Foodborne transmission of cholera in Micronesian households

During a cholera epidemic in Truk (Micronesia), in a survey of 1 village, transmission of Vibrio cholerae O1 in the 28 households with illness appeared to be through food contaminated in the home. Households in which the index case was a foodhandler had significantly higher attack rates than households in which the index case was not a foodhandler. Members of households with illness were significantly more likely to become ill if they had eaten food prepared by a foodhandler who had recently been ill. A matched-pair case-control study on several adjacent islands confirmed this relation. Those who had tended an ill person were not at increased risk of cholera in either study. This study suggests that in this outbreak, foodborne transmission of V cholerae O1 was more important than contact spread.