Vol. 16, No. 2	July 1995

Cholera in the Americas

From the onset of the cholera epidemic by V. cholerae 01in Peru in 1991 until June 15, 1995 a total of 1,075,372 cases and 10,098 deaths were reported in the Region of the Americas. The number of cases reported decreased by 45% between 1993 and 1994. More than 90% of this reduction is attributed to the decline in the number of cases reported in Bolivia, Ecuador, Peru, Guatemala and Mexico. In 1994, the overall case-fatality ratio for the region was 1.09%.

During this same year, all countries where transmission of V. cholerae has been detected continued to register new cases, with the exception of Honduras and Nicaragua, and a few states in Brazil, increased the number of reported cases. Uruguay and the countries of the Caribbean continue to be free from the disease since the beginning of the epidemic.

In 1994, the 38 cases reported in Costa Rica and 34 reported in the United States, were classified as imported. In the American continent, only the United States of America has reported isolating Vibrio cholerae 0139 among individuals who have traveled to Asia in 1994. A small amount of antiserum 0139 for agglutination test is available through PAHO for reference public health laboratories. The use of this antiserum is indicated for V. cholerae 01 isolates from patients who have recently traveled to Bangladesh, Burma, India, Malaysia, Nepal, Pakistan, China and Thailand; patients with severe diarrheal disease associated with an outbreak; or patients with severe cholera presentation.

During the first few months of 1995, explosive cholera outbreaks were registered in Peru (Lima and El Callao), El Salvador (San Salvador) and Mexico, in accordance with the seasonal distribution pattern of the disease.

Cholera Situation in the Americas
Number of cases and deaths of cholera reported, by country and year,
1991-1995

Source: Division of Health and Human Development, Health Situation Analysis Program, HDP/HDA and Division of Disease Prevention and Control, Communicable Disease Program, HPC/HCT, PAHO.