title: Cholera--a possible endemic focus in the United States.
abstract: In September and October 1978, after a case of cholera had been discovered in southwestern Louisiana, 10 more Vibrio cholerae O-Group 1 infections were detected in four additional clusters. All 11 infected persons had recently eaten cooked crabs from five widely separated sites in the coastal marsh, and a matched-triplet case-control study showed a significant relation between cholera and eating such crabs (P = 0.007). V. cholerae O1 was isolated from estuarine water, from fresh shrimp, from a leftover cooked crab from a patient's refrigerator, and from sewage in six towns, including three without identified cases. All isolates in Louisiana and an isolate from a single unexplained case in Texas in 1973 were biotype El Tor and serotype inaba; they were hemolytic and of a phage type unique to the United States--suggesting that the organism persisted undetected along the Gulf Coast for at least five years.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D003386:Brachyura / Q000382:microbiology; D002353:Carrier State / Q000453:epidemiology; D002648:Child; D002771:Cholera / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D033364:Decapoda / Q000382:microbiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D012722:Sewage; D012758:Shellfish / Q000009:adverse effects; D013781:Texas; D014734:Vibrio cholerae / Q000254:growth & development / Q000302:isolation & purification*; D014871:Water Microbiology
chemical_list: D012722:Sewage