VIBRIO CHOLERAE O139 BENGAL INFECTIONS AMONG TOURISTS TO SOUTHEAST-ASIA - AN INTERCONTINENTAL FOODBORNE OUTBREAK

To determine the source and extent of an outbreak of Vibrio cholerae O 139 Bengal infections among 630 cruise ship passengers to Southeast As ia, a retrospective cohort study was done. Questionnaires were sent to all passengers from the United States, Canada, and the United Kingdom , and serum samples were requested from all passengers reporting diarr hea, A case was defined as diarrheal illness with onset between 8 and 28 February 1994 and a cholera antitoxic antibody titer greater than o r equal to 800. Six passengers, including 1 with bacteremia, met the c ase definition, Illness was associated with eating yellow rice at a bu ffet restaurant in Bangkok on 10 February (relative risk undefined, P = .005), This international outbreak demonstrates foodborne transmissi on of Vibrio cholerae O139 Bengal, an emerging cause of epidemic chole ra in Asia, to tourists from Western countries. Physicians should susp ect infection with either V. cholerae O1 or O139 in any patient with s evere watery diarrhea after travel to the developing world.