DIARRHEAL DISEASE IN PERU AFTER THE INTRODUCTION OF CHOLERA

Surveillance was conducted one day each week from December 1992 throug h May 1993 to determine the clinical features and etiology of diarrhea among a population in a suburban community of Lima, Peru. Patients wh o had had three or more loose stools during the previous 24 hr were en rolled at a clinic located in the community or at a nearby regional ho spital. A total of 143 cases of diarrhea were detected for an overall rate of 7.1 cases per 1,000 population. The enteropathogens isolated w ere Vibrio cholerae 01 (31%), enterotoxigenic Escherichia coli (22%), and Salmonella, Shigella, Campylobacter, and Aeromonas species (10%). Specimens from the remaining cases were negative for enteropathogens. All isolates of V. cholerae were susceptible to tetracycline, doxycycl ine, nalidixic acid, norfloxacin, trimethoprim-sulfamethoxazole, trime thoprim, gentamicin, chloramphenicol, and cephalothin. Cases of diarrh ea associated with V. cholerae were more common among adults, and more likely to experience severe dehydration and require hospitalization t han the non-cholera cases. Data indicated that among the cases diagnos ed, V. cholerae and enterotoxigenic E. coli were the more common cause s of diarrhea in a suburban community of Lima during the summer season .