The Cholera Family of Enterotoxins

Cholera continues to plague developing nations which lack the sanitary facilities to prevent bacterial contamination of food and water supplies.1,2 Seven pandemics have been recorded since 1817 with current major outbreaks in South America and Asia.3 Untreated, the profuse diarrhea characteristic of the classical form of cholera rapidly leads to dehydration and hypovolemic shock.4 Antibiotics are of secondary importance to fluid therapy in the short-term management of infected patients. Efforts to prevent the spread of cholera focus on improving sanitation, protecting water supplies, and developing effective vaccines. Current vaccines, using either purified toxin or peptide epitopes, have failed to provide long-term immunity.5