Cholera is a disease caused by Vibrio cholerae that presentsas severe, watery diarrhea caused by an enterotoxin secretedby the 01-serotype of V. cholerae. The disease occurs in pandemicsin India, Bangladesh, Peru, and Latin America. Theorganisms never invade the enteric epithelium; instead, theyremain in the lumen and secrete their enterotoxin. There areabout 17 known virulence-associated genes necessary forcolonization and toxin secretion. Secretory diarrhea is causedby release of an enterotoxin called cholera toxin, which isnearly identical with E. coli enterotoxin. It is composed offive binding peptides B and a catalytic peptide A. The peptidesB bind to ganglioside GM1 on the surface of the epithelialcells, setting in motion a series of events that causesdiarrhea. The vaccine consists of whole cells of V. cholerae01 that have been inactivated. The antigen form of the vaccineis whole bacterium, and the antigen type is protein toxinand lipopolysaccharide. Indications are the following: ? Induction of active immunity against cholera, such as inindividuals traveling to or residing in epidemic or endemicareas ? Individuals residing in areas where cholera is endemic.
