Stanley Plotkin, Section Editor Oral Vaccines Against Cholera

The current seventh pandemic of cholera, caused by serogroup O1, El Tor biotype, has now involved almost the entire developing world. The ongoing dynamic epidemiology of cholera, involving evolution of new strains, prolonged and more frequent epidemics, increased antimicrobial resistance, and awareness of the role of climate change upon the global burden has returned cholera to the forefront of global public health discussions. Improved water and sanitation should continue to be the mainstays of cholera-prevention efforts, but major improvements are a far-off goal for much of the cholera-affected developing world. The advent of safe and effective, new-generation oral vaccines against cholera has created renewed interest in the use of vaccines as a tool to control cholera. Cholera remains an important global health challenge, particularly in resource poor countries in Asia and Af-rica. This rapidly dehydrating diarrheal disease, caused by O1 and O139 serogroups of the bacterium Vibrio cholerae, is transmitted primarily by contaminated water or food and has the ability to spread quickly, with case fatality rates in excess of 20 % without appropriat