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Cholera is surging worldwide but the vaccine is not widely available

Cholera bacteria under electron microscope | Sanofi Pasteur

Cholera is a bacterial disease that is spread mainly through water contamination. The bacteria is shed in the feces of infected individuals which material then ends up back in the drinking water supply. This disease still causes tens of thousands of deaths every year in crowded areas that lack modern sanitation. Fortunately, the disease can be treated with fluids and antibiotics. There are also a number of cholera vaccines available throughout the world.

The cholera vaccine is unfortunately not available at all in the United States and is in short supply elsewhere where the risk of cholera infection is an ever-present and growing threat. The company that had produced the cholera vaccine for U.S. customers stopped producing it during the COVID-19 pandemic.

In areas where cholera is endemic, vaccine is still available but not enough to meet the demand given the current surge in 27 countries. The reason for the surge seems to be a breakdown of public sanitation and water purification. In response, there is a shift from a 2-dose vaccination program to a single-dose system. Administration of a single dose, when cholera vaccine supply is limited, is more effective overall in controlling the spread of the disease rather than giving two shots to some people and zero shots to others.

Cholera is often not recommended for travelers because people rarely travel to areas with active cholera transmission. Lately, however, travelers have been returning to the U.S. with cholera. There were at least 8 cases of this occurring in 2022.

Cholera is another disease that disproportionately affects poor, developing countries of the world where there are few resources to stop its spread. If cholera's impact is to be lessened, it will require help from developed nations in coming up with practical, affordable water and sanitation systems, as well as vaccine campaigns.


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