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American Journal of Epidemiology Vol. 105, No. 4: 349-361
Copyright © 1977 by The Johns Hopkins University School of Hygiene and Public Health

other

CHOLERA ON GUAM, 1974

EPIDEMIOLOGIC FINDINGS AND ISOLATION OF NON-TOXINOGENIC STRAINS

MICHAEL H. MERSON1,, WILLIAM T. MARTIN1,, JOHN P. CRAIG2, GEORGE K. MORRIS1,, PAUL A. BLAKE1,, GUNTHER F. CRAUN3, JOHN C. FEELEY4, JOAQUIN C. CAMACHO5 and EUGENE J. GANGAROSA1,

1Bureau of Epidemiology, Center for Disease Control Atlanta, GA 30333
2Department of Microbiology and Immunology, State University of New York, Downstate Medical Center Brooklyn, NY
3Water Quality Division, Health Effects Research Laboratory, Environmental Protection Agency Cincinnati, Ohio
4Bureau of Laboratories, Center for Disease Control Atlanta
5Department of Public Health and Social Services Agana, Guam

address for reprint requests.

In August 1974, six cases of cholera occurred on Guam. The index case had severe diarrhea and metabolic acidosis and died from pneumonia on the ninth day of illness; the other five cases had only mild to moderate diarrhea. Fish caught in Agana Bay and home-preserved was found to be the vehicle most likely responsible for the cases. Vibrio cholerae, El Tor Ogawa, was isolated from two patients, the Guam sewerage system, and a river emptying into Agana Bay. V. cholerae, El Tor Inaba, was isolated from the sewerage system, three storm drains emptying into Agana Bay, and Agana Bay. The Ogawa and Inaba isolates differed in their sucrose fermentation and hemolysis reactions, phage type and ability to produce toxin. Although this was the first reported cholera outbreak on Guam, the isolation of different V. cholerae strains suggested that multiple introductions of V. cholerae had occurred on the island.

cholera; fish; fermentation, sucrose; outbreaks; sewage; toxins; Vibrio cholerae


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