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Letter
1990s Vibrio cholerae
Epidemic, Brazil
Ana C.P. Vicente*
and Ana M. Coelho†
*Institute Oswaldo Cruz, Rio de Janeiro, Brazil; and †Federal University
of Rio de Janeiro, Rio de Janeiro, Brazil
Suggested
citation for this article
To the Editor: We read with interest the letter by Sarkar et al.
on new Vibrio cholerae phages (1). The description
of new V. cholerae phages is a welcome tool for epidemiologic studies
of this species. Our main concern about their work is the inaccurate picture
that is presented of the cholera epidemic in Brazil. Some of the statements
made in the final paragraphs are in disagreement with the official epidemiologic
records and the characteristics of the Vibrio bacteria that occurred
in Brazil during the 1990s epidemic (2).
In 1991, the seventh cholera pandemic reached South America by the Pacific
coast, spreading to Brazil in the same year (3). In Brazil,
the first cholera cases were reported in the Amazon region bordering Peru;
within a few months a large number of cholera cases were recorded in states
facing the Atlantic Ocean in the northeastern region (2).
According to the official figures of the Brazilian Ministry of Health
(2), 168,598 cases of cholera caused by a V. cholerae
O1 El Tor strain occurred in Brazil from 1991 to 2001. Of these, 155,363
(92.1%) occurred in the northeastern area of the country, with 2,037 deaths.
From 2001 to 2003, the number of confirmed cases was 4,756, 734, and 7,
respectively.
Sarkar et al. (1) indicate that 60,000 cases occurred
from 1991 to 2001 in Rio de Janeiro, a city localized in the southeastern
region; the official records report only 349 cases. The statement that
"since 1993, no cholera cases caused by O1 have been reported"
is also perplexing. From 1994 to 2001, the official records report 68,583
cases of cholera in Brazil (51,324 of these in 1994, the second major
year of cholera incidence). Are the authors suggesting that this number
of cases was caused by non-O1 V. cholerae? The official records
state that the cholera epidemic in Brazil was caused by an El Tor O1 strain
(4,5).
References
- Sarkar BL, Ghosh AN, Sen A, Rodrigues DP. Newly
isolated Vibrio cholerae non-O1, non-O139 phages. Emerg Infect
Dis. 2004;10:754–6.
- Ministry of Health. Epidemiological record/FUNASA. Brazil 2001. Available
from http://dtr2001.saude.gov.br/svs/epi/pdfs/sh_dnc_uf_1980_2001.pdf
- Popovic T, Bopp C, Olsvik Ø, Wachsmuth K. Epidemiologic
application of a standardized ribotype scheme for Vibrio cholerae
O1. J Clin Microbiol. 1993;31:2474–82.
- Salles CA, Momen H, Vicente AC, Coelho A. Vibrio
cholerae in South America: polymerase chain reaction and zymovar
analysis. Trans R Soc Trop Med Hyg. 1993;87:272.
- Wachsmuth IK, Evins GM, Fields PI, Olsvik O, Popovic T, Bopp CA, et
al. The
molecular epidemiology of cholera in Latin America. J Infect Dis.
1993;167:621–6.
Suggested citation
for this article:
Vincente ACP, Coelho
AM. 1990s Vibrio cholerae epidemic, Brazil [letter]. Emerg Infect
Dis [serial on the Internet]. 2005 Jan [date cited]. Available
from http://www.cdc.gov/ncidod/EID/vol11no01/04-0484.htm
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