Cholera In The Americas 10/12 – 10/13 - Credit PAHO
# 7875
Following up a report from a little over a week ago (see ECDC: Epidemiological Update On Cholera In Mexico), this morning the World Health Organization has posted a GAR (Global Alert & Response) update on the expanding Cholera outbreak in central Mexico.
Cholera in Mexico - 19 October 2013
19/10/2013
The Ministry of Health in Mexico has reported 171 confirmed cases, including one death, of infection with Vibrio cholerae O1 Ogawa toxigenic between 9 September to 18 October 2013.
In the second week of September 2013, Mexico was affected simultaneously by a hurricane and tropical storm which caused heavy rains, floods, landslides and internal displacement of populations, thus increasing the risk of diarrhoeal diseases.
Of the 171 confirmed cases, two are from the Federal District, 157 cases from the state of Hidalgo, nine from the state of Mexico, one from the state of San Luis Potosi and two from the state of Veracruz.
Eighty-six of the total confirmed cases are women and 85 are men with ages ranging from three months to 88 years old. Of these, thirty-nine cases were hospitalised.
The health authorities of Mexico continue to strengthen the outbreak investigation and surveillance at the national level and ensure the availability and quality care in medical units. Health professionals at different levels of the health care system are being trained about prevention, treatment and control of the disease. Measures are implemented to ensure access to drinking water and basic sanitation at the community level. Awareness campaigns, particularly around safe water and food consumption is being carried out in Spanish and indigenous languages.
This is the first local transmission of cholera recorded since the 1991-2001 cholera epidemic in Mexico. The genetic profile of the bacterium obtained from patients in Mexico presents high similarity (95 percent) with the strain that is currently circulating in three Caribbean countries (Haiti, Dominican Republic and Cuba), and is different from the strain that had been circulating in Mexico during 1991-2001 epidemic.
WHO does not recommend that any travel or trade restrictions be applied to Mexico with respect to this event.
Related links:
- Information on WHO’s statement relating to international travel and trade to and from countries experiencing outbreaks of cholera: http://www.who.int/cholera/technical/prevention/choleratravelandtradeadvice231110.pdf
- WHO cholera fact sheet: http://www.who.int/mediacentre/factsheets/fs107/en/index.html
- PAHO cholera health topic: www.paho.org/cholera
- Official guidelines of Mexico and protocol for cholera surveillance, prevention and control (available in Spanish): http://www.epidemiologia.salud.gob.mx/dgae/lineamientos/index.html
Although endemic in many developing countries, due to our modern water and sewage treatment infrastructure, cholera is a rarely reported illness in the United States. However, when there are outbreaks of Cholera around the world, the number of imported cases to the United States (and other developed countries) usually goes up.
During the 1991-1994 Cholera epidemic in Peru, which infected roughly a million people (killing 10,000), the number of imported cases to the United States jumped nearly 10-fold (n=53/yr).
Similarly, in the first six months following the 2010 outbreak of Cholera in Haiti, the number of imported cases jumped from an average of 6/yr to 22 (see EID: Cholera In The U.S. Associated With Hispaniola Epidemic).
According to that EID report, no secondary transmission of Cholera was reported in the United States from the cases imported from Haiti.
On October 15th, the CDC updated their Health Information for Travelers headed to Mexico, urging the diligent use of standard precautions (drinking safe water, handwashing, using proper sanitation facilities, safe cooking procedures) to avoid infection (see CDC Travel Notice – Cholera In Mexico).
For more on Cholera, and travel, you may wish to refer to the CDC’s Yellow Book, which is freely available online, or as a PDF download. The section dealing with Cholera is available at this link.
