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
CDC. Update: cholera -- Western Hemisphere, 1992. MMWR
1992;41:667-8.
CDC. Cholera associated with an international airline flight,
1992. MMWR 1992;41:134-5.
CDC. Update: cholera -- Western Hemisphere, and recommendations
for treatment of cholera. MMWR 1991;40:562-5.
Swerdlow DL, Ries AA. Cholera in the Americas: guidelines for
the clinician. JAMA 1992;267:1495-9.
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