Retrospective analysis of the cholera cases imported to France from 1973 to 2005.
BACKGROUND
The manners of traveling and travelers' vulnerability to infection are changing: increasing numbers of travelers, travels at the extreme ages of life, "backpacker" tourism in close contact with local populations. What is the epidemiologic situation and what are the trends of imported cholera to Metropolitan France?


METHODS
A descriptive retrospective study was undertaken on all the confirmed cases of cholera imported to France, and notified from January 1, 1973, to December 31, 2005, using compulsory notification data from local health departments and information from the National Reference Centre.


RESULTS
A total of 129 imported cases of cholera were notified between 1973 and 2005 (3.9 cases/y on average). The geographical sources of infection have changed with time: in the 1980s, 94% of the patients were infected in Maghreb (Morocco and Algeria) but none were in 2000. On the other hand, Asia and West Africa progressively emerged and now predominate. In spite of certain poorly informed data and possible underdetection, the number of cases of importation appears to be low and falling.


CONCLUSIONS
The patient profile seems to have evolved and increasingly concerns people at the extreme ages of life, living elsewhere than the principal basins of immigration in France, and diagnosis is increasingly made in nonteaching hospitals. The lessons likely to help clinicians will be discussed.
Tarantola
Arnaud
A
Département International et Tropical, Institut de Veille Sanitaire, Saint-Maurice, France. a.tarantola@invs.sante.fr
Ioos
Sophie
S
Rotureau
Brice
B
Paquet
Christophe
C
Quilici
Marie-Laure
ML
Fournier
Jean-Michel
JM
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology*; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D004641:Emigration and Immigration; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014195:Travel; D014329:Tropical Climate; D014505:Urban Population / Q000706:statistics & numerical data; D014734:Vibrio cholerae / Q000302:isolation & purification*