Pandemics of cholera were common in the 19th and early 20th centuries, before
the advent of antibiotics. This highly debilitating and, if untreated, deadly
disease is caused by the bacterium Vibrio cholerae.
Iraq, among other countries, developed V. cholerae for use as a
biological weapon. Bioterrorists would likely use the bacteria to contaminate food
or water. However, it would be difficult to poison water supplies regularly
treated with chemicals to kill contaminants.
Because cholera is readily treated with proper medical attention, it is less
likely to be used as agent of terror in the United States.
Rehydration is essential. A variety of antibiotics shorten the course of
illness and reduce its severity.
The manufacture of the only licensed cholera vaccine in the U.S. has been
discontinued. It was generally not recommended because it protects only roughly
half of those vaccinated, and immunity is short-term (3-6 months). Two newly
developed vaccines are available in other countries.