The incubation period of cholera: a systematic review.

TitleThe incubation period of cholera: a systematic review.
Publication TypeJournal Article
Year of Publication2013
AuthorsAzman AS, Rudolph KE, Cummings DAT, Lessler J
JournalJ Infect
Volume66
Issue5
Pagination432-8
Date Published2013 May
ISSN1532-2742
KeywordsCholera, Humans, Infectious Disease Incubation Period, Vibrio cholerae
Abstract

OBJECTIVES: Recent large cholera outbreaks highlight the need for improved understanding of the pathogenesis and epidemiology of cholera. The incubation period of cholera has important implications for clinical and public health decision-making, yet statements of the incubation period of cholera are often imprecise. Here we characterize the distribution of cholera's incubation period.METHODS: We conducted a systematic review of the literature for statements of the incubation period of cholera and data that might aid in its estimation. We extracted individual-level data, parametrically estimated the distribution of toxigenic cholera's incubation period, and evaluated evidence for differences between strains.RESULTS: The incubation period did not differ by a clinically significant margin between strains (except O1 El Tor Ogawa). We estimate the median incubation period of toxigenic cholera to be 1.4 days (95% CI, 1.3-1.6). Five percent of cholera cases will develop symptoms by 0.5 days (95% CI 0.4-0.5), and 95% by 4.4 days (95% CI 3.9-5.0) after infection.CONCLUSIONS: We recommend that cholera investigations use a recall period of at least five days to capture relevant exposures; significantly longer than recent risk factor studies from the Haitian epidemic. This characterization of cholera's incubation period can help improve clinical and public health practice and advance epidemiologic research.

DOI10.1016/j.jinf.2012.11.013
Alternate JournalJ. Infect.
PubMed ID23201968
PubMed Central IDPMC3677557
Grant ListK22 AI092150 / AI / NIAID NIH HHS / United States
K22 AI092150-01 / AI / NIAID NIH HHS / United States
U54 GM088491 / GM / NIGMS NIH HHS / United States
U54GM088491-01 / GM / NIGMS NIH HHS / United States
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