Biological Weapon - Cholera

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What It Is

Vibrio cholerae is a short, curved, motile, gram-negative, non-sporulating rod. There are two serogroups, O1 and O139, that have been associated with cholera in humans. The O1 serotype exists as 2 biotypes, classical and El Tor. The organisms are facultative anaerobes, growing best at a pH of 7.0, but able to tolerate an alkaline environment. They do not invade the intestinal mucosa, but rather "adhere" to it. Cholera is the prototype toxigenic diarrhea, which is secretory in nature. All strains elaborate the same enterotoxin, a protein molecule with a molecular weight of 84,000 daltons. The entire clinical syndrome is caused by the action of the toxin on the intestinal epithelial cell. Fluid loss in cholera originates in the small intestine with the colon being relatively insensitive to the toxin. The large volume of fluid produced in the upper intestine overwhelms the capacity of the lower intestine to absorb. Transmission is made through direct or indirect fecal contamination of water or foods, and by heavily soiled hands or utensils. All populations are susceptible, while natural resistance to infection is variable. Recovery from an attack is followed by a temporary immunity which may furnish some protection for years. The organism is easily killed by drying. It is not viable in pure water, but will survive up to 24 hours in sewage, and as long as 6 weeks in certain types of relatively impure water containing organic matter. It can withstand freezing for 3 to 4 days. It is readily killed by dry heat at 117 ° C, by steam and boiling, by short exposure to ordinary disinfectants, and by chlorination of water.

What It Does

Incubation period 4 hours to 5 days; average 2-3 days. Asymptomatic to severe with sudden onset. Vomiting, headache, intestinal cramping with little or no fever followed rapidly by painless, voluminous diarrhea. Fluid losses may exceed 5 to 10 liters per day. Without treatment, death may result from severe dehydration, hypovolemia and shock.

Be Prepared

A licensed, killed vaccine is available but provides only about 50 percent protection that lasts for no more than 6 months. Vaccination schedule is at 0 and 4 weeks, with booster doses every 6 months.

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