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Persistence of Cholera in the United States^*

Wayne X. Shandera, Barry Hafkin, Deborah L. Martin, Jeffery P. Taylor, David L. Maserang, Joy G. Wells, Michael Kelly, Kanti Ghandi^||, James B. Kaper^**, John V. Lee AND Paul A. Blake

Enteric Diseases Branch, Division of Bacterial Diseases, Center for Infectious Diseases, Department of Health and Human Services, Public Health Service, Centers for Disease Control, Atlanta, Georgia 30333
Bureau of Epidemiology and Bureau of Laboratories, Texas Department of Health, Austin, Texas 78711
Department of Microbiology, University of Texas Medical Branch, Galveston, Texas 77550
^< Orange Memorial Hospital, Orange, Texas 77630
^** Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland 21201
Public Health Laboratory, Preston Hall Hospital, Maidstone, Kent, United Kingdom

In 1973, 1978, and 1981, cases of cholera were acquired along the Gulf Coast of the United States. The isolates from all of the cases were toxigenic Vibrio cholerae O-group 1, biotype El Tor, serotype Inaba, hemolytic, and of the same phage sensitivity pattern, and all had the same restriction endonuclease pattern by molecular genetic analysis. The strain from one of the two 1981 cases differed from the others in having a small plasmid and a negative Voges-Proskauer reaction. Multiple importations, chronic carriers, and continuous occurrence of undetected cases are unlikely explanations for these findings, which suggest that toxigenic V. cholerae 01 can multiply and persist for years in some environments, making eradication of cholera a formidable task.

Accepted for publication October 28, 1982.

^* Address reprint requests to: Paul Blake, M.D., CID: BDD: EDB, Centers for Disease Control, Atlanta, Georgia 30333.