Cholera in Africa: lessons on transmission and control for Latin America.
Lancet
; 338(8770): 791-5, 1991 Sep 28.
Article
em En
| MEDLINE
| ID: mdl-1681168
ABSTRACT
PIP: Latin America had been free of cholera for 70 years until January 1991 when the 7th pandemic of El Tor cholera struck Peru. It killed 1500 people and affected 200,000 people within 6 months. It soon spread to at least 7 other Latin American countries. 20 years earlier the it reached Africa. Foci of infections in Africa included markets, fairs, funerals, and refugee camps. Scientists doubted that vaccination or quarantine would have prevented its introduction into Africa. Yet, in Latin America, public health officials should earnestly reconsider chemoprophylaxis (tetracycline) of family contacts in families with high rates of illness. Presently no such data exist in Latin America. In addition, health workers should test the new oral vaccine in Latin America since there is no preexisting immunity and the people are exposed to high levels of contamination. Little epidemic research was done in Africa to pinpoint modes of transmission so health workers could learn what types of intervention were warranted. It should be done in Latin America, however. As for quarantine, symptomatic and mild to moderate cholera cases can outnumber severe cases as much as 100 to 1, so confining cases would not prevent the spread of the disease. Latin America should broaden diarrheal disease control programs to include adults so they will accept oral rehydration therapy (ORT). It should be used in mild to moderate dehydration cases and intravenous rehydration therapy for severe cases. If the environmental factors are not known and understood and if feces contaminate water supplies, foods, and fisheries, cholera may become endemic in Latin America. In conclusion prompt disease reporting, surveillance, and implementation of control measures could prevent the endemicity of cholera in Latin America.
Palavras-chave
Africa; Americas; Antibiotics; Biology; Culture; Delivery Of Health Care; Demographic Factors; Developing Countries; Diarrhea--prevention and control; Diarrhea--transmission; Diseases; Drugs; Environment; Epidemics; Food Supply; Health; Health Services; Historical Survey; Immunization; Latin America; Migrants; Migration; Natural Resources; Oral Rehydration; Peru; Population; Population Dynamics; Primary Health Care; Refugees; Risk Factors; South America; Treatment; Vaccination
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vibrio cholerae
/
Cólera
/
Surtos de Doenças
Tipo de estudo:
Risk_factors_studies
Limite:
Child
/
Humans
/
Infant
País/Região como assunto:
Africa
/
America do sul
/
Peru
Idioma:
En
Revista:
Lancet
Ano de publicação:
1991
Tipo de documento:
Article
País de publicação:
Reino Unido