Surveillance for early confirmation of cholera in the Americas: Guidance document

Surveillance for early confirmation of cholera in the Americas provides a comprehensive framework for the timely detection, confirmation, and response to cholera cases in the Region of the Americas. Developed under the coordination of the Pan American Health Organization, this guidance document aligns with the Global Task Force on Cholera Control strategy and aims to strengthen early cholera detection and response capacities, contributing to the broader goal of cholera elimination in the Region by 2030.

The document reviews the microbiology, pathophysiology, and clinical manifestations of Vibrio cholerae, with a focus on the epidemiology of cholera in the Region of the Americas, including historical outbreaks and the recent resurgence in the Dominican Republic and Haiti. It highlights molecular epidemiology trends, risk factors, and the public health burden of the disease.

A key focus is the surveillance framework, which sets out case definitions, laboratory confirmation criteria, and epidemiological classifications, distinguishing between suspected, confirmed, imported, and locally acquired cases. The guidance details laboratory diagnostic approaches, including culture, polymerase chain reaction, whole-genome sequencing, and antimicrobial susceptibility testing. The document also highlights immediate notification protocols, case investigation, and field assessment procedures.

The document further outlines clinical management recommendations and preventive and control measures, including water, sanitation, and hygiene interventions, and vaccination strategies.