Cholera outbreak - Peru, Ecuador, and Colombia

Article Abstract:

A report from the Weekly Epidemiological Record of the World Health Organization is reprinted; the report concerns the possible contamination of imported foods by cholera organisms. Despite concerns, no documented evidence of outbreaks of that disease have been traced to food imported across international borders. Dried and acidic or pickled foods are likely to be safe, as are coffee and cereals. Canned and irradiated foods, prepared according to Codex standards (which are international), are rendered safe even if originally contaminated. But contamination with cholera organisms can be suspected in fresh seafood and fresh vegetables and fruits (surface contamination). Animal feeds do not contain cholera organisms. Disease transmission can be prevented by thorough cooking and by avoiding contact between cooked and raw (contaminated) food; refrigeration prevents the organism from multiplying but does not necessarily kill it. Vaccination against cholera is not recommended for travelers, and movement between countries should not be restricted because of fears of this disease. This issue has arisen in the aftermath of reports in January 1991 of cholera in South America, for the first time this century. People became concerned that food exported from Peru, Ecuador, and Colombia could be contaminated. Even if this were the case, infection normally requires a large number of organisms. The disease is easily treated and has a low death rate when appropriate care is provided. Surveillance of imported foods has been intensified by the Food and Drug Administration since February 1991. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, International aspects, Communicable diseases, Disease transmission, South America, Food contamination, World Health Organization

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Cholera - New Jersey and Florida

Article Abstract:

Cholera is an acute intestinal infection that causes diarrhea, vomiting, muscle cramps, dehydration, and ultimately collapse. Cholera epidemics have been reported recently in five countries in South America, while in the United States, 10 confirmed cases have been reported in New Jersey, Florida and Georgia. The cases from New Jersey and Florida are discussed. In New Jersey, eight people became ill after eating crab meat brought from Ecuador. The crab was purchased in a fish market, boiled, shelled, and packaged in foil. It was not refrigerated during air transport to New Jersey. Five people who ate the crab meat had to be hospitalized. The infection was the same type as that currently epidemic in South America. All eight patients recovered, and the cholera was not passed to other persons. In Florida, a woman returned from Ecuador with severe diarrhea. She had eaten raw oysters and used ice during her stay in Central America. She recovered, and no other people were infected. Until January 1991, epidemic cholera had not been reported in South America in this century. To date, no cases of cholera in the United States have been related to commercially imported foods. The New Jersey case was caused by crab meat that had been badly mishandled and illegally brought into the country. Other cases of cholera have been caused by inadequately cooked crabs or raw oysters from the Gulf of Mexico. The risk to tourists of contracting cholera is low if they follow the rule,''boil it, cook it, peel it, or forget it.'' More precise instructions are outlined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, New Jersey, Florida, Crab meat

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Cholera - Peru, 1991

Article Abstract:

Cholera, a disease associated with massive diarrhea, has been diagnosed in several towns along the coast of Peru, prompting a wave of epidemiological and medical investigations. Between January 24 and February 9, 1991, 66 deaths were reported to the Ministry of Health of the General Office of Epidemiology in Lima, Peru. A permanent Committee of Epidemiologic Surveillance has been set up, and information concerning preventive measures has been circulated. These include: drinking only boiled water; cleaning fruits and vegetables; and avoiding raw or incompletely cooked fish or seafood. This is the first cholera epidemic in the 20th century in South America; the epidemic in Southeast Asia in the 1960s did not extend to that part of the world. A description is presented of past epidemics. If untreated, patients may die of cholera within a few hours from dehydration, but effective treatment can dramatically reduce the death rate. The optimal approaches to this disease focus on treatment and control of transmission, rather than chemoprophylaxis, vaccination, or quarantine. Epidemiologic investigations can also help contain outbreaks. The risk of travelers from the United States contracting cholera in endemic areas is low. Since vaccination leads only to temporary and incomplete immunity, it is not recommended. Travelers are advised to take normal precautions against traveler's diarrhea. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Peru

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