An Epidemic of Bloody Diarrhea: Escherichia coli O157 Emerging in Cameroon?

In December 1997, an epidemic of bloody diarrhea was reported in Ngoïla, a village of approximately 500 inhabitants, approximately 400 km from Yaoundé.Canoes and motorbikes are necessary to reach Ngoïla, which is linked to Lomié by a difficult road across the Dja River.The remote zone to the south of the river is inhabited by 2,610 persons, who belong to two ethnic groups (Bantus and Baka Pygmies) and live in 22 villages (Figure 1).The population of the outbreak area is 20,600.The sanitation system is weak, latrines do not exist, and human feces are used as fertilizer.No village has running water; drinking water, which is neither chlorinated nor filtered, comes from wells or small streams.Between December 1997 and March 1998, teams from Lomié Hospital and the East Provincial Delegation of Health went to Ngoïla to treat patients and make an inventory of the cases.After a March 19, 1998, wire service report of a possible viral hemorrhagic fever epidemic in Ngoïla, a joint mission of Centre Pasteur du Cameroun and the World Health Organization visited the area March 25-28, 1998.