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[The cholera epidemic in Latin America]
1Enteric Diseases Branch, Centers for Disease Control, Atlanta, GA 30333.
Insights
The 1991 cholera epidemic in Latin America, caused by a unique Vibrio cholerae strain, affected millions. Effective oral rehydration treatment led to a low mortality rate of only 1%.
Area of Science:
- Epidemiology
- Infectious Diseases
- Microbiology
Context:
- The 1991 cholera epidemic marked the first major outbreak in the Americas in over a century.
- The epidemic rapidly spread across Latin America, originating in Peru and affecting numerous countries.
- This event highlighted the re-emergence of cholera in a region with limited recent experience with the disease.
Purpose:
- To document the emergence, spread, and impact of the 1991 cholera epidemic in Latin America.
- To identify the causative agent and its unique characteristics.
- To assess the effectiveness of public health interventions, particularly oral rehydration therapy.
Summary:
- The epidemic, caused by Vibrio cholerae O1, serotype Inaba/Ogawa (El Tor biotype), began in Peru in January 1991 and spread throughout Latin America.
- Peru reported over 321,000 cases in 1991, with other affected nations accounting for 20% of Peru's case load.
- The causative strain was genetically unique, designated as the Latin American strain, distinguishing it from other El Tor isolates.
- Despite the widespread outbreak, a low mortality rate of approximately 1% was achieved, attributed to effective oral rehydration treatment and local health services support.
Impact:
- Demonstrated the significant public health threat posed by the re-emergence of cholera in the Americas.
- Highlighted the critical role of accessible and effective treatments like oral rehydration in controlling epidemic mortality.
- Provided valuable insights into the genetic distinctiveness of the Latin American cholera strain, aiding future epidemiological surveillance.
Abstract:
An outbreak of cholera started in Peru in January 1991 and spread through most Latin American countries within a year. This was the first known epidemic of cholera in America for more than a century. In 1991, 321,334 persons were reported to have cholera in Peru, 119,063 were hospitalized, and 2,906 died. Other countries like Ecuador, Colombia, Guatemala, Brazil, Mexico, Bolivia, Chile, El Salvador, Venezuela and Honduras were also affected, but these countries combined accounted for only 20% of the cases registered in Peru. In April 1992, all Latin American countries except Uruguay, Paraguay and French Guyana have reported cholera. The mortality rate for the epidemic in Latin America was only 1%, mainly owing to good oral rehydration treatment provided by Local health services and the Pan American Health Organization. The causative organism was Vibrio cholerae, serogroup O1, serotype Inaba (and Ogawa) of the El Tor biotype. Genetic characterization shows this strain to be unique, and the designation is reserved for the Latin American strain, distinguishing it from the other El Tor isolates from the 7th pandemic.