Cholera: the true burden
The true incidence of cholera is likely to be seriously underestimated in most endemic areas, according to a study published recently in The Lancet Infectious Diseases.
Jane Zuckerman and colleagues point out that cholera is a substantial health burden in the developing world and is endemic in Africa, Asia, South America, and Central America. Undereporting is likely to exist because of limited surveillance systems, differences in reporting proceedures and failure to report outbreaks of the disease to the World Health Organisation (WHO).
This group carried out extensive literature searches and found additional outbreaks of cholera, in addition to those reported to WHO, mainly in India and southeast Asia. This underestimate could have important implications for public health decision making and could also put traveller's health at risk. Availability of the new cholera vaccine, which is both effective and relatively free of side effects, should help resolve this problem, with mass vaccination campaigns in low-income countries and among travellers.
Zuckerman JN et al. The Lancet Infectious Diseases 2007; 7: 521
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