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
CDC. Cholera -- Peru, 1991. MMWR 1991;40:108-10.
CDC. Update: cholera outbreak -- Peru, Ecuador, and Colombia.
MMWR
1991;40:225-7.
CDC. Update: cholera -- Western Hemisphere, and recommendations
for treatment of cholera. MMWR 1991;40:562-5.
CDC. Update: cholera -- Western Hemisphere, 1991. MMWR
1991;40:860.
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.
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.
Tauxe RV, Blake PA. Epidemic cholera in Latin America. JAMA
1992;267:1388-90.
Swerdlow DL, Ries AA. Cholera in the Americas: guidelines for
the clinician. JAMA 1992;267:1495-9.
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