title: An outbreak of cholera from food served on an international aircraft.
abstract: In February 1992, an outbreak of cholera occurred among persons who had flown on a commercial airline flight from South America to Los Angeles. This study was conducted to determine the magnitude and the cause of the outbreak. Passengers were interviewed and laboratory specimens were collected to determine the magnitude of the outbreak. A case-control study was performed to determine the vehicle of infection. Seventy-five of the 336 passengers in the United States had cholera; 10 were hospitalized and one died. Cold seafood salad, served between Lima, Peru and Los Angeles, California was the vehicle of infection (odds ratio, 11.6; 95% confidence interval, 3.3-44.5). This was the largest airline-associated outbreak of cholera ever reported and demonstrates the potential for airline-associated spread of cholera from epidemic areas to other parts of the world. Physicians should obtain a travel history and consider cholera in patients with diarrhoea who have travelled from cholera-affected countries. This outbreak also highlights the risks associated with eating cold foods prepared in cholera-affected countries.
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Los Angeles, CA 90012, USA.
authors.forename: J
authors.initials: J
authors.lastname: Eberhart-Phillips
authors.forename: R E
authors.initials: RE
authors.lastname: Besser
authors.forename: M P
authors.initials: MP
authors.lastname: Tormey
authors.forename: D
authors.initials: D
authors.lastname: Koo
authors.forename: D
authors.initials: D
authors.lastname: Feikin
authors.forename: M R
authors.initials: MR
authors.lastname: Araneta
authors.forename: J
authors.initials: J
authors.lastname: Wells
authors.forename: L
authors.initials: L
authors.lastname: Kilman
authors.forename: G W
authors.initials: GW
authors.lastname: Rutherford
authors.forename: P M
authors.initials: PM
authors.lastname: Griffin
authors.forename: R
authors.initials: R
authors.lastname: Baron
authors.forename: L
authors.initials: L
authors.lastname: Mascola
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000401:Aircraft; D016022:Case-Control Studies; D002648:Child; D002771:Cholera / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D005516:Food Microbiology; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008875:Middle Aged; D010568:Peru; D014734:Vibrio cholerae / Q000302:isolation & purification*