A diarrheal disease by any other name…

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Bathers in Philippines River

Residents along the Cagayan River in Cagayan de Oro, Philippines, bathe themselves with river water.

In many countries, the true burden of cholera may not be clear, as the disease is frequently reported under various names such as “acute watery diarrhea.” Policymakers often deny the existence of cholera and perhaps justifiably so. Cholera has a terrible reputation and to invoke its name may threaten a country’s tourism industry and seafood exports.

At an informal gathering in November, cholera experts from around the globe opined that this situation could be changing. With the availability of a reasonably priced, easy to administer, WHO-prequalified oral cholera vaccine (Shanchol), governments now have the immediate (albeit relatively short-term) option to reduce endemic or epidemic cholera using vaccination. Aside from the proven safety and effectiveness of the oral cholera vaccine, there is increasing experience of successful mass oral cholera vaccination of large populations [1]. StopCholera has created an interactive map that displays the disease burden of cholera, as well as the number of vaccination doses successfully administered since vaccine licensure around the world. 

Perhaps, with the growing evidence base for vaccine effectiveness, policymakers can be now be convinced to improved surveillance and reporting of cholera?

It is about time that cholera comes out from under the shadows and its true burden of disease is recognized. After all, the diarrheal disease we call cholera, by any other name, still produces the same suffering among the population it afflicts, and this must be addressed.

[1] Martin S, Lopez AL, Bellos A, Deen J, Ali M, et al. (2013) Post-licensure deployment of currently available oral cholera vaccines: A systematic review. Submitted for publication.


Image caption: 
Residents along the Cagayan River in Cagayan de Oro, Philippines, bathe themselves with river water. The river turns brown during the rain season. It is also a repository of domestic, agricultural, and industrial waste. © 2006 Elson T. Elizaga, Courtesy of Photoshare