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Problems of Cholera (El Tor)

The El Tor type of cholera, caused by Vibrio el tor, occurred in four epidemics between 1937 and 1959 in Celebes and since then has been reported from Thailand, Hong Kong, Macao, Java, Borneo, Sarawak, and the Philippines. Thus it appears to be spreading. It differs from classical cholera in its usually sporadic occurrence and low rate of morbidity despite the presence of vibrios in surface water, but its high epidemic potentialities are evident in the estimated 10,000 cases and 13% mortality in the Philippine outbreak of 1961. Existing sanitary and quarantine regulations may require revision.

Epidemiological factors and interrelationship between pathogenic and non-pathogenic strains of vibrios, and the most efficient means of immunization, require investigation. Diagnosis is hindered by variations in hemolytic characteristics, and agglutination and phage-susceptibility tests are being developed to solve the problem. Phage tests are essential for diagnosis and are promising as a survey tool.