Skip to main content Accessibility help
×
×
Home

Epidemic cholera in Ecuador: multidrug–resistance and transmission by water and seafood

  • J. T. Weber (a1), E. D. Mintz (a1), R. Cañizares (a2), A. Semiglia (a2), I. Gomez (a2), R. Sempértegui (a3), A. Dávila (a4), K. D. Greene (a1), N. D. Puhr (a1), D. N. Cameron (a1), F. C. Tenover (a5), T. J. Barrett (a1), N. H. Bean (a6), C. Ivey (a6), R. V. Tauxe (a1) and P. A. Blake (a1)...
Summary

To determine risk factors for cholera in an epidemic-disease area in South America, a case–control investigation was performed in Guayaquil, Ecuador, in July 1991. Residents > 5 years old who were hospitalized for treatment of acute, watery diarrhoea and two matched controls for each were interviewed regarding sources of water and food, and eating, drinking, and hygienic habits. Interviewers inspected homes of case-patients and controls to document water treatment, food-handling, and hygienic practices. Faecal specimens and shellfish were cultured for Vibrio cholerae O 1. Isolates were tested for susceptibility to a variety of antimicrobial agents. Drinking unboiled water (odds ratio [OR] = 4.0, confidence interval [CI] = 1.8–7.5), drinking a beverage from a street vendor (OR = 2.8, CI = 1.3–5.9), eating raw seafood (OR = 3.4, CI = 1.4–11.5), and eating cooked crab (OR = 5.1, CI = 1.4–19.2) were associated with illness. Always boiling drinking water at home (OR = 0.5, CI = 0.2–0.9) was protective against illness. The presence of soap in either the kitchen (OR = 0.3, CI = 0.2–0.8) or bathroom (OR = 0.4, CI = 0.2–0.9) at home was also protective. V. cholerae O 1 was recovered from a pooled sample of a bivalve mollusc and from 68% of stool samples from case-patients. Thirty-six percent of the isolates from stool specimens were resistant to multiple antimicrobial agents. Specific prevention measures may prevent transmission through these vehicles in the future. The appearance of antimicrobial resistance suggests the need for changes in current methods of prevention and treatment.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Epidemic cholera in Ecuador: multidrug–resistance and transmission by water and seafood
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Epidemic cholera in Ecuador: multidrug–resistance and transmission by water and seafood
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Epidemic cholera in Ecuador: multidrug–resistance and transmission by water and seafood
      Available formats
      ×
Copyright
References
Hide All
Sack, DA, Huda, S, Neogi, PKB, Daniel, RR, Spira, WM. Microtiter ganglioside enzyme-linked immunosorbent assay for Vibrio and Escherichia coli heat-labile enterotoxins and antitoxin. J Clin Microbiol 1980; 11: 3540.
National Committee for Clinical Laboratory Standards. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically, second edition. Approved standard, M7-A2, vol. 10. National Committee for Clinical Laboratory Standards, Villanova, PA, 1990.
National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial disk susceptibility tests, fourth edition. Approved standard, M2-A4, vol. 10. National Committee for Clinical Laboratory Standards, Villanova, PA, 1990.
Wachsmuth, IK, Evins, GM, Fields, PI et al. , The molecular epidemiology of cholera in Latin America. J Infect Dis 1993; 167: 621–6.
Kado, CI, Liu, ST. Rapid procedure for detection and isolation of large and small plasmids. J Bacteriol 1981; 145: 1365–73.
Young, CR, Wachsmuth, IK, Olsvik, O, Feeley, JC. Immune response to Vibrio cholerae. In: Rose, NR, Friedman, H, Fahey, JL, eds. Manual of clinical laboratory immunology. Washington, D.C.: American Society for Microbiology, 1986: 363–70.
Ries, AA, Vugia, DJ, Beingolea, L et al. , Cholera in Piura, Peru: a modern urban epidemic. J Infect Dis 1992; 166: 1429–33.
Swerdlow, DL, Mintz, ED, Rodriguez, M et al. , Waterborne transmission of epidemic cholera in Trujillo. Peru: lessons for a continent at risk. Lancet 1992; 340: 2833.
Mujica, O, Quick, R, Palacios, A et al. , Epidemic cholera in the Amazon: transmission and prevention by food [abstract 936]. In: Program and Abstracts of the 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy, Anaheim, 1992: 266.
Mata, L. Efecto del jugo y de la pulpa de frutas ácidas sobre el Vibrio cholerae. In: El cólerá: historia, prevención y control. Costa Rica: Universidad de Costa Rica, 1992: 275310.
Merson, MH, Martin, WT, Craig, JP et al. , Cholera on Guam, 1974. Am J Epidemiol 1977; 105: 349–61.
Mclntyre, RC, Tira, T, Flood, T, Blake, PA. Modes of transmission of cholera in a newly infected population on an atoll: implications for control measures. Lancet 1979; 1: 311–14.
Blake, PA, Allegra, DT, Snyder, JD et al. , Cholera: a possible endemic focus in the United States. N Engl J Med 1980; 302: 305–9.
Pavia, AT, Campbell, JF, Blake, PA, Smith, JD, McKinley, TW, Martin, DL. Cholera from raw oysters shipped interstate. Jama 1987; 258: 2374.
Finelli, L, Swerdlow, D, Mertz, K, Ragazzoni, H, Spitalny, K. Outbreak of cholera associated with crab brought from an area with epidemic disease. J Infect Dis 1992; 166: 1433–5.
Centers for Disease Control. Cholera – New York. MMWR 40: 30: 516–18.
Rice, EW, Johnson, CH. Cholera in Peru. Lancet 1991; 338: 455.
Deb, BC, Sircar, BK, Sengupta, PG et al. , Intrafamilial transmission of Vibrio cholerae biotype El Tor in Calcutta slums. Indian J Med Res 1982; 76: 814–19.
Deb, BC, Sircar, BK, Sengupta, PG et al. , Studies on interventions to prevent El Tor cholera transmission in urban slums. Bull WHO 1986; 64: 127–31.
Glass, RI, Huq, MI, Lee, JV et al. , Plasmid-borne multiple drug resistance in Vibrio cholerae serogroup O 1. biotype El Tor: evidence for point-source outbreak in Bangladesh. J Infect Dis 1983; 147: 204–9.
Mhalu, FS, Mmari, PW, Ijumba, J. Rapid emergence of El Tor Vibrio cholerae resistant to antimicrobial agents during first six months of fourth cholera epidemic in Tanzania. Lancet 1979; 1: 345–7.
de Macedo, CG. Presentation of the PAHO regional plan. In: Confronting cholera: The development of a hemispheric response to the epidemic [conference proceedings]. University of Miami North–South Center. 1991: 3944.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed