Epidemic cholera in rural El Salvador: risk factors in a region covered by a cholera prevention campaign.
In response to the Latin American cholera epidemic, El Salvador began a prevention programme in April 1991. The first case was confirmed in August, and 700 cases were reported within 3 months. A matched case-control study was conducted in rural La Libertad Department in November 1991. Illness was associated with eating cold cooked or raw seafood (odds ratio [OR] = 7.0; 95% confidence limits [CL] = 1.4, 35.0) and with drinking water outside the home (OR = 8.8; 95% CL = 1.7, 44.6). Assertion of knowledge about how to prevent cholera (OR = 0.2; 95% CL = 0.1, 0.8) and eating rice (OR = 0.2; 95% CL = 0.1, 0.8) were protective. More controls than patients regularly used soap (OR = 0.3; 95% CL = 0.1, 1.0). This study demonstrated three important points for cholera prevention: (1) seafood should be eaten cooked and hot; (2) populations at risk should be taught to treat household drinking water and to avoid drinking water outside the home unless it is known to be treated; and (3) education about hygiene can be an important tool in preventing cholera.
Quick
R E
RE
Division of Field Epidemiology, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Thompson
B L
BL
Zuniga
A
A
Dominguez
G
G
De Brizuela
E L
EL
De Palma
O
O
Almeida
S
S
Valencia
A
A
Ries
A A
AA
Bean
N H
NH
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002771:Cholera / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D003296:Cooking; D004544:El Salvador / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006920:Hygiene; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017747:Seafood; D014881:Water Supply