Cholera in Africa: lessons on transmission and control for Latin America

In January, 1991, epidemic cholera emerged in Peru and spread to 7 other countries of Latin America. Cholera was introduced 20 years ago to Africa, where it spread rapidly to 30 of the 46 countries of the region and by 1990 accounted for 90% of all cases reported to the World Health Organisation. Ma...

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Bibliographic Details
Published in:The Lancet (British edition) 1991-09, Vol.338 (8770), p.791-795
Main Authors: Glass, R.I., Blake, P.A., Waldman, R.J., Claeson, M., Pierce, N.F.
Format: Article
Language:English
Subjects:
Africa - epidemiology
Bacterial diseases
Biological and medical sciences
Child
Cholera
Cholera - epidemiology
Cholera - prevention & control
Cholera - therapy
Cholera - transmission
Disease control
Disease Outbreaks - prevention & control
Disease transmission
Epidemics
Fluid Therapy
Food Microbiology
Human bacterial diseases
Humans
Infant
Infectious diseases
Latin America - epidemiology
Medical sciences
Pandemics
Peru - epidemiology
Public health
Refugees
Rehydration
Travellers
Tropical bacterial diseases
Vaccines
Vibrio cholerae
Water Microbiology
Water pollution
Waterborne diseases
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Summary:In January, 1991, epidemic cholera emerged in Peru and spread to 7 other countries of Latin America. Cholera was introduced 20 years ago to Africa, where it spread rapidly to 30 of the 46 countries of the region and by 1990 accounted for 90% of all cases reported to the World Health Organisation. Many lessons from the cholera epidemic in Africa are relevant to efforts to control the disease in Latin America. Public health practices from the past— quarantine and cordon sanitaire to halt introduction of cholera by travellers, and vaccination and mass chemoprohylaxis to control epidemics—are ineffective in preventing spread of the disease. Cholera can be transmitted not only by contaminated water but also by food. Social phenomena such as mass migrations and burial practices may play a greater role than previously understood. While efforts to prevent the spread of cholera have been ineffective, cholera-associated mortality can be decreased with rehydration therapy. Since the current pandemic is unlikely to retreat soon, new strategies are urgently needed to control the spread of cholera through sanitary and behavioural interventions or improved vaccines.
ISSN:0140-6736
1474-547X
DOI:10.1016/0140-6736(91)90673-D