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Epidemic cholera in Ecuador: multidrug–resistance and transmission by water and seafood

Published online by Cambridge University Press:  15 May 2009

J. T. Weber ,
E. D. Mintz ,
R. Cañizares ,
A. Semiglia ,
I. Gomez ,
R. Sempértegui ,
A. Dávila ,
K. D. Greene ,
N. D. Puhr  and
D. N. Cameron
...Show all authors
J. T. Weber
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases (DBMD), National Center for Infectious Diseases (NCID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333
E. D. Mintz
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases (DBMD), National Center for Infectious Diseases (NCID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333
R. Cañizares
Affiliation:
Subsecretariat for Health, Zone II, Guayaquil, Ecuador
A. Semiglia
Affiliation:
Subsecretariat for Health, Zone II, Guayaquil, Ecuador
I. Gomez
Affiliation:
Subsecretariat for Health, Zone II, Guayaquil, Ecuador
R. Sempértegui
Affiliation:
Ministry of Health, Quito, Ecuador
A. Dávila
Affiliation:
National Institute of Hygiene, Guayaquil, Ecuador
K. D. Greene
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases (DBMD), National Center for Infectious Diseases (NCID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333
N. D. Puhr
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases (DBMD), National Center for Infectious Diseases (NCID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333
D. N. Cameron
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases (DBMD), National Center for Infectious Diseases (NCID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333
F. C. Tenover
Affiliation:
Nosocomial Pathogens Laboratory Branch, Hospital Infections Program, NCID, CDC
T. J. Barrett
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases (DBMD), National Center for Infectious Diseases (NCID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333
N. H. Bean
Affiliation:
Biostatistics and Information Management Branch, DBMD, NCID, CDC
C. Ivey
Affiliation:
Biostatistics and Information Management Branch, DBMD, NCID, CDC
R. V. Tauxe
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases (DBMD), National Center for Infectious Diseases (NCID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333
P. A. Blake
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases (DBMD), National Center for Infectious Diseases (NCID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333
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To determine risk factors for cholera in an epidemic-disease area in South America, a case–control investigation was performed in Guayaquil, Ecuador, in July 1991. Residents > 5 years old who were hospitalized for treatment of acute, watery diarrhoea and two matched controls for each were interviewed regarding sources of water and food, and eating, drinking, and hygienic habits. Interviewers inspected homes of case-patients and controls to document water treatment, food-handling, and hygienic practices. Faecal specimens and shellfish were cultured for Vibrio cholerae O 1. Isolates were tested for susceptibility to a variety of antimicrobial agents. Drinking unboiled water (odds ratio [OR] = 4.0, confidence interval [CI] = 1.8–7.5), drinking a beverage from a street vendor (OR = 2.8, CI = 1.3–5.9), eating raw seafood (OR = 3.4, CI = 1.4–11.5), and eating cooked crab (OR = 5.1, CI = 1.4–19.2) were associated with illness. Always boiling drinking water at home (OR = 0.5, CI = 0.2–0.9) was protective against illness. The presence of soap in either the kitchen (OR = 0.3, CI = 0.2–0.8) or bathroom (OR = 0.4, CI = 0.2–0.9) at home was also protective. V. cholerae O 1 was recovered from a pooled sample of a bivalve mollusc and from 68% of stool samples from case-patients. Thirty-six percent of the isolates from stool specimens were resistant to multiple antimicrobial agents. Specific prevention measures may prevent transmission through these vehicles in the future. The appearance of antimicrobial resistance suggests the need for changes in current methods of prevention and treatment.

Type
Research Article
Information
Epidemiology & Infection , Volume 112 , Issue 1 , February 1994 , pp. 1 - 11
Copyright
Copyright © Cambridge University Press 1994

References

REFERENCES

Sack, DA, Huda, S, Neogi, PKB, Daniel, RR, Spira, WM. Microtiter ganglioside enzyme-linked immunosorbent assay for Vibrio and Escherichia coli heat-labile enterotoxins and antitoxin. J Clin Microbiol 1980; 11: 35–40.CrossRefGoogle ScholarPubMed
National Committee for Clinical Laboratory Standards. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically, second edition. Approved standard, M7-A2, vol. 10. National Committee for Clinical Laboratory Standards, Villanova, PA, 1990.Google Scholar
National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial disk susceptibility tests, fourth edition. Approved standard, M2-A4, vol. 10. National Committee for Clinical Laboratory Standards, Villanova, PA, 1990.Google Scholar
Wachsmuth, IK, Evins, GM, Fields, PI et al. , The molecular epidemiology of cholera in Latin America. J Infect Dis 1993; 167: 621–6.CrossRefGoogle ScholarPubMed
Kado, CI, Liu, ST. Rapid procedure for detection and isolation of large and small plasmids. J Bacteriol 1981; 145: 1365–73.CrossRefGoogle ScholarPubMed
Young, CR, Wachsmuth, IK, Olsvik, O, Feeley, JC. Immune response to Vibrio cholerae. In: Rose, NR, Friedman, H, Fahey, JL, eds. Manual of clinical laboratory immunology. Washington, D.C.: American Society for Microbiology, 1986: 363–70.Google Scholar
Ries, AA, Vugia, DJ, Beingolea, L et al. , Cholera in Piura, Peru: a modern urban epidemic. J Infect Dis 1992; 166: 1429–33.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
Mujica, O, Quick, R, Palacios, A et al. , Epidemic cholera in the Amazon: transmission and prevention by food [abstract 936]. In: Program and Abstracts of the 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy, Anaheim, 1992: 266.Google Scholar
Mata, L. Efecto del jugo y de la pulpa de frutas ácidas sobre el Vibrio cholerae. In: El cólerá: historia, prevención y control. Costa Rica: Universidad de Costa Rica, 1992: 275–310.Google Scholar
Merson, MH, Martin, WT, Craig, JP et al. , Cholera on Guam, 1974. Am J Epidemiol 1977; 105: 349–61.CrossRefGoogle ScholarPubMed
Mclntyre, RC, Tira, T, Flood, T, Blake, PA. Modes of transmission of cholera in a newly infected population on an atoll: implications for control measures. Lancet 1979; 1: 311–14.Google Scholar
Blake, PA, Allegra, DT, Snyder, JD et al. , Cholera: a possible endemic focus in the United States. N Engl J Med 1980; 302: 305–9.CrossRefGoogle ScholarPubMed
Pavia, AT, Campbell, JF, Blake, PA, Smith, JD, McKinley, TW, Martin, DL. Cholera from raw oysters shipped interstate. Jama 1987; 258: 2374.CrossRefGoogle ScholarPubMed
Finelli, L, Swerdlow, D, Mertz, K, Ragazzoni, H, Spitalny, K. Outbreak of cholera associated with crab brought from an area with epidemic disease. J Infect Dis 1992; 166: 1433–5.CrossRefGoogle ScholarPubMed
Centers for Disease Control. Cholera – New York. MMWR 40: 30: 516–18.Google Scholar
Rice, EW, Johnson, CH. Cholera in Peru. Lancet 1991; 338: 455.CrossRefGoogle ScholarPubMed
Deb, BC, Sircar, BK, Sengupta, PG et al. , Intrafamilial transmission of Vibrio cholerae biotype El Tor in Calcutta slums. Indian J Med Res 1982; 76: 814–19.Google Scholar
Deb, BC, Sircar, BK, Sengupta, PG et al. , Studies on interventions to prevent El Tor cholera transmission in urban slums. Bull WHO 1986; 64: 127–31.Google Scholar
Glass, RI, Huq, MI, Lee, JV et al. , Plasmid-borne multiple drug resistance in Vibrio cholerae serogroup O 1. biotype El Tor: evidence for point-source outbreak in Bangladesh. J Infect Dis 1983; 147: 204–9.CrossRefGoogle Scholar
Mhalu, FS, Mmari, PW, Ijumba, J. Rapid emergence of El Tor Vibrio cholerae resistant to antimicrobial agents during first six months of fourth cholera epidemic in Tanzania. Lancet 1979; 1: 345–7.CrossRefGoogle ScholarPubMed
de Macedo, CG. Presentation of the PAHO regional plan. In: Confronting cholera: The development of a hemispheric response to the epidemic [conference proceedings]. University of Miami North–South Center. 1991: 39–44.Google Scholar