title: Cholera in Piura, Peru: a modern urban epidemic.
abstract: In late January 1991, epidemic cholera appeared in Peru. Within 2 months, 7922 cases and 17 deaths occurred in Piura, a Peruvian city of 361,868. A hospital-based culture survey showed that 79%-86% of diarrhea cases were cholera. High vibriocidal antibody titers were detected in 34% of the asymptomatic population. A study of 50 case-patients and 100 matched controls demonstrated that cholera was associated with drinking unboiled water (odds ratio [OR], 3.9; 95% confidence interval [CI], 1.7-8.9), drinking beverages from street vendors (OR, 14.6; CI, 4.2-51.2), and eating food from street vendors (OR, 24.0; CI, 3.0-191). In a second study, patients were more likely than controls to consume beverages with ice (OR, 4.0; CI, 1.1-18.3). Ice was produced from municipal water. Municipal water samples revealed no or insufficient chlorination, and fecal coliform bacteria were detected in samples from 6 of 10 wells tested. With epidemic cholera spreading throughout Latin America, these findings emphasize the importance of safe municipal drinking water.
authors.affiliation: Enteric Diseases Branch, Centers for Disease Control, Atlanta, GA 30333.
authors.forename: A A
authors.initials: AA
authors.lastname: Ries
authors.forename: D J
authors.initials: DJ
authors.lastname: Vugia
authors.forename: L
authors.initials: L
authors.lastname: Beingolea
authors.forename: A M
authors.initials: AM
authors.lastname: Palacios
authors.forename: E
authors.initials: E
authors.lastname: Vasquez
authors.forename: J G
authors.initials: JG
authors.lastname: Wells
authors.forename: N
authors.initials: N
authors.lastname: Garcia Baca
authors.forename: D L
authors.initials: DL
authors.lastname: Swerdlow
authors.forename: M
authors.initials: M
authors.lastname: Pollack
authors.forename: N H
authors.initials: NH
authors.lastname: Bean
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000635:transmission; D004196:Disease Outbreaks; D004326:Drinking; D005243:Feces / Q000382:microbiology; D005260:Female; D005516:Food Microbiology; D006801:Humans; D007053:Ice; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D014505:Urban Population; D014734:Vibrio cholerae / Q000145:classification / Q000276:immunology / Q000302:isolation & purification; D014871:Water Microbiology; D014881:Water Supply
chemical_list: D000907:Antibodies, Bacterial; D007053:Ice