EID Weekly Updates:
Emerging and Reemerging Infectious Diseases, Region of the Americas
Vol. 2, No. 16—24 April 2004
From Epidemiological Weeks (EWs) 4 to 11, an increase in the number of cases of acute diarrhea has been detected in the municipality of São Bento do Una, state of Pernambuco, Brazil, similar to the peak that occurred during the first trimester of last year.
Two cases with serious acute diarrhea tested positive for Vibrio cholerae O1 Ogawa (a girl of 2 years of age and a male of 39) in a São Bento do Una neighborhood. The cases occurred in 27 March and 6 April 2004. Samples from the examinations carried out identified toxigenic strains in these two patients. Results from ongoing studies will later show the genotypical characterization of this strain. The environmental samples and feces samples taken from other patients from the same neighborhood tested negative for cholera.
Epidemiological monitoring of acute diarrhea cases has been intensified in all the municipalities, as well as surveillance of drinking-water quality. Prevention and control activities include distributing hypochlorite to the population, as well as intensive activities to ensure safe drinking water distribution. The public is being informed of what to do, and health-care professionals are being trained on how to identify and treat new cases, as well as on how to procure the necessary input for adequate case management.
Since second semester 2001, no cholera cases from this strain have been detected. Between 1991 and 2001, 168,598 cases of cholera were reported to the Ministry of Health, the last being reported in 2001 and all originating in the northeastern region. During 2002 and 2003, Vibrio cholerae 01 Ogawa was isolated in 6 environmental samples from the northeastern states, though the results of the analysis carried out turned out negative for toxigenic strains.
Health authorities are investigating the current identification of cholera cases in the municipality of São Bento do Una. For the time being, it is not possible to say that Vibrio cholerae is the agent responsible for the increase of diarrhea cases, since no toxigenic strains have been identified in other clinical and environmental samples. Ongoing research will elucidate the factors implied in such an increase and in the occurrence of the two cholera cases.
Source: Report to PAHO by the Ministry of Health of Brazil.
Sources: Reports to PAHO from the Department of Health, Pará (Secretária da Saúde, Pará/SES-PA) and the Department of Health Surveillance (Secretária de Vigiláncia em Saúde/SVS), Brazil.