Cholera in the Americas: Foodborne Aspects

Abstract

Over 100 serotypes of Vibrio cholerae exist, but generally the toxigenic strains of the serogroup O1 cause cholera and possess documented epidemic potential. The main symptom of cholera is a profuse diarrhea resulting in dehydration, that if untreated, leads to death. Seven pandemics of this contagious disease have been recorded during the last 200 years. A sick person secrets in his stool billions of organisms daily, and water and food contaminated with such a stool are the primary sources of infection during the epidemics. With the increase of the international food trade, food is often shipped from countries with endemic or epidemic cholera. With one exception, no documented cases of cholera have been reported, as a result of the internationally regulated food trade. However, during the present Latin American epidemic, inadequately cooked seafood has been implicated as a source of cholera. As a result of the epidemic, over 100 cases of cholera have occurred in the United States related to seafood consumed during a visit to Latin America or after its noncommercial transport into the country. Furthermore, V. cholerae persists as a free-living organism in environmental reservoirs in Australia and the U.S. Gulf Coast; there have been 65 domestically acquired cases of cholera in the United States since 1973. Molecular typing methods have enabled us to identify and characterize endemic and epidemic strains, and to document transmission of cholera when food was implicated epidemiologically as a vehicle of transmission.