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Update: Cholera -- Western Hemisphere, 1992

Epidemic cholera continues to spread throughout Central and South America (Figure 1) (1). This report updates the surveillance of this problem during 1992.

In 1992, 339,561 cholera cases and 2321 cholera-related deaths were reported from 21 countries in the Western Hemisphere, bringing to 731,312 cases and 6323 deaths the total numbers reported since the beginning of the epidemic in January 1991 (Table 1).

In 1992, 102 cases of cholera were reported in the United States -- more than in any year since CDC began cholera surveillance in 1961 (Figure 2). Cases were reported from 12 states: California (64 cases), Nevada (15), Texas (four), Maryland (three), New York (three), Arizona (two), Connecticut (two), Florida (two), Hawaii (two), Louisiana (two), Washington (two), and New Jersey (one). Seventy-five cases occurred among passengers who had been served contaminated seafood salad on an airplane arriving in Los Angeles from South America in February 1992; one person died (2).

Reported by: Div of Communicable Disease Prevention and Control, Pan American Health Organization, Washington, DC. Enteric Diseases Br, Div of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: During the current Latin American epidemic, no cases of cholera have been reported from countries in the Caribbean; however, because all adjacent Latin American countries have been affected, spread to the Caribbean is likely to occur as the epidemic continues.

Since the beginning of the epidemic, cholera cases have been reported in 14 states in the United States, representing all regions of the country. Because persons who have returned from travel in cholera-affected countries may seek medical care in areas throughout the United States, health-care providers should consider cholera as a possible diagnosis in any patient with watery diarrhea who has recently returned from a cholera-affected country. Stool specimens from patients with suspected cholera should be cultured on thiosulfate citrate bile salts sucrose agar, and suspected cases should be reported to local and state health departments. Effective treatment of cholera requires rapid and appropriate replacement of fluid and electrolytes (3,4).

References

  1. CDC. Update: cholera -- Western Hemisphere, 1992. MMWR 1992;41:667-8.

  2. CDC. Cholera associated with an international airline flight, 1992. MMWR 1992;41:134-5.

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

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



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