16 July 2012
Acute watery diarrhoea and cholera: Cuba
This updates the Clinical Update 5 July, 2012
As of 14 July, 2012 The Ministry of Public Health of Cuba reported 158 confirmed cases of toxigenic Vibrio Cholerae El Tor (serotype O1, Ogawa) in the outbreak of acute watery diarrhoea (AWD) first reported 2 July, 2012 [1, 2].
In recent weeks 1,000 cases of AWD including three deaths have been reported. The province with the highest incidence is Granma, with most cases reported from the municipality of Manzanillo. Public health measures, including surveillance, have been implemented; isolated cases of AWD occuring elsewhere in Cuba, associated with this outbreak, have been identified promptly and treated [1, 2].
Advice for travellers
Cholera is an acute diarrhoeal disease caused by the Gram negative bacillus Vibrio cholerae serogroup O1 or O139. Vibrio cholerae is transmitted through contaminated water or food in areas of poor sanitation.
Most travellers are at very low risk, but should practise food and water hygiene precautions. Cholera vaccine is not routinely recommended for travellers, but may be considered for those at higher risk of the toxigenic O1 strain of V. cholerae travelling to affected areas such as humanitarian aid workers and those who will have limited access to safe drinking water [3-4]. Country recommendations for Cuba have been updated.
1. InfoMed Red du Salud de Cuba. Nota informativa del Ministerio de Salud Pública [In Spanish]. 14 de jullio, 2012. [Accessed 16 July, 2012], Available at: http://www.sld.cu/
2. Centro Nacional de Información de Ciencias Médicas, Nota Informativa. 2 de jullio, 2012 [In Spanish]. [Accessed 16 July 2012]. Available at: http://www.sld.cu/verpost.php?blog=http://articulos.sld. cu/editorhome&post_id=10261&c=226&tipo=2&idblog=
3. Hill DR, Ford L, Lalloo DG. Oral cholera vaccines: use in clinical practice. Lancet Infect Dis 6:361-73, 2006.