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Epidemiol Infect. Apr 1996; 116(2): 121–126.
PMCID: PMC2271612

Epidemic cholera in Guatemala, 1993: transmission of a newly introduced epidemic strain by street vendors.

Abstract

Epidemic cholera reached Guatemala in July 1991. By mid-1993, Guatemala ranked third in the hemisphere in reported cases of cholera. We conducted a case-control study with two age-, sex-, and neighbourhood-matched controls per patient in periurban Guatemala City. Twenty-six patients hospitalized for cholera and 52 controls were enrolled. Seven (47%) of 15 stool cultures obtained after admission yielded toxigenic Vibrio cholerae O1. All seven were resistant to furazolidone, sulfisoxazole, and streptomycin, and differed substantially by pulsed-field gel electrophoresis from the Latin American epidemic strain dominant in the hemisphere since 1991. In univariate analysis, illness was associated with consumption of left-over rice (odds ratio [OR] = 7.0, 95% confidence interval [CI] = 1.4-36), flavored ices (-helados') (OR = 3.6, CI = 1.1 - 12), and street-vended non-carbonated beverages (OR = 3.8, CI = 1.2-12) and food items (OR = 11.0, CI = 2.3-54). Street-vended food items remained significantly associated with illness in multivariate analysis (OR = 6.5, CI = 1.4-31). Illness was not associated with drinking municipal tap water. Maintaining water safety is important, but slowing the epidemic in Guatemala City and elsewhere may also require improvement in street vendor food handling and hygiene.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Cholera--Peru, 1991. MMWR Morb Mortal Wkly Rep. 1991 Feb 15;40(6):108–110. [PubMed]
  • Fields PI, Popovic T, Wachsmuth K, Olsvik O. Use of polymerase chain reaction for detection of toxigenic Vibrio cholerae O1 strains from the Latin American cholera epidemic. J Clin Microbiol. 1992 Aug;30(8):2118–2121. [PMC free article] [PubMed]
  • Cameron DN, Khambaty FM, Wachsmuth IK, Tauxe RV, Barrett TJ. Molecular characterization of Vibrio cholerae O1 strains by pulsed-field gel electrophoresis. J Clin Microbiol. 1994 Jul;32(7):1685–1690. [PMC free article] [PubMed]
  • Evins GM, Cameron DN, Wells JG, Greene KD, Popovic T, Giono-Cerezo S, Wachsmuth IK, Tauxe RV. The emerging diversity of the electrophoretic types of Vibrio cholerae in the Western Hemisphere. J Infect Dis. 1995 Jul;172(1):173–179. [PubMed]
  • Swerdlow DL, Mintz ED, Rodriguez M, Tejada E, Ocampo C, Espejo L, Greene KD, Saldana W, Seminario L, Tauxe RV, et al. Waterborne transmission of epidemic cholera in Trujillo, Peru: lessons for a continent at risk. Lancet. 1992 Jul 4;340(8810):28–33. [PubMed]
  • Ries AA, Vugia DJ, Beingolea L, Palacios AM, Vasquez E, Wells JG, Garcia Baca N, Swerdlow DL, Pollack M, Bean NH, et al. Cholera in Piura, Peru: a modern urban epidemic. J Infect Dis. 1992 Dec;166(6):1429–1433. [PubMed]
  • Weber JT, Mintz ED, Cañizares R, Semiglia A, Gomez I, Sempértegui R, Dávila A, Greene KD, Puhr ND, Cameron DN, et al. Epidemic cholera in Ecuador: multidrug-resistance and transmission by water and seafood. Epidemiol Infect. 1994 Feb;112(1):1–11. [PMC free article] [PubMed]
  • Kolvin JL, Roberts D. Studies on the growth of Vibrio cholerae biotype eltor and biotype classical in foods. J Hyg (Lond) 1982 Oct;89(2):243–252. [PMC free article] [PubMed]
  • Felsenfeld O. Notes on food, beverages and fomites contaminated with Vibrio cholerae. Bull World Health Organ. 1965;33(5):725–734. [PMC free article] [PubMed]
  • Imported cholera associated with a newly described toxigenic Vibrio cholerae O139 strain--California, 1993. MMWR Morb Mortal Wkly Rep. 1993 Jul 9;42(26):501–503. [PubMed]

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