Abstract
West Africa had been free of cholera during the entire twentieth century until August 1970 when a devastating epidemic of more than 150 000 cases and 20 000 deaths occurred. Cholera is now endemic in all the areas involved. The patterns of spread initially involved coastal waterways, but subsequently extended to desert areas. The role of various modes of transportation and the high carrier-to-case ratio characteristic of Vibrio cholerae biotype El Tor are discussed. The fundamental importance of adequate fluid replacement therapy in preventing panic and dispersal of affected populations with consequent spread to new areas is stressed. It is urged that all physicians become familiar with cholera in order to be prepared to render appropriate care when cases occur in the Americas.
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