Health Professionals

Clinical Updates

17 October 2013

Cholera in Mexico: update

This updates the previous Clinical Update 8 October 2013


The International Health Regulations National Focal Point in Mexico first reported confirmed autochthonous cases of infection with toxigenic Vibrio cholerae O1 Ogawa on 26 September 2013 [1].

As of 10 October 2013, a total of 159 cases have been reported: 145 cases and one death in Hidalgo state, two cases in the Federal District, nine cases in Mexico state, one in San Luis Potosi state and two from the state of Veracruz [2].

A map showing the location of the reported cholera cases in Mexico is available here.

The strain circulating in Mexico is genetically similar with the strain that is currently circulating in three Caribbean countries: Haiti, Dominican Republic and Cuba [2].

The Mexico health authorities are strengthening epidemiological activities at the national level, increasing the availability of medical care and implementing actions to ensure access to safe drinking water and basic sanitation at the community level [2].


Advice for travellers

Cholera is transmitted through contaminated water or food in areas of poor sanitation. Although the current outbreak has not yet affected the main tourist areas, all those travelling to Mexico should practise strict food and water hygiene precautions.

Most travellers are at low risk of cholera. Cholera vaccination is not currently routinely recommended for travel to Mexico; it may be considered for those travelling to the affected regions, who will have limited access to safe drinking water or medical care [3].

Current advice for travellers to Mexico can be found on the NaTHNaC Country Information Page.

Health professionals should be alert to the possibility of cholera in those who have recently returned from an endemic area presenting with a severe watery diarrhoeal illness, and send the appropriate samples (with a full clinical and travel history) to the Public Health England Gastrointestinal Infections Reference Unit.



1. Pan American Health Organization. Epidemiological Alert - Cholera. 26 September 2013. [Accessed 16 October 2013]. Available at:


2. Pan American Health Organization. Epidemiological Update  Cholera. 12 October 2013. [Accessed 16 October 2013]. Available at:


3. Cholera. Ch 14 In: Salisbury D, Ramsay M, Noakes K., eds. Immunisation against infectious disease. Department of Health. 3rd ed, London:TSO. 99-108, 2006. [Accessed16 October 2013]. Available at: