An illness indistinguishable clinically from classical cholera but caused by a non-cholera vibrio occurred in an over-the-road truck driver. The infecting organism was not finally identified as Vibrio cholerae, Smith serotype 113 toxin positive, until 4 weeks after his hospital discharge. Hospital laboratories in most parts of the United States are unlikely to identify Vibrio cholerae in stool cultures unless specifically requested to do so. If one recognizes that chronic cholera carriers have been documented, that small epidemics do occur in unlikely places, and the lack of evidence that toxigenic V. cholerae 01 differs from toxigenic V. cholerae non-01 in these two respects, then the potential for epidemics in the United States is real.