="/wiki/2010_Haiti_cholera_outbreak" class="mw-redirect" title="2010 Haiti cholera outbreak">outbreak swept over Haiti</a>, traced to a <a href="/wiki/United_Nations" title="United Nations">United Nations</a> base of <a href="/wiki/Peacekeeping" title="Peacekeeping">peacekeepers</a> from <a href="/wiki/Nepal" title="Nepal">Nepal</a>.<sup id="cite_ref-149" class="reference"><a href="#cite_note-149"><span class="cite-bracket">&#91;</span>148<span class="cite-bracket">&#93;</span></a></sup> This marks the worst cholera outbreak in recent history, as well as the best documented cholera outbreak in modern public health.</li> <li><a href="/wiki/Adam_Mickiewicz" title="Adam Mickiewicz">Adam Mickiewicz</a>, Polish poet and novelist, is thought to have died of cholera in Istanbul in 1855.</li> <li><a href="/wiki/Nicolas_L%C3%A9onard_Sadi_Carnot" title="Nicolas Léonard Sadi Carnot">Sadi Carnot</a>, physicist, a pioneer of thermodynamics (d. 1832)<sup id="cite_ref-150" class="reference"><a href="#cite_note-150"><span class="cite-bracket">&#91;</span>149<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Charles_X_of_France" title="Charles X of France">Charles X</a>, <a href="/wiki/List_of_French_monarchs" title="List of French monarchs">King of France</a> (d. 1836)<sup id="cite_ref-151" class="reference"><a href="#cite_note-151"><span class="cite-bracket">&#91;</span>150<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/James_K._Polk" title="James K. Polk">James K. Polk</a>, eleventh <a href="/wiki/President_of_the_United_States" title="President of the United States">president of the United States</a> (d. 1849)<sup id="cite_ref-152" class="reference"><a href="#cite_note-152"><span class="cite-bracket">&#91;</span>151<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Carl_von_Clausewitz" title="Carl von Clausewitz">Carl von Clausewitz</a>, <a href="/wiki/Prussia" title="Prussia">Prussian</a> soldier and German <a href="/wiki/Military_theory" title="Military theory">military theorist</a> (d. 1831)<sup id="cite_ref-153" class="reference"><a href="#cite_note-153"><span class="cite-bracket">&#91;</span>152<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Elliot_Bovill" title="Elliot Bovill">Elliot Bovill</a>, <a href="/wiki/Chief_Justice_of_Singapore" title="Chief Justice of Singapore">Chief Justice of the Straits Settlements</a> (1893)<sup id="cite_ref-154" class="reference"><a href="#cite_note-154"><span class="cite-bracket">&#91;</span>153<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Nikola_Tesla" title="Nikola Tesla">Nikola Tesla</a>, <a href="/wiki/Serbian-American" class="mw-redirect" title="Serbian-American">Serbian-American</a> <a href="/wiki/Inventor" class="mw-redirect" title="Inventor">inventor</a>, <a href="/wiki/Engineer" title="Engineer">engineer</a> and <a href="/wiki/Futurist" title="Futurist">futurist</a> known for his contributions to the design of the modern <a href="/wiki/Alternating_current" title="Alternating current">alternating current</a> (AC) <a href="/wiki/Electricity_supply" class="mw-redirect" title="Electricity supply">electricity supply</a> system, contracted cholera in 1873 at the age of 17. He was bedridden for nine months, and near death multiple times, but survived and fully recovered.</li></ul> <div class="mw-heading mw-heading3"><h3 id="In_popular_culture">In popular culture</h3></div> <p>Unlike <a href="/wiki/Tuberculosis" title="Tuberculosis">tuberculosis</a> ("consumption") which in literature and the arts was often romanticized as a disease of denizens of the <a href="/wiki/Demimondaine" class="mw-redirect" title="Demimondaine">demimonde</a> or those with an artistic temperament,<sup id="cite_ref-155" class="reference"><a href="#cite_note-155"><span class="cite-bracket">&#91;</span>154<span class="cite-bracket">&#93;</span></a></sup> cholera is a disease which almost entirely affects the poor living in unsanitary conditions. This, and the unpleasant course of the disease – which includes voluminous "rice-water" diarrhea, the hemorrhaging of liquids from the mouth, and violent muscle contractions which continue even after death – has discouraged the disease from being romanticized, or even being factually presented in popular culture.<sup id="cite_ref-snowden_156-0" class="reference"><a href="#cite_note-snowden-156"><span class="cite-bracket">&#91;</span>155<span class="cite-bracket">&#93;</span></a></sup> </p> <ul><li>The 1889 novel <i><a href="/wiki/Mastro-don_Gesualdo" title="Mastro-don Gesualdo">Mastro-don Gesualdo</a></i> by <a href="/wiki/Giovanni_Verga" title="Giovanni Verga">Giovanni Verga</a> presents the course of a cholera epidemic across the island of <a href="/wiki/Sicily" title="Sicily">Sicily</a>, but does not show the suffering of those affected.<sup id="cite_ref-snowden_156-1" class="reference"><a href="#cite_note-snowden-156"><span class="cite-bracket">&#91;</span>155<span class="cite-bracket">&#93;</span></a></sup></li> <li>Cholera is a major plot device in <a href="/wiki/The_Painted_Veil_(novel)" title="The Painted Veil (novel)">The Painted Veil</a>, a 1925 novel by <a href="/wiki/W._Somerset_Maugham" title="W. Somerset Maugham">W. Somerset Maugham</a>. The story concerns a shy bacteriologist who discovers his young, pretty wife is having an adulterous affair. The doctor exacts revenge on his wife by inducing her to travel with him to mainland China which is in the grips of an horrific cholera outbreak. The ravages of the disease are frankly described in the novel.</li> <li>In <a href="/wiki/Thomas_Mann" title="Thomas Mann">Thomas Mann</a>'s <a href="/wiki/Novella" title="Novella">novella</a> <i><a href="/wiki/Death_in_Venice" title="Death in Venice">Death in Venice</a></i>, first published in 1912 as <i>Der Tod in Venedig</i>, Mann "presented the disease as emblematic of the final 'bestial degradation' of the sexually transgressive author Gustav von Aschenbach." Contrary to the actual facts of how violently cholera kills, Mann has his protagonist die peacefully on a beach in a deck chair. <a href="/wiki/Luchino_Visconti" title="Luchino Visconti">Luchino Visconti</a>'s <a href="/wiki/Death_in_Venice_(film)" title="Death in Venice (film)">1971 film version</a> also hid from the audience the actual course of the disease.<sup id="cite_ref-snowden_156-2" class="reference"><a href="#cite_note-snowden-156"><span class="cite-bracket">&#91;</span>155<span class="cite-bracket">&#93;</span></a></sup> Mann's novella was also <a href="/wiki/Death_in_Venice_(opera)" title="Death in Venice (opera)">made into an opera</a> by <a href="/wiki/Benjamin_Britten" title="Benjamin Britten">Benjamin Britten</a> in 1973, his last one, and into a ballet by <a href="/wiki/John_Neumeier" title="John Neumeier">John Neumeier</a> for his <a href="/wiki/Hamburg_Ballet" title="Hamburg Ballet">Hamburg Ballet</a> company, in December 2003.*</li> <li><i><a href="/wiki/The_Horseman_on_the_Roof_(novel)" title="The Horseman on the Roof (novel)">The Horseman on the Roof</a></i> (orig. French <i>Le Hussard sur le toit</i>) is a 1951 adventure novel written by <a href="/wiki/Jean_Giono" title="Jean Giono">Jean Giono</a>. It tells the story of Angelo Pardi, a young Italian <a href="/wiki/Carbonari" title="Carbonari">carbonaro</a> colonel of <a href="/wiki/Hussars" class="mw-redirect" title="Hussars">hussars</a>, caught up in the <a href="/wiki/1826%E2%80%931837_cholera_pandemic" title="1826–1837 cholera pandemic">1832 cholera epidemic</a> in <a href="/wiki/Provence" title="Provence">Provence</a>. In 1995, it was made into <a href="/wiki/The_Horseman_on_the_Roof" title="The Horseman on the Roof">a film of the same name</a> directed by <a href="/wiki/Jean-Paul_Rappeneau" title="Jean-Paul Rappeneau">Jean-Paul Rappeneau</a>.<sup id="cite_ref-157" class="reference"><a href="#cite_note-157"><span class="cite-bracket">&#91;</span>156<span class="cite-bracket">&#93;</span></a></sup></li> <li>In <a href="/wiki/Gabriel_Garcia_M%C3%A1rquez" class="mw-redirect" title="Gabriel Garcia Márquez">Gabriel Garcia Márquez</a>'s 1985 novel <i><a href="/wiki/Love_in_the_Time_of_Cholera" title="Love in the Time of Cholera">Love in the Time of Cholera</a></i>, cholera is "a looming background presence rather than a central figure requiring vile description."<sup id="cite_ref-snowden_156-3" class="reference"><a href="#cite_note-snowden-156"><span class="cite-bracket">&#91;</span>155<span class="cite-bracket">&#93;</span></a></sup> The novel was adapted in 2007 for the <a href="/wiki/Love_in_the_Time_of_Cholera_(film)" title="Love in the Time of Cholera (film)">film of the same name</a> directed by <a href="/wiki/Mike_Newell_(director)" title="Mike Newell (director)">Mike Newell</a>.</li> <li>In <i><a href="/wiki/The_Secret_Garden" title="The Secret Garden">The Secret Garden</a></i>, Mary Lennox's parents die from cholera.</li></ul> <div class="mw-heading mw-heading2"><h2 id="Country_examples">Country examples</h2></div> <div class="mw-heading mw-heading3"><h3 id="Zambia">Zambia</h3></div> <p>In <a href="/wiki/Zambia" title="Zambia">Zambia</a>, widespread cholera outbreaks have occurred since 1977, most commonly in the capital city of <a href="/wiki/Lusaka" title="Lusaka">Lusaka</a>.<sup id="cite_ref-158" class="reference"><a href="#cite_note-158"><span class="cite-bracket">&#91;</span>157<span class="cite-bracket">&#93;</span></a></sup> In 2017, an outbreak of cholera was declared in Zambia after laboratory confirmation of <i><a href="/wiki/Vibrio_cholerae" title="Vibrio cholerae">Vibrio cholerae</a></i> O1, biotype El Tor, serotype Ogawa, from stool samples from two patients with acute watery diarrhea. There was a rapid increase in the number of cases from several hundred cases in early December 2017 to approximately 2,000 by early January 2018.<sup id="cite_ref-Sinyange_et_al_2018_159-0" class="reference"><a href="#cite_note-Sinyange_et_al_2018-159"><span class="cite-bracket">&#91;</span>158<span class="cite-bracket">&#93;</span></a></sup> With intensification of the rains, new cases increased on a daily basis reaching a peak on the first week of January 2018 with over 700 cases reported.<sup id="cite_ref-160" class="reference"><a href="#cite_note-160"><span class="cite-bracket">&#91;</span>159<span class="cite-bracket">&#93;</span></a></sup> </p><p>In collaboration with partners, the Zambia Ministry of Health (MoH) launched a multifaceted public health response that included increased chlorination of the Lusaka municipal water supply, provision of emergency water supplies, water quality monitoring and testing, enhanced surveillance, epidemiologic investigations, a cholera vaccination campaign, aggressive case management and health care worker training, and laboratory testing of clinical samples.<sup id="cite_ref-Sinyange_et_al_2018_159-1" class="reference"><a href="#cite_note-Sinyange_et_al_2018-159"><span class="cite-bracket">&#91;</span>158<span class="cite-bracket">&#93;</span></a></sup> </p><p>The Zambian Ministry of Health implemented a reactive one-dose Oral Cholera Vaccine (OCV) campaign in April 2016 in three Lusaka compounds, followed by a pre-emptive second-round in December.<sup id="cite_ref-161" class="reference"><a href="#cite_note-161"><span class="cite-bracket">&#91;</span>160<span class="cite-bracket">&#93;</span></a></sup> </p><p><b><big>Nigeria</big></b> </p><p>In June 2024, the <a href="/w/index.php?title=Nigeria_Centre_for_Disease_Control_and_Prevention&amp;action=edit&amp;redlink=1" class="new" title="Nigeria Centre for Disease Control and Prevention (page does not exist)">Nigeria Centre for Disease Control and Prevention</a> (NCDC) announced a total of 1,141 suspected and 65 confirmed cases of cholera with 30 deaths from 96 Local Government Areas (LGAs) in 30 states of the country.<sup id="cite_ref-162" class="reference"><a href="#cite_note-162"><span class="cite-bracket">&#91;</span>161<span class="cite-bracket">&#93;</span></a></sup> NCDC, in its public health advisory, said Abia, Bayelsa, Bauchi, Cross River, Delta, Imo, Katsina, Lagos, Nasarawa and Zamfara states were the 10 states that contributed 90 percent of the burden of cholera in the country at the time.<sup id="cite_ref-163" class="reference"><a href="#cite_note-163"><span class="cite-bracket">&#91;</span>162<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="India">India</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Kolkata_City_skyline_from_Hoogly_bridge.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c7/Kolkata_City_skyline_from_Hoogly_bridge.jpg/220px-Kolkata_City_skyline_from_Hoogly_bridge.jpg" decoding="async" width="220" height="146" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c7/Kolkata_City_skyline_from_Hoogly_bridge.jpg/330px-Kolkata_City_skyline_from_Hoogly_bridge.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c7/Kolkata_City_skyline_from_Hoogly_bridge.jpg/440px-Kolkata_City_skyline_from_Hoogly_bridge.jpg 2x" data-file-width="960" data-file-height="639" /></a><figcaption><a href="/wiki/Kolkata" title="Kolkata">Kolkata</a> suffers from frequent cholera outbreaks</figcaption></figure> <p>The city of <a href="/wiki/Kolkata" title="Kolkata">Kolkata</a>, <a href="/wiki/India" title="India">India</a> in the state of <a href="/wiki/West_Bengal" title="West Bengal">West Bengal</a> in the <a href="/wiki/Ganges_delta" class="mw-redirect" title="Ganges delta">Ganges delta</a> has been described as the "homeland of cholera", with regular outbreaks and pronounced seasonality. In India, where the disease is <a href="/wiki/Endemism" title="Endemism">endemic</a>, cholera outbreaks occur every year between <a href="/wiki/Dry_season" title="Dry season">dry seasons</a> and <a href="/wiki/Wet_season" title="Wet season">rainy seasons</a>. India is also characterized by high population density, unsafe drinking water, open drains, and poor sanitation which provide an optimal niche for survival, sustenance and transmission of <i>Vibrio cholerae</i>.<sup id="cite_ref-164" class="reference"><a href="#cite_note-164"><span class="cite-bracket">&#91;</span>163<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Democratic_Republic_of_Congo">Democratic Republic of Congo</h3></div> <p>In <a href="/wiki/Goma" title="Goma">Goma</a> in the <a href="/wiki/Democratic_Republic_of_Congo" class="mw-redirect" title="Democratic Republic of Congo">Democratic Republic of Congo</a>, cholera has left an enduring mark on human and medical history. Cholera pandemics in the 19th and 20th centuries led to the growth of epidemiology as a science and in recent years it has continued to press advances in the concepts of <a href="/wiki/Disease_ecology" title="Disease ecology">disease ecology</a>, basic membrane biology, and transmembrane signaling and in the use of scientific information and treatment design.<sup id="cite_ref-165" class="reference"><a href="#cite_note-165"><span class="cite-bracket">&#91;</span>164<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Explanatory_notes">Explanatory notes</h2></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap"><ol class="references"> <li id="cite_note-26"><span class="mw-cite-backlink"><b><a href="#cite_ref-26">^</a></b></span> <span class="reference-text">According to <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">CDC</a>,"The infection [cholera] is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk factor for becoming ill."</span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239543626"><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-textbook-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-textbook_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-textbook_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-textbook_1-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFTodar_K" class="citation web cs1">Todar K. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20101228115128/http://www.textbookofbacteriology.net/cholera.html">"<i>Vibrio cholerae</i> and Asiatic Cholera"</a>. 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Retrieved <span class="nowrap">17 March</span> 2015</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=Sources+of+Infection+%26+Risk+Factors&amp;rft.pub=Centers+for+Disease+Control+and+Prevention&amp;rft.date=2014-11-07&amp;rft_id=https%3A%2F%2Fwww.cdc.gov%2Fcholera%2Finfection-sources.html&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-10"><span class="mw-cite-backlink"><b><a href="#cite_ref-10">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cdc.gov/cholera/diagnosis.html">"Diagnosis and Detection"</a>. <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a>. February 10, 2015. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20150315041832/http://www.cdc.gov/cholera/diagnosis.html">Archived</a> from the original on 15 March 2015<span class="reference-accessdate">. Retrieved <span class="nowrap">17 March</span> 2015</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=Diagnosis+and+Detection&amp;rft.pub=Centers+for+Disease+Control+and+Prevention&amp;rft.date=2015-02-10&amp;rft_id=https%3A%2F%2Fwww.cdc.gov%2Fcholera%2Fdiagnosis.html&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-11"><span class="mw-cite-backlink"><b><a href="#cite_ref-11">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.health.ny.gov/diseases/communicable/cholera/fact_sheet.htm">"Cholera Fact Sheet"</a>. <i>www.health.ny.gov</i>. 2017<span class="reference-accessdate">. Retrieved <span class="nowrap">2020-05-26</span></span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=unknown&amp;rft.jtitle=www.health.ny.gov&amp;rft.atitle=Cholera+Fact+Sheet&amp;rft.date=2017&amp;rft_id=https%3A%2F%2Fwww.health.ny.gov%2Fdiseases%2Fcommunicable%2Fcholera%2Ffact_sheet.htm&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-immunity-12"><span class="mw-cite-backlink">^ <a href="#cite_ref-immunity_12-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-immunity_12-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFHarris2018" class="citation journal cs1">Harris JB (November 15, 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188552">"Cholera: Immunity and Prospects in Vaccine Development"</a>. <i>J Infect Dis</i>. <b>218</b> (Suppl 3): S141–S146. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Finfdis%2Fjiy414">10.1093/infdis/jiy414</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188552">6188552</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30184117">30184117</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=J+Infect+Dis&amp;rft.atitle=Cholera%3A+Immunity+and+Prospects+in+Vaccine+Development&amp;rft.volume=218&amp;rft.issue=Suppl+3&amp;rft.pages=S141-S146&amp;rft.date=2018-11-15&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6188552%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F30184117&amp;rft_id=info%3Adoi%2F10.1093%2Finfdis%2Fjiy414&amp;rft.aulast=Harris&amp;rft.aufirst=Jason+B&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6188552&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-13"><span class="mw-cite-backlink"><b><a href="#cite_ref-13">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation news cs1"><a rel="nofollow" class="external text" href="http://www.cbc.ca/news/technology/cholera-s-seven-pandemics-1.758504">"Cholera's seven pandemics"</a>. <i>CBC</i>. 9 May 2008<span class="reference-accessdate">. Retrieved <span class="nowrap">15 July</span> 2018</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=CBC&amp;rft.atitle=Cholera%27s+seven+pandemics&amp;rft.date=2008-05-09&amp;rft_id=http%3A%2F%2Fwww.cbc.ca%2Fnews%2Ftechnology%2Fcholera-s-seven-pandemics-1.758504&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-14"><span class="mw-cite-backlink"><b><a href="#cite_ref-14">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cdc.gov/cholera/index.html">"Cholera – Vibrio cholerae infection"</a>. <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a>. October 27, 2014. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20150317031930/http://www.cdc.gov/cholera/index.html">Archived</a> from the original on 17 March 2015<span class="reference-accessdate">. Retrieved <span class="nowrap">17 March</span> 2015</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=Cholera+%E2%80%93+Vibrio+cholerae+infection&amp;rft.pub=Centers+for+Disease+Control+and+Prevention&amp;rft.date=2014-10-27&amp;rft_id=https%3A%2F%2Fwww.cdc.gov%2Fcholera%2Findex.html&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-rosenberg-15"><span class="mw-cite-backlink">^ <a href="#cite_ref-rosenberg_15-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-rosenberg_15-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCharles_E._Rosenberg2009" class="citation book cs1">Charles E. Rosenberg (2009). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=k2pL9c00rl4C&amp;pg=PA74"><i>The Cholera Years the United States in 1832, 1849, and 1866</i></a>. Chicago: University of Chicago Press. p.&#160;74. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-0-226-72676-2" title="Special:BookSources/978-0-226-72676-2"><bdi>978-0-226-72676-2</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20151109080652/https://books.google.com/books?id=k2pL9c00rl4C&amp;pg=PA74">Archived</a> from the original on 2015-11-09.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=The+Cholera+Years+the+United+States+in+1832%2C+1849%2C+and+1866.&amp;rft.place=Chicago&amp;rft.pages=74&amp;rft.pub=University+of+Chicago+Press&amp;rft.date=2009&amp;rft.isbn=978-0-226-72676-2&amp;rft.au=Charles+E.+Rosenberg&amp;rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3Dk2pL9c00rl4C%26pg%3DPA74&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-16"><span class="mw-cite-backlink"><b><a href="#cite_ref-16">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFTimmreck2002" class="citation book cs1">Timmreck TC (2002). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=yyrbKemADL4C&amp;pg=PA77"><i>An introduction to epidemiology</i></a> (3.&#160;ed.). Sudbury, MA: Jones and Bartlett Publishers. p.&#160;77. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-0-7637-0060-7" title="Special:BookSources/978-0-7637-0060-7"><bdi>978-0-7637-0060-7</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20161203190442/https://books.google.com/books?id=yyrbKemADL4C&amp;pg=PA77">Archived</a> from the original on 2016-12-03.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=An+introduction+to+epidemiology&amp;rft.place=Sudbury%2C+MA&amp;rft.pages=77&amp;rft.edition=3.&amp;rft.pub=Jones+and+Bartlett+Publishers&amp;rft.date=2002&amp;rft.isbn=978-0-7637-0060-7&amp;rft.aulast=Timmreck&amp;rft.aufirst=Thomas+C.&amp;rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DyyrbKemADL4C%26pg%3DPA77&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-Lancet2004-17"><span class="mw-cite-backlink">^ <a href="#cite_ref-Lancet2004_17-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-17"><sup><i><b>r</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-18"><sup><i><b>s</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-19"><sup><i><b>t</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-20"><sup><i><b>u</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-21"><sup><i><b>v</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-22"><sup><i><b>w</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-23"><sup><i><b>x</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-24"><sup><i><b>y</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-25"><sup><i><b>z</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-26"><sup><i><b>aa</b></i></sup></a> <a href="#cite_ref-Lancet2004_17-27"><sup><i><b>ab</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSackSackNairSiddique2004" class="citation journal cs1">Sack DA, Sack RB, Nair GB, Siddique AK (January 2004). 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title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Proceedings+of+the+National+Academy+of+Sciences+of+the+United+States+of+America&amp;rft.atitle=Regulatory+cascade+controls+virulence+in+Vibrio+cholerae&amp;rft.volume=88&amp;rft.issue=12&amp;rft.pages=5403-5407&amp;rft.date=1991-06&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC51881%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F2052618&amp;rft_id=info%3Adoi%2F10.1073%2Fpnas.88.12.5403&amp;rft_id=info%3Abibcode%2F1991PNAS...88.5403D&amp;rft.aulast=DiRita&amp;rft.aufirst=VJ&amp;rft.au=Parsot%2C+C&amp;rft.au=Jander%2C+G&amp;rft.au=Mekalanos%2C+JJ&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC51881&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-who.int-36"><span class="mw-cite-backlink">^ <a href="#cite_ref-who.int_36-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-who.int_36-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-who.int_36-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-who.int_36-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text">"Cholera Fact Sheet", World Health Organization. <a rel="nofollow" class="external text" href="https://www.who.int/mediacentre/factsheets/fs107/en/index.html">who.int</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20120505185900/http://www.who.int/mediacentre/factsheets/fs107/en/index.html">Archived</a> 2012-05-05 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a>. Retrieved November 5, 2013.</span> </li> <li id="cite_note-37"><span class="mw-cite-backlink"><b><a href="#cite_ref-37">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPetersonGellings2018" class="citation journal cs1">Peterson KM, Gellings PS (1 February 2018). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Ffemspd%2Fftx126">"Multiple intraintestinal signals coordinate the regulation of Vibrio cholerae virulence determinants"</a>. <i>Pathogens and Disease</i>. <b>76</b> (1). <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Ffemspd%2Fftx126">10.1093/femspd/ftx126</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29315383">29315383</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Pathogens+and+Disease&amp;rft.atitle=Multiple+intraintestinal+signals+coordinate+the+regulation+of+Vibrio+cholerae+virulence+determinants&amp;rft.volume=76&amp;rft.issue=1&amp;rft.date=2018-02-01&amp;rft_id=info%3Adoi%2F10.1093%2Ffemspd%2Fftx126&amp;rft_id=info%3Apmid%2F29315383&amp;rft.aulast=Peterson&amp;rft.aufirst=Kenneth+M&amp;rft.au=Gellings%2C+Patrick+S&amp;rft_id=https%3A%2F%2Fdoi.org%2F10.1093%252Ffemspd%252Fftx126&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-38"><span class="mw-cite-backlink"><b><a href="#cite_ref-38">^</a></b></span> <span class="reference-text"><sup class="noprint Inline-Template" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag may rely on an unreliable or less reliable medical source. (December 2013)">unreliable medical source?</span></a></i>&#93;</sup> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLanReeves2002" class="citation journal cs1">Lan R, Reeves PR (January 2002). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC120103">"Pandemic spread of cholera: genetic diversity and relationships within the seventh pandemic clone of Vibrio cholerae determined by amplified fragment length polymorphism"</a>. <i>Journal of Clinical Microbiology</i>. <b>40</b> (1): 172–181. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1128%2FJCM.40.1.172-181.2002">10.1128/JCM.40.1.172-181.2002</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC120103">120103</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11773113">11773113</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Journal+of+Clinical+Microbiology&amp;rft.atitle=Pandemic+spread+of+cholera%3A+genetic+diversity+and+relationships+within+the+seventh+pandemic+clone+of+Vibrio+cholerae+determined+by+amplified+fragment+length+polymorphism&amp;rft.volume=40&amp;rft.issue=1&amp;rft.pages=172-181&amp;rft.date=2002-01&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC120103%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F11773113&amp;rft_id=info%3Adoi%2F10.1128%2FJCM.40.1.172-181.2002&amp;rft.aulast=Lan&amp;rft.aufirst=R&amp;rft.au=Reeves%2C+PR&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC120103&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-NEJM2006-39"><span class="mw-cite-backlink">^ <a href="#cite_ref-NEJM2006_39-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-NEJM2006_39-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-NEJM2006_39-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-NEJM2006_39-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-NEJM2006_39-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-NEJM2006_39-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-NEJM2006_39-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-NEJM2006_39-7"><sup><i><b>h</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSackSackChaignat2006" class="citation journal cs1">Sack DA, Sack RB, Chaignat CL (August 2006). 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(June 2024)">page&#160;needed</span></a></i>&#93;</sup></span> </li> <li id="cite_note-Ramamurthy-41"><span class="mw-cite-backlink"><b><a href="#cite_ref-Ramamurthy_41-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRamamurthy_T2008" class="citation book cs1">Ramamurthy T (2008). <a rel="nofollow" class="external text" href="https://www.caister.com/hsp/abstracts/vib/12.html">"Antibiotic resistance in <i>Vibrio cholerae</i>"</a>. <i>Vibrio cholerae: Genomics and molecular biology</i>. 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Retrieved <span class="nowrap">2017-06-30</span></span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=Laboratory+Methods+for+the+Diagnosis+of+Epidemic+Dysentery+and+Cholera&amp;rft.pub=Centers+for+Disease+Control+and+Prevention&amp;rft.date=1999&amp;rft_id=https%3A%2F%2Fwww.cdc.gov%2Fcholera%2Fpdf%2FLaboratory-Methods-for-the-Diagnosis-of-Epidemic-Dysentery-and-Cholera.pdf&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-moltke1-44"><span class="mw-cite-backlink"><b><a href="#cite_ref-moltke1_44-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation news cs1"><a rel="nofollow" class="external text" href="https://www.nytimes.com/1911/07/18/archives/cholera-kills-boy-eighth-death-here-all-other-suspected-cases-now.html">"CHOLERA KILLS BOY; EIGHTH DEATH HERE; All Other Suspected Cases Now in Quarantine and Show No Alarming Symptoms"</a>. <i>The New York Times</i>. 18 July 1911.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=The+New+York+Times&amp;rft.atitle=CHOLERA+KILLS+BOY%3B+EIGHTH+DEATH+HERE%3B+All+Other+Suspected+Cases+Now+in+Quarantine+and+Show+No+Alarming+Symptoms.&amp;rft.date=1911-07-18&amp;rft_id=https%3A%2F%2Fwww.nytimes.com%2F1911%2F07%2F18%2Farchives%2Fcholera-kills-boy-eighth-death-here-all-other-suspected-cases-now.html&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-moltke2-45"><span class="mw-cite-backlink"><b><a href="#cite_ref-moltke2_45-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation news cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20081216072507/http://pqasb.pqarchiver.com/washingtonpost_historical/access/250061412.html?dids=250061412%3A250061412&amp;FMT=ABS&amp;FMTS=ABS%3AFT&amp;date=OCT+10%2C+1910&amp;author=&amp;pub=The+Washington+Post&amp;desc=MORE+CHOLERA+IN+PORT&amp;pqatl=google">"More Cholera in Port"</a>. <i><a href="/wiki/The_Washington_Post" title="The Washington Post">The Washington Post</a></i>. October 10, 1910. Archived from <a rel="nofollow" class="external text" href="https://pqasb.pqarchiver.com/washingtonpost_historical/access/250061412.html?dids=250061412:250061412&amp;FMT=ABS&amp;FMTS=ABS:FT&amp;date=OCT+10%2C+1910&amp;author=&amp;pub=The+Washington+Post&amp;desc=MORE+CHOLERA+IN+PORT&amp;pqatl=google">the original</a> on December 16, 2008<span class="reference-accessdate">. Retrieved <span class="nowrap">2008-12-11</span></span>. <q>A case of cholera developed today in the steerage of the Hamburg-American liner <a href="/wiki/SMS_Moltke_(1877)" title="SMS Moltke (1877)">Moltke</a>, which has been detained at quarantine as a possible cholera carrier since Monday last. Dr. A.H. Doty, health officer of the port, reported the case tonight with the additional information that another cholera patient from the Moltke is under treatment at <a href="/wiki/Swinburne_Island" title="Swinburne Island">Swinburne Island</a>.</q></cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=The+Washington+Post&amp;rft.atitle=More+Cholera+in+Port&amp;rft.date=1910-10-10&amp;rft_id=https%3A%2F%2Fpqasb.pqarchiver.com%2Fwashingtonpost_historical%2Faccess%2F250061412.html%3Fdids%3D250061412%3A250061412%26FMT%3DABS%26FMTS%3DABS%3AFT%26date%3DOCT%2B10%252C%2B1910%26author%3D%26pub%3DThe%2BWashington%2BPost%26desc%3DMORE%2BCHOLERA%2BIN%2BPORT%26pqatl%3Dgoogle&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-46"><span class="mw-cite-backlink"><b><a href="#cite_ref-46">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.who.int/news-room/fact-sheets/detail/cholera">"Cholera"</a>. <i>www.who.int</i><span class="reference-accessdate">. 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Lanham, MD: Rowman &amp; Littlefield. p.&#160;<a rel="nofollow" class="external text" href="https://archive.org/details/plaguesworldhist00aber/page/n114">102</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-0-7425-5705-5" title="Special:BookSources/978-0-7425-5705-5"><bdi>978-0-7425-5705-5</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Plagues+in+World+History&amp;rft.place=Lanham%2C+MD&amp;rft.pages=102&amp;rft.pub=Rowman+%26+Littlefield&amp;rft.date=2011&amp;rft.isbn=978-0-7425-5705-5&amp;rft.aulast=Aberth&amp;rft.aufirst=John&amp;rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fplaguesworldhist00aber&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-103"><span class="mw-cite-backlink"><b><a href="#cite_ref-103">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFHuber2020" class="citation journal cs1">Huber V (November 2020). <a rel="nofollow" class="external text" href="https://doi.org/10.1017%2FS1740022820000236">"Pandemics and the politics of difference: rewriting the history of internationalism through nineteenth-century cholera"</a>. <i>Journal of Global History</i>. <b>15</b> (3): 394–407. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1017%2FS1740022820000236">10.1017/S1740022820000236</a></span>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a>&#160;<a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:228940685">228940685</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Journal+of+Global+History&amp;rft.atitle=Pandemics+and+the+politics+of+difference%3A+rewriting+the+history+of+internationalism+through+nineteenth-century+cholera&amp;rft.volume=15&amp;rft.issue=3&amp;rft.pages=394-407&amp;rft.date=2020-11&amp;rft_id=info%3Adoi%2F10.1017%2FS1740022820000236&amp;rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A228940685%23id-name%3DS2CID&amp;rft.aulast=Huber&amp;rft.aufirst=Valeska&amp;rft_id=https%3A%2F%2Fdoi.org%2F10.1017%252FS1740022820000236&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-104"><span class="mw-cite-backlink"><b><a href="#cite_ref-104">^</a></b></span> <span class="reference-text"><a href="/wiki/Kelley_Lee" title="Kelley Lee">Kelley Lee</a> (2003) <i>Health impacts of globalization: towards global governance</i>. Palgrave Macmillan. p.131. <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/0-333-80254-3" title="Special:BookSources/0-333-80254-3">0-333-80254-3</a></span> </li> <li id="cite_note-105"><span class="mw-cite-backlink"><b><a href="#cite_ref-105">^</a></b></span> <span class="reference-text">Geoffrey A. Hosking (2001). <i><a rel="nofollow" class="external text" href="https://books.google.com/books?id=oh-5AAmboMUC&amp;pg=PA9">Russia and the Russians: a history</a></i>. 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href="http://www.legatum.sk/en:ahr:bayes-cholera-as-treated-by-dr-rubini-158-10355">www.legatum.sk</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20130514193601/http://www.legatum.sk/en%3Aahr%3Abayes-cholera-as-treated-by-dr-rubini-158-10355">Archived</a> 2013-05-14 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a>, <i>The American Homoeopathic Review</i>, Vol. 06 No. 11–12, 1866, pages 401–403</span> </li> <li id="cite_note-111"><span class="mw-cite-backlink"><b><a href="#cite_ref-111">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.homoeoscan.com/2015/09/trios-in-homeopathic-materia-medica-part-2.html">"Trios in Homeopathic materia medica PART II"</a>.</cite><span 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Retrieved <span class="nowrap">2024-06-22</span></span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=unknown&amp;rft.jtitle=www.thisdaylive.com&amp;rft.atitle=NCDC%3A+30+Deaths+in+30+States+as+Cholera+Outbreak+Hits+Nigeria+%E2%80%93+THISDAYLIVE&amp;rft_id=https%3A%2F%2Fwww.thisdaylive.com%2Findex.php%2F2024%2F06%2F14%2Fncdc-30-deaths-in-30-states-as-cholera-outbreak-hits-nigeria%2F&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-164"><span class="mw-cite-backlink"><b><a href="#cite_ref-164">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMandal2011" class="citation journal cs1">Mandal S (July 2011). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191718">"Cholera epidemic in and around Kolkata, India: endemicity and management"</a>. <i>Oman Medical Journal</i>. <b>26</b> (4): 288–9. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5001%2Fomj.2011.71">10.5001/omj.2011.71</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191718">3191718</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22043439">22043439</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Oman+Medical+Journal&amp;rft.atitle=Cholera+epidemic+in+and+around+Kolkata%2C+India%3A+endemicity+and+management&amp;rft.volume=26&amp;rft.issue=4&amp;rft.pages=288-9&amp;rft.date=2011-07&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3191718%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F22043439&amp;rft_id=info%3Adoi%2F10.5001%2Fomj.2011.71&amp;rft.aulast=Mandal&amp;rft.aufirst=S&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3191718&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> <li id="cite_note-165"><span class="mw-cite-backlink"><b><a href="#cite_ref-165">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLacey1995" class="citation journal cs1">Lacey SW (1 May 1995). "Cholera: Calamitous Past, Ominous Future". <i>Clinical Infectious Diseases</i>. <b>20</b> (5): 1409–1419. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fclinids%2F20.5.1409">10.1093/clinids/20.5.1409</a>. <a href="/wiki/JSTOR_(identifier)" class="mw-redirect" title="JSTOR (identifier)">JSTOR</a>&#160;<a rel="nofollow" class="external text" href="https://www.jstor.org/stable/4458566">4458566</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/7620035">7620035</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Clinical+Infectious+Diseases&amp;rft.atitle=Cholera%3A+Calamitous+Past%2C+Ominous+Future&amp;rft.volume=20&amp;rft.issue=5&amp;rft.pages=1409-1419&amp;rft.date=1995-05-01&amp;rft_id=info%3Apmid%2F7620035&amp;rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F4458566%23id-name%3DJSTOR&amp;rft_id=info%3Adoi%2F10.1093%2Fclinids%2F20.5.1409&amp;rft.aulast=Lacey&amp;rft.aufirst=S.+W.&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2></div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFArnold1986" class="citation journal cs1">Arnold D (1986). "Cholera and Colonialism in British India". <i>Past &amp; Present</i> (113): 118–151. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fpast%2F113.1.118">10.1093/past/113.1.118</a>. <a href="/wiki/JSTOR_(identifier)" class="mw-redirect" title="JSTOR (identifier)">JSTOR</a>&#160;<a rel="nofollow" class="external text" href="https://www.jstor.org/stable/650982">650982</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11617906">11617906</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Past+%26+Present&amp;rft.atitle=Cholera+and+Colonialism+in+British+India&amp;rft.issue=113&amp;rft.pages=118-151&amp;rft.date=1986&amp;rft_id=info%3Apmid%2F11617906&amp;rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F650982%23id-name%3DJSTOR&amp;rft_id=info%3Adoi%2F10.1093%2Fpast%2F113.1.118&amp;rft.aulast=Arnold&amp;rft.aufirst=David&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAziziAzizi2010" class="citation journal cs1">Azizi MH, Azizi F (January 2010). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154910">"History of Cholera Outbreaks in Iran during the 19th and 20th Centuries"</a>. <i>Middle East Journal of Digestive Diseases</i>. <b>2</b> (1): 51–55. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154910">4154910</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25197514">25197514</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Middle+East+Journal+of+Digestive+Diseases&amp;rft.atitle=History+of+Cholera+Outbreaks+in+Iran+during+the+19th+and+20th+Centuries&amp;rft.volume=2&amp;rft.issue=1&amp;rft.pages=51-55&amp;rft.date=2010-01&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4154910%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F25197514&amp;rft.aulast=Azizi&amp;rft.aufirst=MH&amp;rft.au=Azizi%2C+F&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4154910&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></li> <li>Bilson, Geoffrey. <i>A Darkened House: Cholera in Nineteenth-Century Canada</i> (U of Toronto Press, 1980).</li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCooper1986" class="citation journal cs1">Cooper DB (1986). "The New 'Black Death': Cholera in Brazil, 1855–1856". <i>Social Science History</i>. <b>10</b> (4): 467–488. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.2307%2F1171027">10.2307/1171027</a>. <a href="/wiki/JSTOR_(identifier)" class="mw-redirect" title="JSTOR (identifier)">JSTOR</a>&#160;<a rel="nofollow" class="external text" href="https://www.jstor.org/stable/1171027">1171027</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11618140">11618140</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Social+Science+History&amp;rft.atitle=The+New+%27Black+Death%27%3A+Cholera+in+Brazil%2C+1855%E2%80%931856&amp;rft.volume=10&amp;rft.issue=4&amp;rft.pages=467-488&amp;rft.date=1986&amp;rft_id=info%3Apmid%2F11618140&amp;rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F1171027%23id-name%3DJSTOR&amp;rft_id=info%3Adoi%2F10.2307%2F1171027&amp;rft.aulast=Cooper&amp;rft.aufirst=Donald+B.&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFEchenberg2011" class="citation book cs1">Echenberg M (2011). <i>Africa in the Time of Cholera: A History of Pandemics from 1817 to the Present</i>. Cambridge University Press. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-0-521-18820-3" title="Special:BookSources/978-0-521-18820-3"><bdi>978-0-521-18820-3</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Africa+in+the+Time+of+Cholera%3A+A+History+of+Pandemics+from+1817+to+the+Present&amp;rft.pub=Cambridge+University+Press&amp;rft.date=2011&amp;rft.isbn=978-0-521-18820-3&amp;rft.aulast=Echenberg&amp;rft.aufirst=Myron&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFEvans1988" class="citation journal cs1">Evans RJ (1988). 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"Cholera, Community, and Public Health in Gold Rush Sacramento and San Francisco". <i>Pacific Historical Review</i>. <b>66</b> (4): 527–551. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.2307%2F3642236">10.2307/3642236</a>. <a href="/wiki/JSTOR_(identifier)" class="mw-redirect" title="JSTOR (identifier)">JSTOR</a>&#160;<a rel="nofollow" class="external text" href="https://www.jstor.org/stable/3642236">3642236</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Pacific+Historical+Review&amp;rft.atitle=Cholera%2C+Community%2C+and+Public+Health+in+Gold+Rush+Sacramento+and+San+Francisco&amp;rft.volume=66&amp;rft.issue=4&amp;rft.pages=527-551&amp;rft.date=1997&amp;rft_id=info%3Adoi%2F10.2307%2F3642236&amp;rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F3642236%23id-name%3DJSTOR&amp;rft.aulast=Roth&amp;rft.aufirst=Mitchel&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></li> <li>Snowden, Frank M. <i>Naples in the Time of Cholera, 1884–1911</i> (Cambridge UP, 1995).</li> <li>Vinten-Johansen, Peter, ed. <i>Investigating Cholera in Broad Street: A History in Documents</i> (Broadview Press, 2020). regarding 1850s in England.</li> <li>Vinten-Johansen, Peter, et al. <i>Cholera, chloroform, and the science of medicine: a life of John Snow</i> (2003).</li></ul> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output .side-box-right{clear:right;float:right;margin-left:1em}.mw-parser-output .side-box-left{margin-right:1em}}</style><style data-mw-deduplicate="TemplateStyles:r1237033735">@media print{body.ns-0 .mw-parser-output .sistersitebox{display:none!important}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}</style><div class="side-box side-box-right plainlinks sistersitebox"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style> <div class="side-box-flex"> <div class="side-box-image"><span class="noviewer" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png" decoding="async" width="30" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/45px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/59px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></span></span></div> <div class="side-box-text plainlist">Wikimedia Commons has media related to <span style="font-weight: bold; font-style: italic;"><a href="https://commons.wikimedia.org/wiki/Category:Cholera" class="extiw" title="commons:Category:Cholera">Cholera</a></span>.</div></div> </div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1235681985"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1237033735"><div class="side-box side-box-right plainlinks sistersitebox"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"> <div class="side-box-flex"> <div class="side-box-image"><span class="noviewer" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/40px-Wiktionary-logo-en-v2.svg.png" decoding="async" width="40" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/60px-Wiktionary-logo-en-v2.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/80px-Wiktionary-logo-en-v2.svg.png 2x" data-file-width="512" data-file-height="512" /></span></span></div> <div class="side-box-text plainlist">Look up <i><b><a href="https://en.wiktionary.org/wiki/Cholera" class="extiw" title="wiktionary:Cholera">Cholera</a></b></i> in Wiktionary, the free dictionary.</div></div> </div> <ul><li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20130622144054/http://www.who.int/cholera/technical/prevention/control/en/">Prevention and control of cholera outbreaks: WHO policy and recommendations</a></li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20060324155246/http://www.who.int/cholera/">Cholera</a>&#160;&#8211;&#32;<a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a></li> <li><a rel="nofollow" class="external text" href="https://www.cdc.gov/cholera/index.html">Cholera – <i>Vibrio cholerae</i> infection</a>&#160;&#8211;&#32;<a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation encyclopaedia cs1"><span class="cs1-ws-icon" title="s:1911 Encyclopædia Britannica/Cholera"><a class="external text" href="https://en.wikisource.org/wiki/1911_Encyclop%C3%A6dia_Britannica/Cholera">"Cholera"&#160;</a></span>. <i><a href="/wiki/Encyclop%C3%A6dia_Britannica_Eleventh_Edition" title="Encyclopædia Britannica Eleventh Edition">Encyclopædia Britannica</a></i>. Vol.&#160;6 (11th&#160;ed.). 1911. pp.&#160;262–267.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=bookitem&amp;rft.atitle=Cholera&amp;rft.btitle=Encyclop%C3%A6dia+Britannica&amp;rft.pages=262-267&amp;rft.edition=11th&amp;rft.date=1911&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3ACholera" class="Z3988"></span></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 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("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q12090" class="extiw" title="d:Q12090">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#257068234">1A00</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/A00">A00</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=001">001</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D002771">D002771</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb29089.htm">29089</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000303.htm">000303</a></li><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/med/351-overview">med/351</a></li><li><b><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a></b>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/cholera-pro">Cholera</a></li><li><b><a href="/wiki/Orphanet" title="Orphanet">Orphanet</a></b>: <a rel="nofollow" class="external text" href="https://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=en&amp;Expert=173">173</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Cholera" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link 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li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Cholera" title="Template:Cholera"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Cholera" title="Template talk:Cholera"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Cholera" title="Special:EditPage/Template:Cholera"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Cholera" style="font-size:114%;margin:0 4em"><a class="mw-selflink selflink">Cholera</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Bacteria</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Vibrio_cholerae" title="Vibrio cholerae">Vibrio cholerae</a></i> <ul><li><a href="/wiki/El_Tor" title="El Tor">El Tor</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Treatment</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><td colspan="2" class="navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Oral_rehydration_therapy" title="Oral rehydration therapy">Oral rehydration therapy</a></li> <li><a href="/wiki/Cholera_vaccine" title="Cholera vaccine">Vaccine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Antibiotics</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Tetracycline" title="Tetracycline">Tetracycline</a></li> <li><a href="/wiki/Cotrimoxazole" class="mw-redirect" title="Cotrimoxazole">Cotrimoxazole</a></li> <li><a href="/wiki/Erythromycin" title="Erythromycin">Erythromycin</a></li> <li><a href="/wiki/Doxycycline" title="Doxycycline">Doxycycline</a></li> <li><a href="/wiki/Chloramphenicol" title="Chloramphenicol">Chloramphenicol</a></li> <li><a href="/wiki/Furazolidone" title="Furazolidone">Furazolidone</a></li> <li><a href="/wiki/Virstatin" title="Virstatin">Virstatin</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Fluoroquinolones</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Norfloxacin" title="Norfloxacin">Norfloxacin</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Outbreaks</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Pandemics</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/1817%E2%80%931824_cholera_pandemic" title="1817–1824 cholera pandemic">1817–24</a></li> <li><a href="/wiki/1826%E2%80%931837_cholera_pandemic" title="1826–1837 cholera pandemic">1826–37</a></li> <li><a href="/wiki/1846%E2%80%931860_cholera_pandemic" title="1846–1860 cholera pandemic">1846–60</a></li> <li><a href="/wiki/1863%E2%80%931875_cholera_pandemic" title="1863–1875 cholera pandemic">1863–75</a></li> <li><a href="/wiki/1881%E2%80%931896_cholera_pandemic" title="1881–1896 cholera pandemic">1881–96</a></li> <li><a href="/wiki/1899%E2%80%931923_cholera_pandemic" title="1899–1923 cholera pandemic">1899–1923</a></li> <li><a href="/wiki/Seventh_cholera_pandemic" title="Seventh cholera pandemic">1961–present</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">1800s</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Lord_Wellington_(1811_Quebec_ship)" title="Lord Wellington (1811 Quebec ship)">1832 (Lord Wellington)</a></li> <li><a href="/wiki/1832_Sligo_cholera_outbreak" title="1832 Sligo cholera outbreak"> 1832 (Sligo)</a></li> <li><a href="/wiki/Cholera_epidemic_in_Lexington,_Kentucky" title="Cholera epidemic in Lexington, Kentucky">1833 (Lexington)</a></li> <li><a href="/wiki/Tennessee_cholera_epidemic_(1849%E2%80%931850)" title="Tennessee cholera epidemic (1849–1850)">1849–50 (Tennessee)</a></li> <li><a href="/wiki/1853_Copenhagen_cholera_outbreak" title="1853 Copenhagen cholera outbreak">1853 (Copenhagen)</a></li> <li><a href="/wiki/1853_Stockholm_cholera_outbreak" title="1853 Stockholm cholera outbreak">1853 (Stockholm)</a></li> <li><a href="/wiki/1854_Broad_Street_cholera_outbreak" title="1854 Broad Street cholera outbreak">1854 (Broad Street)</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">1900s</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/1913_Romanian_Army_cholera_outbreak" title="1913 Romanian Army cholera outbreak">1913 (Romanian Army)</a></li> <li><a href="/wiki/Aerol%C3%ADneas_Argentinas_Flight_386" title="Aerolíneas Argentinas Flight 386">1992 (Aerolíneas Argentinas)</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">2000s</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/2007_Iraq_cholera_outbreak" title="2007 Iraq cholera outbreak">2007 (Iraq)</a></li> <li><a href="/wiki/2008_Zimbabwean_cholera_outbreak" title="2008 Zimbabwean cholera outbreak">2008 (Zimbabwe)</a></li> <li><a href="/wiki/2009_Papua_New_Guinea_cholera_outbreak" title="2009 Papua New Guinea cholera outbreak">2009 (Papua New Guinea)</a></li> <li><a href="/wiki/2010s_Haiti_cholera_outbreak" title="2010s Haiti cholera outbreak">2010s (Haiti)</a></li> <li><a href="/wiki/2012_Sierra_Leonean_cholera_outbreak" title="2012 Sierra Leonean cholera outbreak">2012 (Sierra Leone)</a></li> <li><a href="/wiki/2014%E2%80%932015_African_cholera_outbreak" title="2014–2015 African cholera outbreak">2014–15 (Africa)</a></li> <li><a href="/wiki/2016%E2%80%932022_Yemen_cholera_outbreak" title="2016–2022 Yemen cholera outbreak">2016–22 (Yemen)</a></li> <li><a href="/wiki/2018%E2%80%932019_Zimbabwe_cholera_outbreak" title="2018–2019 Zimbabwe cholera outbreak">2018–2019 (Zimbabwe)</a></li> <li><a href="/wiki/2020_cholera_outbreak_in_Bengaluru" title="2020 cholera outbreak in Bengaluru">2020 (Bengaluru)</a></li> <li><a href="/wiki/2022_cholera_outbreak_in_Lebanon" title="2022 cholera outbreak in Lebanon">2022 (Lebanon)</a></li> <li><a href="/wiki/2022%E2%80%932024_Southern_Africa_cholera_outbreak" title="2022–2024 Southern Africa cholera outbreak">2022–24 (Southern Africa)</a></li> <li><a href="/wiki/2023_cholera_outbreak_in_South_Africa" class="mw-redirect" title="2023 cholera outbreak in South Africa">2023 (South Africa)</a></li> <li><a href="/wiki/2023_Zimbabwe_cholera_outbreak" class="mw-redirect" title="2023 Zimbabwe cholera outbreak">2023 (Zimbabwe)</a></li> <li><a href="/wiki/2023%E2%80%932024_Zambian_cholera_outbreak" title="2023–2024 Zambian cholera outbreak">2023–24 (Zambia)</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/History_of_cholera" title="History of cholera">History</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chicago_1885_cholera_epidemic_myth" title="Chicago 1885 cholera epidemic myth">Chicago cholera myth</a></li> <li><a href="/wiki/Cholera_belt" title="Cholera belt">Cholera belt</a></li> <li><a href="/wiki/Cholera_Hospital" title="Cholera Hospital">Cholera Hospital</a></li> <li><a href="/wiki/Cholera_pit" title="Cholera pit">Cholera pit</a></li> <li><a href="/wiki/Cholera_riots" title="Cholera riots">Cholera riots</a></li></ul> </div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">People</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gaspard_Goyrand" title="Gaspard Goyrand">Gaspard Goyrand</a></li> <li><a href="/wiki/Waldemar_Haffkine" title="Waldemar Haffkine">Waldemar Haffkine</a></li> <li><a href="/wiki/George_Johnson_(physician)" title="George Johnson (physician)">George Johnson</a></li> <li><a href="/wiki/Robert_Koch" title="Robert Koch">Robert Koch</a></li> <li><a href="/wiki/Filippo_Pacini" title="Filippo Pacini">Filippo Pacini</a></li> <li><a href="/wiki/John_Snow" title="John Snow">John Snow</a></li> <li><a href="/wiki/Henry_Whitehead_(priest)" title="Henry Whitehead (priest)">Henry Whitehead</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Memorials</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Broad_Street_Pump" class="mw-redirect" title="Broad Street Pump">Broad Street Pump</a></li> <li><a href="/wiki/Cefn_Golau" title="Cefn Golau">Cefn Golau</a></li> <li><a href="/wiki/Cholera_Monument_Grounds_and_Clay_Wood" title="Cholera Monument Grounds and Clay Wood">Cholera Monument Grounds and Clay Wood</a></li> <li><a href="/wiki/Duffy%27s_Cut" title="Duffy&#39;s Cut">Duffy's Cut</a></li></ul> </div></td></tr></tbody></table><div> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Cultural depictions</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Mastro-don_Gesualdo" title="Mastro-don Gesualdo">Mastro-don Gesualdo</a></i></li> <li><i><a href="/wiki/Memories_and_Vagaries" title="Memories and Vagaries">Memories and Vagaries</a></i></li> <li><i><a href="/wiki/Death_in_Venice" title="Death in Venice">Death in Venice</a></i> <ul><li><a href="/wiki/Death_in_Venice_(film)" title="Death in Venice (film)">film</a></li> <li><a href="/wiki/Death_in_Venice_(opera)" title="Death in Venice (opera)">opera</a></li></ul></li> <li><i><a href="/wiki/The_Painted_Veil_(novel)" title="The Painted Veil (novel)">The Painted Veil</a></i> <ul><li><a href="/wiki/The_Painted_Veil_(1934_film)" title="The Painted Veil (1934 film)">1934 film</a></li> <li><a href="/wiki/The_Painted_Veil_(2006_film)" title="The Painted Veil (2006 film)">2006 film</a></li> <li><i><a href="/wiki/The_Seventh_Sin" title="The Seventh Sin">The Seventh Sin</a></i></li></ul></li> <li><i><a href="/wiki/Love_in_the_Time_of_Cholera" title="Love in the Time of Cholera">Love in the Time of Cholera</a></i> <ul><li><a href="/wiki/Love_in_the_Time_of_Cholera_(film)" title="Love in the Time of Cholera (film)">film</a></li></ul></li> <li><i><a href="/wiki/The_Horseman_on_the_Roof" title="The Horseman on the Roof">The Horseman on the Roof</a></i></li> <li><i><a href="/wiki/Contagious_(film)" title="Contagious (film)">Contagious</a></i></li> <li><i><a href="/wiki/The_Ghost_Map" title="The Ghost Map">The Ghost Map</a></i></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Diseases_of_poverty" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Diseases_of_poverty" title="Template:Diseases of poverty"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a 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href="/wiki/Measles" title="Measles">Measles</a></li> <li><a href="/wiki/Pneumonia" title="Pneumonia">Pneumonia</a></li> <li><a href="/wiki/Diarrhea" title="Diarrhea">Diarrheal diseases</a></li> <li><a href="/wiki/Plague_(disease)" title="Plague (disease)">Plague</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Neglected_tropical_diseases" title="Neglected tropical diseases">Neglected diseases</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a class="mw-selflink selflink">Cholera</a></li> <li><a href="/wiki/Chagas_disease" title="Chagas disease">Chagas disease</a></li> <li><a href="/wiki/African_trypanosomiasis" title="African trypanosomiasis">African sleeping sickness</a></li> <li><a href="/wiki/Schistosomiasis" title="Schistosomiasis">Schistosomiasis</a></li> <li><a href="/wiki/Dracunculiasis" title="Dracunculiasis">Dracunculiasis</a></li> <li><a href="/wiki/Onchocerciasis" title="Onchocerciasis">River blindness</a></li> <li><a href="/wiki/Visceral_leishmaniasis" title="Visceral leishmaniasis">Leishmaniasis</a></li> <li><a href="/wiki/Trachoma" title="Trachoma">Trachoma</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Miscellaneous</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Malnutrition" title="Malnutrition">Malnutrition</a></li> <li><a href="/wiki/Priority_review" title="Priority review">Priority review voucher</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Pseudomonadota-associated_Gram-negative_bacterial_infections" style="padding:3px"><table class="nowraplinks hlist mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Gram-negative_proteobacterial_diseases" title="Template:Gram-negative proteobacterial diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Gram-negative_proteobacterial_diseases" title="Template talk:Gram-negative proteobacterial diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Gram-negative_proteobacterial_diseases" title="Special:EditPage/Template:Gram-negative proteobacterial diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Pseudomonadota-associated_Gram-negative_bacterial_infections" style="font-size:114%;margin:0 4em"><a href="/wiki/Pseudomonadota" title="Pseudomonadota">Pseudomonadota</a>-associated <a href="/wiki/Gram-negative_bacterial_infection" class="mw-redirect" title="Gram-negative bacterial infection">Gram-negative bacterial infections</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Alphaproteobacteria" title="Alphaproteobacteria">α</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Rickettsiales" title="Rickettsiales">Rickettsiales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Rickettsiaceae" title="Rickettsiaceae">Rickettsiaceae</a>/<br />(<a href="/wiki/Rickettsiosis" title="Rickettsiosis">Rickettsioses</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Typhus" title="Typhus">Typhus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Rickettsia_typhi" title="Rickettsia typhi">Rickettsia typhi</a></i> <ul><li><a href="/wiki/Murine_typhus" title="Murine typhus">Murine typhus</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_prowazekii" title="Rickettsia prowazekii">Rickettsia prowazekii</a></i> <ul><li><a href="/wiki/Epidemic_typhus" title="Epidemic typhus">Epidemic typhus</a>, <a href="/wiki/Brill%E2%80%93Zinsser_disease" title="Brill–Zinsser disease">Brill–Zinsser disease</a>, <a href="/wiki/Flying_squirrel_typhus" title="Flying squirrel typhus">Flying squirrel typhus</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Spotted_fever" title="Spotted fever">Spotted<br />fever</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Tick-borne_disease" title="Tick-borne disease">Tick-borne</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Rickettsia_rickettsii" title="Rickettsia rickettsii">Rickettsia rickettsii</a></i> <ul><li><a href="/wiki/Rocky_Mountain_spotted_fever" title="Rocky Mountain spotted fever">Rocky Mountain spotted fever</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_conorii" title="Rickettsia conorii">Rickettsia conorii</a></i> <ul><li><a href="/wiki/Boutonneuse_fever" title="Boutonneuse fever">Boutonneuse fever</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_japonica" title="Rickettsia japonica">Rickettsia japonica</a></i> <ul><li><a href="/wiki/Japanese_spotted_fever" title="Japanese spotted fever">Japanese spotted fever</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_sibirica" title="Rickettsia sibirica">Rickettsia sibirica</a></i> <ul><li><a href="/wiki/North_Asian_tick_typhus" title="North Asian tick typhus">North Asian tick typhus</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_australis" title="Rickettsia australis">Rickettsia australis</a></i> <ul><li><a href="/wiki/Queensland_tick_typhus" title="Queensland tick typhus">Queensland tick typhus</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_honei" title="Rickettsia honei">Rickettsia honei</a></i> <ul><li><a href="/wiki/Flinders_Island_spotted_fever" title="Flinders Island spotted fever">Flinders Island spotted fever</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_africae" title="Rickettsia africae">Rickettsia africae</a></i> <ul><li><a href="/wiki/African_tick_bite_fever" title="African tick bite fever">African tick bite fever</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_parkeri" title="Rickettsia parkeri">Rickettsia parkeri</a></i> <ul><li><a href="/wiki/American_tick_bite_fever" class="mw-redirect" title="American tick bite fever">American tick bite fever</a></li></ul></li> <li><i><a href="/wiki/Rickettsia_aeschlimannii" class="mw-redirect" title="Rickettsia aeschlimannii">Rickettsia aeschlimannii</a></i> <ul><li><a href="/wiki/Rickettsia_aeschlimannii_infection" title="Rickettsia aeschlimannii infection"><i>Rickettsia aeschlimannii</i> infection</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Mite#Clinical_significance" title="Mite">Mite-borne</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Rickettsia_akari" title="Rickettsia akari">Rickettsia akari</a></i> <ul><li><a href="/wiki/Rickettsialpox" title="Rickettsialpox">Rickettsialpox</a></li></ul></li> <li><i><a href="/wiki/Orientia_tsutsugamushi" title="Orientia tsutsugamushi">Orientia tsutsugamushi</a></i> <ul><li><a href="/wiki/Scrub_typhus" title="Scrub typhus">Scrub typhus</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Flea#Fleas_as_a_vector" title="Flea">Flea-borne</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Rickettsia_felis" title="Rickettsia felis">Rickettsia felis</a></i> <ul><li><a href="/wiki/Flea-borne_spotted_fever" title="Flea-borne spotted fever">Flea-borne spotted fever</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Anaplasmataceae" class="mw-redirect" title="Anaplasmataceae">Anaplasmataceae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ehrlichiosis" title="Ehrlichiosis">Ehrlichiosis</a>: <i><a href="/wiki/Anaplasma_phagocytophilum" title="Anaplasma phagocytophilum">Anaplasma phagocytophilum</a></i> <ul><li><a href="/wiki/Human_granulocytic_anaplasmosis" title="Human granulocytic anaplasmosis">Human granulocytic anaplasmosis</a>, <a href="/wiki/Anaplasmosis" title="Anaplasmosis">Anaplasmosis</a></li></ul></li> <li><i><a href="/wiki/Ehrlichia_chaffeensis" title="Ehrlichia chaffeensis">Ehrlichia chaffeensis</a></i> <ul><li><a href="/wiki/Human_monocytotropic_ehrlichiosis" title="Human monocytotropic ehrlichiosis">Human monocytotropic ehrlichiosis</a></li></ul></li> <li><i><a href="/wiki/Ehrlichia_ewingii" title="Ehrlichia ewingii">Ehrlichia ewingii</a></i> <ul><li><a href="/wiki/Ehrlichiosis_ewingii_infection" title="Ehrlichiosis ewingii infection">Ehrlichiosis ewingii infection</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Hyphomicrobiales" title="Hyphomicrobiales">Hyphomicrobiales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Brucellaceae" title="Brucellaceae">Brucellaceae</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Brucella_abortus" title="Brucella abortus">Brucella abortus</a></i> <ul><li><a href="/wiki/Brucellosis" title="Brucellosis">Brucellosis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Bartonella" title="Bartonella">Bartonellaceae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bartonellosis" title="Bartonellosis">Bartonellosis</a>: <i><a href="/wiki/Bartonella_henselae" title="Bartonella henselae">Bartonella henselae</a></i> <ul><li><a href="/wiki/Cat-scratch_disease" title="Cat-scratch disease">Cat-scratch disease</a></li></ul></li> <li><i><a href="/wiki/Bartonella_quintana" title="Bartonella quintana">Bartonella quintana</a></i> <ul><li><a href="/wiki/Trench_fever" title="Trench fever">Trench fever</a></li></ul></li> <li>Either <i>B. henselae</i> or <i>B. quintana</i> <ul><li><a href="/wiki/Bacillary_angiomatosis" title="Bacillary angiomatosis">Bacillary angiomatosis</a></li></ul></li> <li><i><a href="/wiki/Bartonella_bacilliformis" title="Bartonella bacilliformis">Bartonella bacilliformis</a></i> <ul><li><a href="/wiki/Carrion%27s_disease" title="Carrion&#39;s disease">Carrion's disease</a>, <a href="/wiki/Verruga_peruana" class="mw-redirect" title="Verruga peruana">Verruga peruana</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Betaproteobacteria" title="Betaproteobacteria">β</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Neisseriaceae" title="Neisseriaceae">Neisseriales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Maltose" title="Maltose">M+</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Neisseria_meningitidis" title="Neisseria meningitidis">Neisseria meningitidis/meningococcus</a></i> <ul><li><a href="/wiki/Meningococcal_disease" title="Meningococcal disease">Meningococcal disease</a>, <a href="/wiki/Waterhouse%E2%80%93Friderichsen_syndrome" title="Waterhouse–Friderichsen syndrome">Waterhouse–Friderichsen syndrome</a>, <a href="/wiki/Meningococcal_septicaemia" class="mw-redirect" title="Meningococcal septicaemia">Meningococcal septicaemia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Maltose" title="Maltose">M−</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Neisseria_gonorrhoeae" title="Neisseria gonorrhoeae">Neisseria gonorrhoeae/gonococcus</a></i> <ul><li><a href="/wiki/Gonorrhea" title="Gonorrhea">Gonorrhea</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><span class="nobold"><i>ungrouped:</i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Eikenella_corrodens" title="Eikenella corrodens">Eikenella corrodens</a></i>/<i><a href="/wiki/Kingella_kingae" title="Kingella kingae">Kingella kingae</a></i> <ul><li><a href="/wiki/HACEK_organisms" title="HACEK organisms">HACEK</a></li></ul></li> <li><i><a href="/wiki/Chromobacterium_violaceum" title="Chromobacterium violaceum">Chromobacterium violaceum</a></i> <ul><li><a href="/wiki/Chromobacteriosis_infection" title="Chromobacteriosis infection">Chromobacteriosis infection</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Burkholderiales" title="Burkholderiales">Burkholderiales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Burkholderia_pseudomallei" title="Burkholderia pseudomallei">Burkholderia pseudomallei</a></i> <ul><li><a href="/wiki/Melioidosis" title="Melioidosis">Melioidosis</a></li></ul></li> <li><i><a href="/wiki/Burkholderia_mallei" title="Burkholderia mallei">Burkholderia mallei</a></i> <ul><li><a href="/wiki/Glanders" title="Glanders">Glanders</a></li></ul></li> <li><i><a href="/wiki/Burkholderia_cepacia_complex" title="Burkholderia cepacia complex">Burkholderia cepacia complex</a></i></li> <li><i><a href="/wiki/Bordetella_pertussis" title="Bordetella pertussis">Bordetella pertussis</a>/<a href="/wiki/Bordetella_parapertussis" title="Bordetella parapertussis">Bordetella parapertussis</a></i> <ul><li><a href="/wiki/Pertussis" class="mw-redirect" title="Pertussis">Pertussis</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gammaproteobacteria" title="Gammaproteobacteria">γ</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Enterobacteriaceae" title="Enterobacteriaceae">Enterobacteriales</a><br />(<a href="/wiki/Oxidase_test#OX−" title="Oxidase test">OX−</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/MacConkey_agar#Lac+" title="MacConkey agar">Lac+</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Klebsiella_pneumoniae" title="Klebsiella pneumoniae">Klebsiella pneumoniae</a></i> <ul><li><a href="/wiki/Rhinoscleroma" title="Rhinoscleroma">Rhinoscleroma</a>, <a href="/wiki/Pneumonia" title="Pneumonia">Pneumonia</a></li></ul></li> <li><i><a href="/wiki/Klebsiella_granulomatis" title="Klebsiella granulomatis">Klebsiella granulomatis</a></i> <ul><li><a href="/wiki/Granuloma_inguinale" title="Granuloma inguinale">Granuloma inguinale</a></li></ul></li> <li><i><a href="/wiki/Klebsiella_oxytoca" title="Klebsiella oxytoca">Klebsiella oxytoca</a></i></li></ul> <ul><li><i><a href="/wiki/Escherichia_coli" title="Escherichia coli">Escherichia coli</a></i>: <a href="/wiki/Enterotoxigenic_Escherichia_coli" title="Enterotoxigenic Escherichia coli">Enterotoxigenic</a></li> <li><a href="/wiki/Enteroinvasive_Escherichia_coli" title="Enteroinvasive Escherichia coli">Enteroinvasive</a></li> <li><a href="/wiki/Verotoxin-producing_Escherichia_coli" class="mw-redirect" title="Verotoxin-producing Escherichia coli">Enterohemorrhagic</a></li> <li><a href="/wiki/Escherichia_coli_O157:H7" title="Escherichia coli O157:H7">O157:H7</a></li> <li><a href="/wiki/Escherichia_coli_O104:H4" title="Escherichia coli O104:H4">O104:H4</a> <ul><li><a href="/wiki/Hemolytic-uremic_syndrome" class="mw-redirect" title="Hemolytic-uremic syndrome">Hemolytic-uremic syndrome</a></li></ul></li></ul> <ul><li><i><a href="/wiki/Enterobacter_aerogenes" class="mw-redirect" title="Enterobacter aerogenes">Enterobacter aerogenes</a>/<a href="/wiki/Enterobacter_cloacae" title="Enterobacter cloacae">Enterobacter cloacae</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/MacConkey_agar#Slow" title="MacConkey agar">Slow/weak</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Serratia_marcescens" title="Serratia marcescens">Serratia marcescens</a></i> <ul><li><a href="/wiki/Serratia_infection" class="mw-redirect" title="Serratia infection"><i>Serratia</i> infection</a></li></ul></li> <li><i><a href="/wiki/Citrobacter_koseri" title="Citrobacter koseri">Citrobacter koseri</a></i>/<i><a href="/wiki/Citrobacter_freundii" title="Citrobacter freundii">Citrobacter freundii</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/MacConkey_agar#Lac−" title="MacConkey agar">Lac−</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Bismuth_sulfite_agar" title="Bismuth sulfite agar">H2S+</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Salmonella_enterica" title="Salmonella enterica">Salmonella enterica</a></i> <ul><li><a href="/wiki/Typhoid_fever" title="Typhoid fever">Typhoid fever</a>, <a href="/wiki/Paratyphoid_fever" title="Paratyphoid fever">Paratyphoid fever</a>, <a href="/wiki/Salmonellosis" title="Salmonellosis">Salmonellosis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue">H2S−</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Shigella_dysenteriae" title="Shigella dysenteriae">Shigella dysenteriae</a>/<a href="/wiki/Shigella_sonnei" title="Shigella sonnei">sonnei</a>/<a href="/wiki/Shigella_flexneri" title="Shigella flexneri">flexneri</a>/<a href="/wiki/Shigella_boydii" title="Shigella boydii">boydii</a></i> <ul><li><a href="/wiki/Shigellosis" title="Shigellosis">Shigellosis</a>, <a href="/wiki/Bacillary_dysentery" title="Bacillary dysentery">Bacillary dysentery</a></li></ul></li> <li><i><a href="/wiki/Proteus_mirabilis" title="Proteus mirabilis">Proteus mirabilis</a></i>/<i><a href="/wiki/Proteus_vulgaris" title="Proteus vulgaris">Proteus vulgaris</a></i></li> <li><i><a href="/wiki/Yersinia_pestis" title="Yersinia pestis">Yersinia pestis</a></i> <ul><li><a href="/wiki/Plague_(disease)" title="Plague (disease)">Plague</a>/<a href="/wiki/Bubonic_plague" title="Bubonic plague">Bubonic plague</a></li></ul></li> <li><i><a href="/wiki/Yersinia_enterocolitica" title="Yersinia enterocolitica">Yersinia enterocolitica</a></i> <ul><li><a href="/wiki/Yersiniosis" title="Yersiniosis">Yersiniosis</a></li></ul></li> <li><i><a href="/wiki/Yersinia_pseudotuberculosis" title="Yersinia pseudotuberculosis">Yersinia pseudotuberculosis</a></i> <ul><li><a href="/wiki/Far_East_scarlet-like_fever" title="Far East scarlet-like fever">Far East scarlet-like fever</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Pasteurellaceae" title="Pasteurellaceae">Pasteurellales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><span class="nobold"><i><a href="/wiki/Haemophilus" title="Haemophilus">Haemophilus</a>:</i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Haemophilus_influenzae" title="Haemophilus influenzae">H. influenzae</a></i> <ul><li><a href="/wiki/Haemophilus_meningitis" title="Haemophilus meningitis"><i>Haemophilus</i> meningitis</a></li> <li><a href="/wiki/Brazilian_purpuric_fever" title="Brazilian purpuric fever">Brazilian purpuric fever</a></li></ul></li> <li><i><a href="/wiki/Haemophilus_ducreyi" title="Haemophilus ducreyi">H. ducreyi</a></i> <ul><li><a href="/wiki/Chancroid" title="Chancroid">Chancroid</a></li></ul></li> <li><i><a href="/wiki/Haemophilus_parainfluenzae" title="Haemophilus parainfluenzae">H. parainfluenzae</a></i> <ul><li><a href="/wiki/HACEK_organisms" title="HACEK organisms">HACEK</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><span class="nobold"><i><a href="/wiki/Pasteurella_multocida" title="Pasteurella multocida">Pasteurella multocida</a></i></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pasteurellosis" title="Pasteurellosis">Pasteurellosis</a></li> <li><i><a href="/wiki/Actinobacillus" title="Actinobacillus">Actinobacillus</a></i> <ul><li><a href="/wiki/Actinobacillosis" title="Actinobacillosis">Actinobacillosis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><span class="nobold"><i><a href="/wiki/Aggregatibacter_actinomycetemcomitans" title="Aggregatibacter actinomycetemcomitans">Aggregatibacter actinomycetemcomitans</a></i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/HACEK_organisms" title="HACEK organisms">HACEK</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Legionellales" title="Legionellales">Legionellales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Legionella_pneumophila" title="Legionella pneumophila">Legionella pneumophila</a>/<a href="/wiki/Legionella_longbeachae" title="Legionella longbeachae">Legionella longbeachae</a></i> <ul><li><a href="/wiki/Legionnaires%27_disease" title="Legionnaires&#39; disease">Legionnaires' disease</a></li></ul></li> <li><i><a href="/wiki/Coxiella_burnetii" title="Coxiella burnetii">Coxiella burnetii</a></i> <ul><li><a href="/wiki/Q_fever" title="Q fever">Q fever</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Thiotrichales" title="Thiotrichales">Thiotrichales</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Francisella_tularensis" title="Francisella tularensis">Francisella tularensis</a></i> <ul><li><a href="/wiki/Tularemia" title="Tularemia">Tularemia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Vibrionaceae" title="Vibrionaceae">Vibrionaceae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Vibrio_cholerae" title="Vibrio cholerae">Vibrio cholerae</a></i> <ul><li><a class="mw-selflink selflink">Cholera</a></li></ul></li> <li><i><a href="/wiki/Vibrio_vulnificus" title="Vibrio vulnificus">Vibrio vulnificus</a></i></li> <li><i><a href="/wiki/Vibrio_parahaemolyticus" title="Vibrio parahaemolyticus">Vibrio parahaemolyticus</a></i></li> <li><i><a href="/wiki/Vibrio_alginolyticus" title="Vibrio alginolyticus">Vibrio alginolyticus</a></i></li> <li><i><a href="/wiki/Plesiomonas_shigelloides" title="Plesiomonas shigelloides">Plesiomonas shigelloides</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Pseudomonadales" title="Pseudomonadales">Pseudomonadales</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Pseudomonas_aeruginosa" title="Pseudomonas aeruginosa">Pseudomonas aeruginosa</a></i> <ul><li><a href="/wiki/Pseudomonas_infection" title="Pseudomonas infection"><i>Pseudomonas</i> infection</a></li></ul></li> <li><i><a href="/wiki/Moraxella_catarrhalis" title="Moraxella catarrhalis">Moraxella catarrhalis</a></i></li> <li><i><a href="/wiki/Acinetobacter_baumannii" title="Acinetobacter baumannii">Acinetobacter baumannii</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Xanthomonadaceae" title="Xanthomonadaceae">Xanthomonadaceae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Stenotrophomonas_maltophilia" title="Stenotrophomonas maltophilia">Stenotrophomonas maltophilia</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Cardiobacteriaceae" title="Cardiobacteriaceae">Cardiobacteriaceae</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Cardiobacterium_hominis" title="Cardiobacterium hominis">Cardiobacterium hominis</a></i> <ul><li><a href="/wiki/HACEK_organisms" title="HACEK organisms">HACEK</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Aeromonadales" title="Aeromonadales">Aeromonadales</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Aeromonas_hydrophila" title="Aeromonas hydrophila">Aeromonas hydrophila</a>/<a href="/wiki/Aeromonas_veronii" title="Aeromonas veronii">Aeromonas veronii</a></i> <ul><li><a href="/wiki/Aeromonas_infection" title="Aeromonas infection"><i>Aeromonas</i> infection</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Campylobacterota" title="Campylobacterota">ε</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Campylobacterales" scope="row" class="navbox-group" style="width:1%;background-color: PowderBlue"><a href="/wiki/Campylobacterales" title="Campylobacterales">Campylobacterales</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Campylobacter_jejuni" title="Campylobacter jejuni">Campylobacter jejuni</a></i> <ul><li><a href="/wiki/Campylobacteriosis" title="Campylobacteriosis">Campylobacteriosis</a>, <a href="/wiki/Guillain%E2%80%93Barr%C3%A9_syndrome" title="Guillain–Barré syndrome">Guillain–Barré syndrome</a></li></ul></li> <li><i><a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">Helicobacter pylori</a></i> <ul><li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic ulcer</a>, <a href="/wiki/MALT_lymphoma" title="MALT lymphoma">MALT lymphoma</a>, <a href="/wiki/Gastric_cancer" class="mw-redirect" title="Gastric cancer">Gastric cancer</a></li></ul></li> <li><i><a href="/wiki/Helicobacter_cinaedi" title="Helicobacter cinaedi">Helicobacter cinaedi</a></i> <ul><li><a href="/wiki/Helicobacter_cellulitis" title="Helicobacter cellulitis"><i>Helicobacter</i> cellulitis</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"></div><div role="navigation" class="navbox authority-control" aria-labelledby="Authority_control_databases_frameless&amp;#124;text-top&amp;#124;10px&amp;#124;alt=Edit_this_at_Wikidata&amp;#124;link=https&amp;#58;//www.wikidata.org/wiki/Q12090#identifiers&amp;#124;class=noprint&amp;#124;Edit_this_at_Wikidata" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Authority_control_databases_frameless&amp;#124;text-top&amp;#124;10px&amp;#124;alt=Edit_this_at_Wikidata&amp;#124;link=https&amp;#58;//www.wikidata.org/wiki/Q12090#identifiers&amp;#124;class=noprint&amp;#124;Edit_this_at_Wikidata" style="font-size:114%;margin:0 4em"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q12090#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">National</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://d-nb.info/gnd/4147855-1">Germany</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Cholera"><a rel="nofollow" class="external text" href="https://id.loc.gov/authorities/sh85024645">United States</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://catalogue.bnf.fr/ark:/12148/cb11940300h">France</a></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://data.bnf.fr/ark:/12148/cb11940300h">BnF data</a></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://id.ndl.go.jp/auth/ndlna/00566625">Japan</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="cholera"><a rel="nofollow" class="external text" href="https://aleph.nkp.cz/F/?func=find-c&amp;local_base=aut&amp;ccl_term=ica=ph136526&amp;CON_LNG=ENG">Czech Republic</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="http://olduli.nli.org.il/F/?func=find-b&amp;local_base=NLX10&amp;find_code=UID&amp;request=987007285758705171">Israel</a></span></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://hls-dhs-dss.ch/fr/articles/022717">Historical Dictionary of Switzerland</a></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://catalog.archives.gov/id/10639659">NARA</a></span></li></ul></div></td></tr></tbody></table></div> <!-- NewPP limit report Parsed by mw‐web.codfw.main‐6b7f745dd4‐v9wvm Cached time: 20241125142917 Cache expiry: 2592000 Reduced expiry: false Complications: [vary‐revision‐sha1, show‐toc] CPU time usage: 2.325 seconds Real time usage: 2.738 seconds Preprocessor visited node count: 14948/1000000 Post‐expand include size: 544004/2097152 bytes Template argument size: 9608/2097152 bytes Highest expansion depth: 19/100 Expensive parser function count: 18/500 Unstrip recursion depth: 1/20 Unstrip post‐expand size: 679477/5000000 bytes Lua time usage: 1.467/10.000 seconds Lua memory usage: 26876586/52428800 bytes Lua Profile: ? 300 ms 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