PMID: 8620902Apr 1, 1996Paper

Epidemic cholera in Guatemala, 1993: transmission of a newly introduced epidemic strain by street vendors

Epidemiology and Infection
D KooR V Tauxe

Abstract

Epidemic cholera reached Guatemala in July 1991. By mid-1993, Guatemala ranked third in the hemisphere in reported cases of cholera. We conducted a case-control study with two age-, sex-, and neighbourhood-matched controls per patient in periurban Guatemala City. Twenty-six patients hospitalized for cholera and 52 controls were enrolled. Seven (47%) of 15 stool cultures obtained after admission yielded toxigenic Vibrio cholerae O1. All seven were resistant to furazolidone, sulfisoxazole, and streptomycin, and differed substantially by pulsed-field gel electrophoresis from the Latin American epidemic strain dominant in the hemisphere since 1991. In univariate analysis, illness was associated with consumption of left-over rice (odds ratio [OR] = 7.0, 95% confidence interval [CI] = 1.4-36), flavored ices (-helados') (OR = 3.6, CI = 1.1 - 12), and street-vended non-carbonated beverages (OR = 3.8, CI = 1.2-12) and food items (OR = 11.0, CI = 2.3-54). Street-vended food items remained significantly associated with illness in multivariate analysis (OR = 6.5, CI = 1.4-31). Illness was not associated with drinking municipal tap water. Maintaining water safety is important, but slowing the epidemic in Guatemala City and elsewhere may als...Continue Reading

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Citations

Nov 7, 2012·BMC Infectious Diseases·Alexander RosewellC Raina MacIntyre
Nov 5, 1997·Lancet·M T Estrada-Garcia
Jan 5, 2011·Health & Place·Sophia GiebultowiczMichael Emch
Dec 6, 2005·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Jaime SepúlvedaLourdes García-García
Jan 29, 2014·The American Journal of Tropical Medicine and Hygiene·Von D NguyenJoan M Brunkard
Jul 4, 2018·The American Journal of Tropical Medicine and Hygiene·Marlene WolfeDaniele Lantagne
Jul 26, 2019·Tropical Medicine & International Health : TM & IH·Matthew D PhelpsPeter K M Jensen
Nov 11, 2017·Science·Daryl DommanNicholas R Thomson
Oct 3, 2002·Nature Reviews. Genetics·Lori B Andrews
Sep 1, 2015·Journal of Water and Health·Elizabeth BlantonDaniele Lantagne
Feb 1, 2003·Paediatrics & Child Health·Pierre J Plourde
Aug 24, 2018·The Journal of Infectious Diseases·Aaron RichtermanLouise C Ivers
Oct 13, 2018·Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association·K AbrahaleN Lunet

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