The 1994 cholera epidemic in Guinea-Bissau resulted in
15878 reported cases and 306 deaths.
Early in the epidemic, although the health ministry mandated
that the bodies of persons dying
of cholera be disinfected, outbreaks occurred in several
villages following funerals in the region
of Biombo. To determine the influence of disinfection and
funeral activities on cholera
transmission, we analysed surveillance data and conducted a
case-control study following a
funeral. The attack rate during the week following funerals
was higher in villages where bodies
were not disinfected (risk ratio = 2·6, 95% confidence
interval [CI] 1·9–3·8). Cholera was
strongly associated with eating at a funeral with a
non-disinfected corpse (odds ratio [OR] =
14·5, 95% CI 0·9–786) and with touching
(i.e., transporting, washing) the body (OR = 36·2,
95% CI 2·6–1769). During cholera epidemics, in
addition to other cholera prevention activities,
health officials should inform community leaders about the
risk of cholera transmission during
funerals, meals should not be served at funerals, and bodies
of persons dying of cholera should be disinfected.