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Update: Cholera -- Western Hemisphere, 1992

The epidemic of cholera that began in Peru in January 1991 and rapidly spread throughout South and Central America (1-4) continues unabated (Figure 1); cholera may persist in some areas of Latin America for years following introduction. Through August 26, 1992, more than 600,000 cases and 5000 deaths have been reported from 20 countries (Table 1). Most recently, cholera has affected Mexico and several countries adjacent to the Caribbean. The risk for tourists of acquiring cholera while traveling in affected areas remains low as long as they follow the precautions described for the prevention of travelers' diarrhea (5).

Cholera transmission results from consumption of contaminated water and foods (6,7). Travelers who develop severe watery diarrhea or diarrhea and vomiting during or within 1 week of travel to an affected area should seek medical attention immediately. Physicians should request that specimens from persons with suspected cholera be cultured on media designed for isolation of Vibrio cholerae and should report all suspected cases of cholera to their local and state health departments (8).

Reported by: Enteric Diseases Br, Div of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, CDC.

References

  1. CDC. Cholera -- Peru, 1991. MMWR 1991;40:108-10.

  2. CDC. Update: cholera outbreak -- Peru, Ecuador, and Colombia. MMWR 1991;40:225-7.

  3. CDC. Update: cholera -- Western Hemisphere, and recommendations for treatment of cholera. MMWR 1991;40:562-5.

  4. CDC. Update: cholera -- Western Hemisphere, 1991. MMWR 1991;40:860.

  5. CDC. Health information for international travel, 1992. Atlanta: US Department of Health and Human Services, Public Health Service, 1992; DHHS publication no. (CDC)92-8280.

  6. Swerdlow DL, Mintz ED, Rodriguez M, et al. Waterborne transmission of epidemic cholera in Trujillo, Peru: lessons for a continent at risk. Lancet 1992;340:28-33.

  7. Tauxe RV, Blake PA. Epidemic cholera in Latin America. JAMA 1992;267:1388-90.

  8. Swerdlow DL, Ries AA. Cholera in the Americas: guidelines for the clinician. JAMA 1992;267:1495-9.



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