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Cholera on a Gulf Coast oil rig
The New England Journal of Medicine
|September 1, 1983
Summary
A Texas oil rig experienced a severe cholera outbreak, the largest in the US in over a century. Contaminated rice, prepared with sewage-tainted water, led to widespread infection, highlighting sanitation risks.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Cholera outbreaks, caused by Vibrio cholerae, pose significant public health risks.
- Maintaining proper sanitation is crucial for preventing the spread of waterborne diseases.
Purpose of the Study:
- To investigate the cause and transmission of a large cholera outbreak on a Texas oil rig.
- To identify the source of infection and contributing factors to the outbreak.
Main Methods:
- Isolation and identification of Vibrio cholerae El Tor Inaba from patient stool samples.
- Serological testing to detect additional cases and asymptomatic infections.
- Case-control investigation to identify risk factors associated with infection.
Main Results:
- A single case of severe diarrhea preceded the outbreak.
- Toxigenic Vibrio cholerae El Tor Inaba (US phage type) was identified.
- 14 additional cholera cases and one asymptomatic infection were detected.
- Infection was significantly associated with consuming rice prepared with contaminated water (P = 0.03).
- Contamination occurred due to an open valve allowing sewage-laden canal water into the drinking water system.
Conclusions:
- The cholera outbreak was linked to contaminated rice, which was rinsed in untreated water and stored at temperatures conducive to bacterial growth.
- Toxigenic Vibrio cholerae 01 persists in the United States.
- Large common-source cholera outbreaks are possible without adequate sanitation.