Cholera--a Possible Endemic Focus in the United States

N Engl J Med. 1980 Feb 7;302(6):305-9. doi: 10.1056/NEJM198002073020601.


In September and October 1978, after a case of cholera had been discovered in southwestern Louisiana, 10 more Vibrio cholerae O-Group 1 infections were detected in four additional clusters. All 11 infected persons had recently eaten cooked crabs from five widely separated sites in the coastal marsh, and a matched-triplet case-control study showed a significant relation between cholera and eating such crabs (P = 0.007). V. cholerae O1 was isolated from estuarine water, from fresh shrimp, from a leftover cooked crab from a patient's refrigerator, and from sewage in six towns, including three without identified cases. All isolates in Louisiana and an isolate from a single unexplained case in Texas in 1973 were biotype El Tor and serotype inaba; they were hemolytic and of a phage type unique to the United States--suggesting that the organism persisted undetected along the Gulf Coast for at least five years.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Animals
  • Brachyura / microbiology
  • Carrier State / epidemiology
  • Child
  • Cholera / epidemiology*
  • Cholera / prevention & control
  • Cholera / transmission
  • Decapoda / microbiology
  • Epidemiologic Methods
  • Female
  • Humans
  • Louisiana
  • Male
  • Middle Aged
  • Sewage
  • Shellfish / adverse effects
  • Texas
  • Vibrio cholerae / growth & development
  • Vibrio cholerae / isolation & purification*
  • Water Microbiology


  • Sewage