LARGE EPIDEMIC OF CHOLERA-LIKE DISEASE IN BANGLADESH CAUSED BY VIBRIO-CHOLERAE 0139 SYNONYM BENGAL

Epidemics of cholera caused by Vibrio cholerae 01 occur regularly in B angladesh, but until lately V cholerae non-01 has been associated only with sporadic cases of diarrhoeal disease in many parts of the world, including Bangladesh. We describe a large epidemic of cholera-like di sease in Bangladesh that is due to a V cholerae non-01. The epidemic b egan in December, 1992, in southern Bangladesh and spread throughout t he country. By the end of March 107 297 cases of diarrhoea and 1473 de aths had been reported. The disease is indistinguishable from cholera in clinical features and response to treatment, but most of the cases are in adults, which suggests that the population has no previous immu nological experience of the organism. At two centres 375 (40%) of 938 and 236 (48%) of 492 rectal swabs were positive for V cholerae non-01, as were 5 of 54 surface water samples. 55 isolates of V cholerae non- 01 were studied in detail. They resembled El Tor vibrios in being resi stant to polymyxin B and positive for agglutination of chicken erythro cytes. The strain did not belong to any of the 138 known V cholerae se rogroups; so a new serogroup 0139, with the suggested name Bengal, is proposed. All the isolates studied produced large amounts of an entero toxin apparently identical to cholera toxin. This strain seems to have pandemic potential. It is important that other countries in southeast Asia are aware of the strain's potential to cause severe morbidity an d mortality.