Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae serogroup O1 and/or O139. People usually catch cholera from contaminated water or food. The infection is often mild or without symptoms, but can sometimes be severe. Approximately one in 10% infected persons will have severe disease characterized by profuse watery diarrhea and vomiting. In these people, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.
During the 19th century, cholera spread across the world from its original reservoir in the Ganges delta in India. Six subsequent pandemics killed millions of people across all continents. The current (seventh) pandemic started in South Asia in 1961, and reached Africa in 1971 and the Americas in 1991. Cholera is now endemic in many countries. Every year, there are an estimated 2.9 million cholera cases and 95,000 deaths around the world due to cholera.
Two serogroups of V. cholerae – O1 and O139 – cause outbreaks. V. cholerae O1 causes the majority of outbreaks, while O139 – first identified in Bangladesh in 1992 – is confined to South-East Asia. Non-O1 and non-O139 V. cholerae can cause mild diarrhoea but do not generate epidemics.
No cholera epidemics have occurred in Taiwan since a severe outbreak caused by V. Cholerae serogroup O1 occurred in 1962. Although, during the period 1962-2013, several cholera infections have occurred, only a few are cluster infections and most of the reported cases are sporadic. The infection sources for most of the indigenous cholera infections occurred during the late twentieth century had been epidemiologically associated with the consumption of soft shelled turtle raised from contaminated farm ponds. The infection sources of indigenous cholera cases occurred during the recent five years were all unable to be identified.
Figure: Cholera Confirmed Cases in Taiwan, 2002-2018
Cholera Surveillance in Taiwan
Taiwan National Infectious Disease Statistics System
Prevention and Control