Cholera in children at Eshowe Hospital

During a 2-week period in May 1983 Eshowe Hospital inpatients were screened for cholera and positive cases were found on all the wards that were investigated. The high incidence among paediatric patients suggested the possibility of an epidemic in the community and/or cross-infection within the ward. At this time 9 paediatric nurses were found to have cholera-positive stools and subsequently 8 children contracted cholera after admission to hospital. The possibility of cross-infection by person-to-person transmission is suggested. In the second part of this study, our clinical experience of cholera among inpatients during the period January 1983 - March 1984 is reviewed. The number of children in hospital with cholera-positive stools decreased sharply during the winter months; this was possibly related to variations in both temperature and rainfall. The full range of symptomatology was seen and several children had repeated episodes of proven cholera. The mortality was highest in bottlefed babies who were malnourished or under 1 year of age. Between 30 May and 15 June 1983, 293 consecutive children attending the paediatric outpatients department were screened for cholera; 99 cases were confirmed. Thus cholera was shown to be present in the paediatric community outside Eshowe Hospital. Diagnosis based on the history and clinical findings proved unreliable and laboratory investigation was essential. Rivers were the most common and dangerous source of domestic water. The majority of accompanying adults questioned were using untreated water or failing to treat the water adequately.(ABSTRACT TRUNCATED AT 250 WORDS)