Cholera and sliced fruit: Probable secondary transmission from an asymptomatic carrier in the United States

Abstract

On September 8, 1995, two California residents developed diarrhea 15 hours after sharing a sliced cantaloupe. Stool culture from one person yielded toxigenic Vibrio cholerae O1, serotype Ogawa, biotype El Tor and the vibriocidal antibody titer was 10,240 for the second person, indicating recent infection with V. cholerae O1. A third person, who had sliced the cantaloupe, had recently returned from Guatemala but denied having gastrointestinal illness during or after the trip. Her vibriocidal antibody titer was 5120, also indicating recent infection with V. cholerae O1. This is the first reported incident of secondary transmission of cholera associated with an asymptomatic foodhandler. Encouraging good sanitary practices among foodhandlers and prompt refrigeration and consumption of sliced fruits may prevent further occurrences.