Waterborne transmission of epidemic cholera in Trujillo, Peru: lessons for a continent at risk.
Lancet
; 340(8810): 28-33, 1992 Jul 04.
Article
em En
| MEDLINE
| ID: mdl-1351608
ABSTRACT
PIP: Researchers conducted various studies simultaneously in Trujillo. Peru (population 626,456) in March 1991 to set up a cholera surveillance system and to determine clinical characteristics of suspect cholera cases, modes of transmission, and municipal water quality during distribution and storage. These studies occurred after the population received information on how to avoid cholera. The cholera attack rate for the 1st 2 months of the epidemic stood at 2.6% (16,400 cases). The case fatality rate was 0.4% (71 deaths). The median hours between onset of symptoms and arrival at Belen hospital were 12 hours. 56% of the patients were treated with oral rehydration solution before coming to the hospital and 13% with homemade rehydration solution. Laboratory personnel isolated toxigenic nonhemolytic Vibrio cholera 01, biotype El Tor, serotype Inaba from the rectal swabs of 79% of cholera patients. None of the hospital patients died. 29% of controls from the case control study claimed to not have witnessed a personal or household attack of diarrhea recently, yet their vibrocidal antibody titers indicated a recent cholera infection. 58% of cases drank unboiled water within 3 days of falling ill compared to only 28% of controls (matched odds ratio [OR] 3.1; p.05). Other significant risk factors (p.05) were drank water from container also used to dip hands (OR 4.2) and attended a fiesta (OR 3.6). There were significantly more total coliforms in water containers than tap water and municipal water (mean 794 vs. 6 and 1 respectively; p.05). The same was true for fecal coliforms (20 vs. 2 and 1 respectively). In conclusion, the drinking water was contaminated with V. cholera. Eventually the city should eliminate cross connections, provide continuous supplies of water at high pressure, and improve the sewage system.
Palavras-chave
Americas; Case Control Studies; Developing Countries; Diarrhea; Diseases; Environment; Epidemics; Epidemiologic Methods; Examinations And Diagnoses; Laboratory Examinations And Diagnoses; Latin America; Methodological Studies; Natural Resources; Peru; Research Methodology; South America; Studies; Water Supply
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Microbiologia da Água
/
Cólera
/
Surtos de Doenças
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
País/Região como assunto:
America do sul
/
Peru
Idioma:
En
Revista:
Lancet
Ano de publicação:
1992
Tipo de documento:
Article
País de afiliação:
Geórgia
País de publicação:
Reino Unido