Paediatric Emergency Department, St Thomas's Hospital, London, SEI 7EH, UK.
Infectious Diseases Unit, The Royal Free Hospital, London, NW3 2QG, UK.
J Infect. 2017 Jun;74 Suppl 1:S66-S73. doi: 10.1016/S0163-4453(17)30194-9.
Cholera is an acute secretory diarrhoeal infection caused by the bacterium Vibrio cholerae. It is likely to have originated in the Indian sub-continent; however, it spread to cause six worldwide pandemics between 1817-1923. The ongoing seventh worldwide pandemic of cholera began in 1961. The intensity, duration and severity of cholera epidemics have been increasing, signaling the need for more effective control and prevention measures. The response to the cholera pandemics of the 19th century led to the development of safe and effective sanitation and water systems which have effectively removed the risk of cholera in many settings. However, such systems are not in place to protect billions of people worldwide. Although some progress has been made in expanding access to water in recent years, achieving optimal infrastructure will, in the most optimistic scenario, take decades. Climate change, extreme weather events and rapid urbanisation suggests that alternatives to the current paradigm of providing large centralised water and sanitation systems should be considered, including smaller decentralised systems. The aim of this review paper is to provide an overview of current knowledge regarding management of cholera with a focus on prevention measures including vaccination and water and sanitation interventions.
霍乱是一种由霍乱弧菌引起的急性分泌性腹泻感染。它可能起源于印度次大陆；然而，它传播到世界各地，在 1817 年至 1923 年间引起了六次大流行。目前正在进行的第七次全球霍乱大流行始于 1961 年。霍乱疫情的强度、持续时间和严重程度一直在增加，这表明需要采取更有效的控制和预防措施。对 19 世纪霍乱大流行的反应导致了安全有效的卫生和供水系统的发展，这些系统在许多情况下有效地消除了霍乱的风险。然而，并没有这样的系统来保护全世界数十亿人。尽管近年来在扩大供水方面取得了一些进展，但在最乐观的情况下，实现最佳基础设施需要几十年的时间。气候变化、极端天气事件和快速城市化表明，应该考虑替代目前提供大型集中供水和卫生系统的模式，包括较小的分散系统。本文的目的是提供关于霍乱管理的现有知识概述，重点是预防措施，包括疫苗接种和水与卫生干预措施。
