Cholera. Implications for the United States

RECENT events have focused renewed attention on cholera as a source of health concern for the United States. During the last week in August 1973, cholera outbreaks occurred in several cities in Italy. More than 200 cases with 23 deaths had been reported by the end of September. This represents a further westward extension of the pandemic of El Tor cholera that, in recent years, has spread from Asia through the Middle East to most of Africa and, on occasion, to Europe. In 1971, Spain and Portugal experienced outbreaks of cholera resulting from cases imported from Africa. In the past few years, more than 100 imported cases have been reported from various other European countries without evidence of subsequent spread. On Aug 25, 1973, a case of cholera occurred in Calhoun County, Texas.1The diagnosis was suspected by an alert physician. As a result, the patient, a 51-year-old man,