Treatment and prophylaxis of cholera with bacteriophage.

The treatment of cholera with bacteriophage has, in the past, been unsuccessful, owing to the fact that the phages prepared by the usual method (multiplication on cholera vibrios in broth) proved incapable of parasitizing cholera vibrios in vivo. In this paper, the author presents the results of therapeutic and prophylactic trials of a phage preparation prepared by a different method-namely, cultivation on cholera vibrios through alternate passages in the small intestine of guinea-pigs and in bile. This preparation was used effectively for the treatment of cholera patients and for the control of epidemic outbreaks in Afghanistan in 1958 and 1960. A single dose of the phage, administered with saline intravenously or intramuscularly, followed by an oral dose daily for three days, gave satisfactory results in the majority of cases, even if the patients were seriously ill and did not receive additional symptomatic treatment. As to the prophylactic value of the phage, when the preparation was administered simultaneously with a single dose of cholera vaccine to the entire population of an epidemic focus, no further cases of the disease occurred in that focus.