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A Vibrio cholerae infection in a transient teamster
The American Journal of Tropical Medicine and Hygiene
|November 1, 1981
Summary
A non-cholera Vibrio caused an illness clinically identical to cholera in a truck driver. Identification challenges in U.S. labs pose a risk for potential cholera epidemics.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Classical cholera is caused by toxigenic Vibrio cholerae O1.
- Non-O1 Vibrio cholerae can also cause cholera-like illness.
- Accurate identification of Vibrio species is crucial for disease control.
Observation:
- A case of cholera-like illness in a truck driver was initially misdiagnosed.
- The causative agent was identified as a non-cholera Vibrio (Vibrio cholerae, Smith serotype 113 toxin positive) four weeks post-discharge.
- U.S. hospital laboratories often do not identify Vibrio cholerae without specific requests.
Findings:
- The clinical presentation of non-O1 Vibrio cholerae infection can be indistinguishable from classical cholera.
- Delayed identification of the causative agent occurred due to standard laboratory protocols.
- Toxigenic V. cholerae O1 and non-O1 strains share characteristics regarding chronic carriage and epidemic potential.
Implications:
- There is a significant risk of underdiagnosis and misidentification of Vibrio cholerae in U.S. clinical settings.
- The potential for unrecognized cholera epidemics in the United States exists due to non-O1 strains.
- Enhanced diagnostic vigilance and specific testing protocols for Vibrio species are necessary to prevent outbreaks.