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An outbreak of cholera from food served on an international aircraft

Published online by Cambridge University Press:  15 May 2009

J. Eberhart-Phillips
Affiliation:
Epidemic Intelligence Service, Division of Field Services, Centers for Disease Control and Prevention
R. E. Bessser*
Affiliation:
Epidemic Intelligence Service, Division of Field Services, Centers for Disease Control and Prevention
M. P. Tormey
Affiliation:
Acute Communicable Disease Control Unit, County of Los Angeles Department of Health Services, 313 N. Figueroa Street, Room 231, Los Angeles, CA 90012
D. Feikin
Affiliation:
Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention
M. R. Araneta
Affiliation:
Acute Communicable Disease Control Unit, County of Los Angeles Department of Health Services, 313 N. Figueroa Street, Room 231, Los Angeles, CA 90012
J. Wells
Affiliation:
Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention
L. Kilman
Affiliation:
Public Health Laboratories, County of Los Angeles Department of Health Services
G. W. Rutherford
Affiliation:
Prevention Services, State of California Department of Health Services
P. M. Griffin
Affiliation:
Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention
R. Baron
Affiliation:
Epidemic Intelligence Service, Division of Field Services, Centers for Disease Control and Prevention
L. Mascola
Affiliation:
Acute Communicable Disease Control Unit, County of Los Angeles Department of Health Services, 313 N. Figueroa Street, Room 231, Los Angeles, CA 90012
*
* Address for correspondence: Richard E. Besser, M.D., Department of Pediatrics, University of California, San Diego, 200 W. Arbor Drive (8454), San Diego, CA 92116.
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Summary

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In February 1992, an outbreak of cholera occurred among persons who had flown on a commercial airline flight from South America to Los Angeles. This study was conducted to determine the magnitude and the cause of the outbreak. Passengers were interviewed and laboratory specimens were collected to determine the magnitude of the outbreak. A case-control study was performed to determine the vehicle of infection. Seventy-five of the 336 passengers in the United States had cholera; 10 were hospitalized and one died. Cold seafood salad, served between Lima, Peru and Los Angeles, California, was the vehicle of infection (odds ratio, 11·6; 95% confidence interval, 3·3–44·5). This was the largest airline-associated outbreak of cholera ever reported and demonstrates the potential for airline-associated spread of cholera from epidemic areas to other parts of the world. Physicians should obtain a travel history and consider cholera in patients with diarrhoea who have travelled from cholera-affected countries. This outbreak also highlights the risks associated with eating cold foods prepared in cholera-affected countries.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1996

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