A Family Outbreak of Cholera in Changhua County

Ying-Shu Liao¹, Sung-Hsi Wei², Hsiao-Lun Wei¹, Chun-Hsing Liao¹, Chi-Sen Tsao¹, Hui-Chih Lo², Du-Lin Ling², Tsung-Chuan Sun³,Tsung-hsien Wu³,Yen-Po Yeh³, Chien-Shun Chiou¹

2013 Vol.29 NO.22

Correspondence Author： Chien-Shun Chiou

Abstract：

       In September 2012, two indigenous cholera cases occurred in Changhua County. An elderly couple in coastal areas was hospitalized due to vomiting, diarrhea and watery stools. Vibrio cholerae was isolated from the stool specimens. Toxigenic strains, biotype E1 Tor and serogroup O1 serotype Ogawa, were confirmed by Taiwan CDC. The investigation revealed that the clam farming couple had a simple diet, mostly home-made ingredients, rarely dined out. The same strain was isolated from family flush toilet. Non-O1 and non-O139 strains were isolated from residual clams and farm site. Non-toxigenic O1 Ogawa was isolated from two aquatic species. PFGE typing showed strains from two cases and the toilet have the same fingerprinting pattern, but obviously differ from non-toxigenic strains. The infection might due to the couple eat raw, not fully cooked or contaminated clams, along with high susceptibility. High diversity of V. cholerae was discovered in the aquaculture farming place, indicating V. cholerae (toxigenic strains) should have widely lived in waters and the surface of aquatic species in estuaries. The prevention control of cholera in Taiwan should emphasize on health education, clam and fish should be fully cooked, avoid eating raw food. Prevent cross-contamination of cooked and uncooked food. In addition, the leftover food should be refrigerated in case of V. cholerae contamination.