Cholera in the 1990s : a disease on the rampage

Abstract

The decade of the 1990s is witnessing a resurgence of cholera on a global scale. Cholera entered Latin America after almost 100 years and for the first time in the 20th century in an explosive fashion beginning with concurrent outbreaks in several coastal cities in Peru in late January 1991. The origin of the strains of Vibrio cholerae responsible for the initial outbreaks in Peru remains an enigma. Across the globe, in October 1992 a series of outbreaks of cholera-like illness in Southern India was found to be caused by a non-O1 serogroup which was subsequently classified as Vibrio cholerae O139 Bengal. As with the Latin American epidemic, the O139 serogroup spread with amazing speed and in the matter of a year affected all the cholera endemic areas in India and several neighbouring countries in south-east Asia. Imported cases of O139 V. cholerae has now been reported from several countries across the globe. These two events have dominated the global cholera scenario in the 1990s and both these events are reviewed.