Kaper J B, Morris J G, Levine M M
Center for Vaccine Development, University of Maryland School of Medicine, Baltimore 21201.
Clin Microbiol Rev. 1995 Jan;8(1):48-86. doi: 10.1128/CMR.8.1.48.
Despite more than a century of study, cholera still presents challenges and surprises to us. Throughout most of the 20th century, cholera was caused by Vibrio cholerae of the O1 serogroup and the disease was largely confined to Asia and Africa. However, the last decade of the 20th century has witnessed two major developments in the history of this disease. In 1991, a massive outbreak of cholera started in South America, the one continent previously untouched by cholera in this century. In 1992, an apparently new pandemic caused by a previously unknown serogroup of V. cholerae (O139) began in India and Bangladesh. The O139 epidemic has been occurring in populations assumed to be largely immune to V. cholerae O1 and has rapidly spread to many countries including the United States. In this review, we discuss all aspects of cholera, including the clinical microbiology, epidemiology, pathogenesis, and clinical features of the disease. Special attention will be paid to the extraordinary advances that have been made in recent years in unravelling the molecular pathogenesis of this infection and in the development of new generations of vaccines to prevent it.
尽管经过了一个多世纪的研究，霍乱仍然给我们带来挑战和惊喜。在20世纪的大部分时间里，霍乱由O1血清群的霍乱弧菌引起，这种疾病主要局限于亚洲和非洲。然而，20世纪的最后十年见证了这种疾病历史上的两大进展。1991年，南美洲爆发了大规模霍乱疫情，而南美洲是本世纪之前未曾受到霍乱侵袭的大陆。1992年，一种由此前未知的霍乱弧菌血清群（O139）引起的明显新型大流行在印度和孟加拉国开始。O139疫情在假定对O1霍乱弧菌具有很大免疫力的人群中发生，并迅速蔓延到包括美国在内的许多国家。在这篇综述中，我们讨论霍乱的各个方面，包括该疾病的临床微生物学、流行病学、发病机制和临床特征。我们将特别关注近年来在揭示这种感染的分子发病机制以及开发新一代预防疫苗方面取得的非凡进展。
