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With the ever-expanding geographic reach and disease burden of the seventh pandemic, as well as alarming fatality rates in newly affected regions, it is apparent that global cholera prevention strategies are failing. The established methods to treat or prevent mortality from cholera; oral rehydration, antibiotics, enhanced water and sanitation infrastructure, and vaccination have performed well in selected settings at local scales. However, the disease burden could be significantly reduced if these preventive measures could be deployed ahead of time with an early warning system before an outbreak hits a particular region. Controlling endemic and epidemic cholera burden will thus require an integrated and proactive approach – a combination of prediction and prevention – based on recent advances in predictive capabilities and demonstrated successes in primary and tertiary prevention.

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