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American Journal of Epidemiology Vol. 105, No. 4: 344-348
Copyright © 1977 by The Johns Hopkins University School of Hygiene and Public Health

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CHOLERA IN PORTUGAL, 1974

II. TRANSMISSION BY BOTTLED MINERAL WATER

PAUL A. BLAKE1,, MARK L. ROSENBERG1,, JOAO FLORENCIA2, JOSE BANDEIRA COSTA3, LUIS DO PRADO QUINTINO2 and EUGENE J. GANGAROSA1,

1Enteric Diseases Branch, Bacterial Diseases Division, Bureau of Epidemiology, Center for Disease Control Atlanta, GA 30333
2District of Lisbon Health Department, Lisbon Portugal
3Directorate General of Health, Lisbon Portugal

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During a cholera epidemic, Vibrio cholerae was isolated from two springs which supplied mineral water to a spa and to a commercial water bottling plant. Epidemiologic investigation found that cholera attack rates were 10-fold greater among visitors to the spa than among non-visitors. A subsequent matched-pair case-control study which excluded persons who had visited the spa showed that a history of consumption of the bottled non-carbonated water was significantly more common among bacteriologically confirmed cholera cases than among paired controls.

cholera; epidemics; mineral waters; Vibrio cholerae; water pollution


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