Background: Two elderly people among a group of eight Belgian travellers who had stayed in Turkey for 2 weeks, developed a severe enteritis shortly after their return to Belgium. They had travelled by private bus, and had visited different places during their stay in Turkey from 6 to 17 September 2005.
Methods: After notification an epidemiological study was conducted by the Public Health authorities in Antwerp to identify the cause of the infection, to detect other cases, and to trace the source in Turkey. Vibrio cholerae was isolated from stools and a slide agglutination test was performed at the reference laboratory for cholera in Belgium.
Results: V. cholerae O1, El Tor, Inaba was identified in the stools of two patients. Four other patients, who suffered from a milder form of the disease, met the case definition of probable cases. No secondary infections among their contacts in Belgium were found. In spite of an epidemiological search conducted by the Turkish Public Health authorities, other cases of cholera in Turkey could not be detected. Nor a source for the outbreak could be established.
Conclusions: The outbreak of imported cholera in Belgium stresses the risk of contracting cholera in a country not considered as a cholera endemic region. It highlights the need for careful laboratory surveillance of intestinal infections in travellers after their return to their homeland. Early detection and prompt reporting are recommended.