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Journal of Travel Medicine
Article . 1997 . Peer-reviewed
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Re-emergence of Cholera Vaccine

Authors: Stephen A. Berger; Itzhak Shapiro;

Re-emergence of Cholera Vaccine

Abstract

Although epidemic cholera was first described in 1817, the disease probably has been common in the Indian subcontinent since ancient times.1 Until recently, a single bacterial type (Vibrio cholerae 01) has been responsible for each of the seven recorded cholera pandemics. The current epidemic began in Celebes (Sulawesi), Indonesia, in 1961, and is currently raging through all continents.2 During the 1990s, over 1 million cholera cases have been reported from Latin America, 2000 from Ukraine and the Russian Republic during 1994 alone (GIDEON computer software, C.Y. Informatics, Ramat Hasharon, Israel). Of the 208,755 cases of cholera (5034 fatal) officially reported to the World Health Organization in 1995,3 41.1% were from Latin America, 34.0% from Africa, 24.4% from Asia, and 0.5% from Europe and Oceania. Interest in our own country of Israel stems from the popularity of tourism (over 1 million travelers exit Israel yearly) and the presence of disease in neighboring areas. Following an epidemic of 397 cases in Jerusalem during 1970, periodic outbreaks have occurred in Gaza, Judea and Samaria.4 Three tourists returned with the infection to Israel during the 1980s, all from Egypt (which officially claims to have no cholera).5 Despite universal interest in this ancient disease, medical science has long been frustrated in its search for an effective vaccine. The most important 'vaccine' against cholera is common sense, and consists of intelligent eating and drinking while in endemic areas. For example, local raw fish (ceviche) is a common source of the disease in Latin America, while shellfish (particularly oysters) are often implicated along the American Gulf Coast. Virtually all forms of water purification are effective against Vibrio cholerae. Although antibiotic prophylaxis might be considered in some circumstances (doxycycline; or a quinolone in areas of tetracycline resistance), it is not routinely advocated.

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Average
Average
Average
bronze