Severity of cholera during concurrent infections with other enteric pathogens.

In a clinic-based case-control study in Bangladesh we evaluated whether children with diarrhoea due to V. cholerae O1 in association with other enteric pathogen(s) are likely to manifest more severe disease as indicated by development of moderate or severe dehydration. Children with moderate or severe dehydration were defined as cases and those with no dehydration were controls; both cases and controls had acute diarrhoea. A systematic sample of 268 dehydrated cases and 699 nondehydrated controls aged 1-35 months with acute watery diarrhoea of 6 days or less was included. In a multivariate analysis it has been shown that infection with Vibrio cholerae O1 in association with another diarrhoea pathogen (odds ratio = 7.07) was strongly correlated with status of dehydration than those with the V. cholerae O1 infection as a single pathogen (odds ratio = 3.63). Either group was associated with significant risk of dehydration. The results of the study suggest that more than one enteropathogen may be simultaneously involved in causing severe diarrhoea, and appropriate public health measures to reduce environmental contamination should be beneficia