3/13/2016 CHOLERA.Number of roported es-Unitod States and U.S..2006 Vibrio cholerae reservoirs Persistence of V.cholerae in the environment is facilitated by its ability to assume the viable but nonculturable state VBNC forms cannot be cultured on media but can cause disease Long-term carriage of V.cholerae is rare and not important in the transmission of the disease Patients not treated with antibiotics may shed the bacterium for 2 weeks after illness Asymptomatic carriers occur in household members of persons with acute illness Modes of Vibrio cholerae transmission Vibrio cholerae foodborne outbreaks Water plays a critical role in the transmission of cholera .1854,John Snow a London physician and epidemiologist determined the illness was associated with drinking water from the Thames River at a point below major sewage inflows >3/13/2016 7 Vibrio cholerae reservoirs • Persistence of V. cholerae in the environment is facilitated by its ability to assume the viable but nonculturable state • VBNC forms cannot be cultured on media but can cause disease • Long-term carriage of V. cholerae is rare and not important in the transmission of the disease • Patients not treated with antibiotics may shed the bacterium for 2 weeks after illness • Asymptomatic carriers occur in household members of persons with acute illness Modes of Vibrio cholerae transmission Vibrio cholerae foodborne outbreaks • Water plays a critical role in the transmission of cholera • 1854, John Snow a London physician and epm g m idemiologist determined the illness was associated with drinking water from the Thames River at a point below major sewage inflows Map of Cholera outbreaks help identify contaminated pump