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PMID: 2857326 Published · ppublish English Journal Article Research Support, Non-U.S. Gov't

Cholera epidemiology in developed and developing countries: new thoughts on transmission, seasonality, and control.

Lancet (London, England) ·Vol. 1 ·No. 8423 ·1985-02-02 ·Pages 261-2

Miller CJ, Feachem RG, Drasar BS

Abstract

暂无摘要

Keywords

Africa Americas Asia Bacterial And Fungal Diseases--prevention and control Bangladesh Biology Communicable Disease Control Communicable Diseases--prevention and control Delivery Of Health Care Developed Countries Developing Countries Diseases--prevention and control Ecology Environment Epidemiologic Methods Food Supply Health Health Services Infections North America Northern America Public Health Research Methodology Southern Asia United States

MeSH Terms

Bangladesh Cholera/epidemiology,prevention & control,transmission Developing Countries Disease Reservoirs Food Microbiology Humans Seasons United States Water Microbiology

Authors & Affiliations

3 authors, click to expand affiliations / ORCID

Miller C J

Feachem R G

Drasar B S

Other Abstracts

eng

It is hypothesized that geographical regions where cholera is endemic, V. cholerae 01 may be maintained in estuarine environments. Endemic cholera, unlike epedemic cholera, occurs regularly, and sometimes seasonally, in certain geographical areas without evidence of importation. Measures used to control epedemic cholera are not very effective in preventing endemic cholera. Areas of endemic cholera include southeastern US and several African and Asian countries, including Bangladesh. It has previously been suggested that V. cholerae 01 is maintained in these areas between outbreaks by 1) living in nonhuman animals

2) residing in chronic human carriers, who may not excrete the organism

3) by continous transmission to individuals who manifest only mild symptoms of the disease

and 4) by living in aquatic environments. The 1st 3 explanations are to supported by available evidence. The 4th explanation, previously thought to be impossible, is now engendering new interest. Recent studies reveal that V. cholerae 01 can survive in warm water with a salinity of 0.25-3.0% and a ph of 8.0 for a considerable length of time. Estuarine environments may be suitable for the organism's survival. It is hypothesized further that outbreaks of primary cases in estuarine environments may be precipatated by eating certain types of raw or inadequately cooked estuarian plants or animals, perhaps on a seasonal basis. In areas where sanitation is poor, the disease will be transmitted to secondary cases, and in areas where sanitation is good, secondary cases will be rare. Primary cases may also develop in areas some distance from the estuarian environment by the importation of estuarian products. Outbreaks of secondary cases in nonestuarian environments may be due to the seasonal movement of estuarian inhabitants through the area. This explanation fits the epidemiological evidence available for the southeastern US and Bangladesh. If this hypothesis is correct, appropriate control measures will include educating people to refrain from eating raw and improperly cooked seafood.

Article Info

Journal

Lancet (London, England)

Abbr.

Lancet

ISSN

0140-6736

DOI

10.1016/s0140-6736(85)91036-0

Published

1985-02-02

Pages

261-2

Language

English

Region

England

NLM ID

2985213R

Subset

External Links

PubMed source DOI: 10.1016/s0140-6736(85)91036-0 View journal details

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Cholera epidemiology in developed and developing countries: new thoughts on transmission, seasonality, and control.

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