Cholera
Cholera
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DOI：
10.1016/s0140-6736(12)60436-x
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发表时间：
2012-06-30
期刊：
影响因子：
168.9
通讯作者：
Calderwood, Stephen B.
中科院分区：
文献类型：
--
作者：
Harris, Jason B.;LaRocque, Regina C.;Calderwood, Stephen B.
霍乱是一种急性分泌性腹泻，由O1或O139群霍乱弧菌感染引起。它在50多个国家流行，也造成大规模流行。自1817年以来，已有7起霍乱疫情从亚洲蔓延到世界大部分地区。第七次大流行始于1961年，每年影响300-500万人，导致12万人死亡。虽然轻度霍乱可能与其他腹泻疾病难以区分，但严重霍乱的表现是明显的，腹泻得到了明显的净化。霍乱患者的治疗包括积极的液体补充；有效的治疗可以将死亡率从50%以上降至0.2%以下。抗生素治疗可将腹泻的量和持续时间减少50%，建议中度至重度脱水的患者使用。预防霍乱有赖于获得安全饮用水和卫生设施。目前已有两种口服霍乱疫苗，目前正在积极评估在综合预防方案中最有效地使用这两种疫苗。
Cholera is an acute, secretory diarrhoea caused by infection with Vibrio cholerae of the O1 or O139 serogroup. It is endemic in more than 50 countries and also causes large epidemics. Since 1817, seven cholera pandemics have spread from Asia to much of the world. The seventh pandemic began in 1961 and affects 3-5 million people each year, killing 120 000. Although mild cholera can be indistinguishable from other diarrhoeal illnesses, the presentation of severe cholera is distinct, with pronounced diarrhoeal purging. Management of patients with cholera involves aggressive fluid replacement; effective therapy can decrease mortality from more than 50% to less than 0.2%. Antibiotic treatment decreases volume and duration of diarrhoea by 50% and is recommended for patients with moderate to severe dehydration. Prevention of cholera depends on access to safe water and sanitation. Two oral cholera vaccines are available and the most effective use of these in integrated prevention programmes is being actively assessed.