[Epidemic of cholera in Chile; 1991]

In January 1991 a severe epidemic of cholera started in Peru, a country located north of Chile. The first case in Chile was confirmed in april and so far 41 cases and 2 deaths have been reported. The epidemic is caused by Vibrio cholerae 01, El Tor biotype, Inaba serotype. Most cases occurred in Santiago, 2/3 of them in men and all above 15 years of age. An unknown number of asymptomatic infected people arriving in Santiago are the likely agents for the epidemic. Contamination of sewage and use of infected water to irrigate vegetable fields is involved in the transmission of the disease. The situation is linked to the inexistence of sewage treatment plants. In comparison to Peru, with near 200,000 patients and over 1000 deaths, the epidemic in Chile has been small as a consequence of intensive health education efforts. Personal hygiene, abstinence from eating raw vegetables and fish, destruction of presumed infected crops, and prohibition of vegetable transportation to other areas have been the cornerstone of the preventive strategies. Early treatment of severely dehydrated patients has determined a low fatality rate. At present, the epidemic is virtually controlled with 1 or 2 cases a week. However, the sanitary problems related to sewage treatment and the existence of cholera in other South American countries poses a serious problem for the future.