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Epidemic cholera in rural El Salvador: risk factors in a region covered by a cholera prevention campaign

Published online by Cambridge University Press:  15 May 2009

R. E. Quick
Affiliation:
Division of Field Epidemiology, Epidemiology Program Office
B. L. Thompson
Affiliation:
Division of Field Epidemiology, Epidemiology Program Office
A. Zuniga
Affiliation:
Ministry of Public Health and Social Assistance
G. Dominguez
Affiliation:
Ministry of Public Health and Social Assistance
E. L. De Brizuela
Affiliation:
Ministry of Public Health and Social Assistance
O. De Palma
Affiliation:
Ministry of Public Health and Social Assistance
S. Almeida
Affiliation:
Ministry of Public Health and Social Assistance
A. Valencia
Affiliation:
Pan American Health Organization, San Salvador, El Salvador
A. A. Ries
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333
N. H. Bean
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333
P. A. Blake
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333
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In response to the Latin American cholera epidemic, El Salvador began a prevention programme in April 1991. The first case was confirmed in August, and 700 cases were reported within 3 months. A matched case-control study was conducted in rural La Libertad Department in November 1991. Illness was associated with eating cold cooked or raw seafood (odds ratio [OR] = 7·0; 95% confidence limits [CL] = 1·4, 35·0) and with drinking water outside the home (OR = 8·8; 95% CL = 1·7, 44·6). Assertion of knowledge about how to prevent cholera (OR = 0·2; 95% CL = 0·1, 0·8) and eating rice (OR = 0·2; 95% CL = 0·1, 0·8) were protective. More controls than patients regularly used soap (OR = 0·3; 95% CL = 0·1, 1·0). This study demonstrated three important points for cholera prevention: (1) seafood should be eaten cooked and hot; (2) populations at risk should be taught to treat household drinking water and to avoid drinking water outside the home unless it is known to be treated; and (3) education about hygiene can be an important tool in preventing cholera.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1995

References

REFERENCES

1.Centers for Disease Control. Update: cholera – Western Hemisphere, 1991. MMWR 1991; 40: 860.Google Scholar
2.Dean, AD, Dean, JA, Burton, JH, Dicker, RC. Epi Info, Version 5: a word processing, database, and statistics program for epidemiology on microcomputers. Stone Mountain, GA: USD Incorporated, 1990.Google Scholar
3.Baine, WB, Mazotti, M, Greco, D et al. , Epidemiology of cholera in Italy in 1973. Lancet 1974; ii: 1370–81.Google Scholar
4.Blake, PA, Rosenberg, ML, Florencia, J et al. , Cholera in Portugal, 1974. II. Transmission by bottled mineral water. Am J Epidemiol 1977; 105: 344–8.CrossRefGoogle ScholarPubMed
5.Merson, MH, Martin, WT, Craig, JP et al. , Cholera on Guam 1974. Epidemiologic findings and isolation of non-toxigenic strains. Am J Epidemiol 1977; 105: 349–61.Google Scholar
6.McIntyre, 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; i: 311–14.CrossRefGoogle Scholar
7.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
8.Lowry, PW, Pavia, AT, McFarland, LM et al. , Cholera in Louisiana – widening spectrum of seafood vehicles. Arch Intern Med 1989; 149: 2079–84.CrossRefGoogle ScholarPubMed
9.Tamplin, ML, Carrillo, C. Environmental spread of Vibrio cholerae in Peru. Lancet 1991; 338: 1216–17.Google Scholar
10.Swerdlow, D, Mintz, E, Rodríguez, M et al. , Transmission of epidemic cholera in Trujillo, Peru: lessons for a continent at risk. Lancet 1992; 340: 2832.Google Scholar
11.Ries, AA, Vugia, DJ, Beingolea, L et al. , Cholera in Piura, Peru: a modern urban epidemic. J Infect Dis 1992; 166: 1429–33.Google Scholar
12.Blake, PA. Epidemiology of cholera in the Americas. Gastroenterol Clin North Am 1993; 22: 639–60.Google Scholar
13.Weber, JT, Mintz, ED, Cañizares, R et al. , Epidemic cholera in Ecuador: antimicrobial resistance and transmission by water and food. Epidemiol Infect 1994; 112: 111.CrossRefGoogle Scholar
14.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
15.Gonzalez, O, Aguilar, A, Antunez, D, Levine, W. An outbreak of cholera in rural Bolivia. In: Program and abstracts of the 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy. Anaheim: American Society for Microbiology, 1992.Google Scholar
16.Mujica, O, Quick, RE, Palacios, AM et al. , Epidemic cholera in the Amazon: the role of produce in disease risk and prevention. J Infect Dis 1994; 169: 1381–4.Google Scholar
17.Cárdenas, V, Saad, C, Varona, M, Linero, M. Waterborne cholera in Riohacha, Colombia, 1992. Bull Pan Am Health Organ, 1993; 27: 313–30.Google ScholarPubMed
18.Centers for Disease Control. Surveillance for cholera – Cochabamba Department, Bolivia, January–June 1992. MMWR 1993; 42: 636–9.Google Scholar
19.Kolvin, JL, Roberts, D. Studies on the growth of Vibrio cholera biotype eltor and biotype classical in foods. J Hyg 1982; 89: 243–52.CrossRefGoogle ScholarPubMed
20.Feachem, RG. Interventions for the control of diarrhoeal diseases among young children: promotion of personal and domestic hygiene. Bull WHO 1984; 62: 467–76.Google ScholarPubMed
21.Kirchhoff, LV, McClelland, KE, Pinho, MDC et al. , Feasibility and efficacy of in-home water chlorination in rural North-eastern Brazil. J Hyg 1985; 94: 173–80.Google Scholar