EPIDEMIOLOGIC, CLINICAL AND THERAPEUTIC EVALUATION OF THE ITALIAN CHOLERA EPIDEMIC IN 1994

In the period between 18 October and 4 December 1994, 12 indigenous ca ses of cholera were registered in the southern Italian region of Pugli a, 10 of them were diagnosed in our Departments of Infectious Diseases . All patients were infected by consumption of raw fish or mussels. Th e patients had an elevated mean age and most were affected with system ic pathologies. The clinical course was mild and rarely complicated, a lthough frequently the characteristic riziform diarrhoea was absent. I n all patients V. cholerae serotype Ogawa biotype El Tor, was isolated ; one patient was co-infected by Salmonella typhi. All strains showed resistance to cotrimoxazole and tetracycline. Nine of ten patients wer e treated with oral ciprofloxacin at 1 g/day for 10 days resulting in disappearance of the symptoms within a median of 36 hours and negative fecal cultures within a median of 24 hours. Our data suggest that Ita ly is at high risk of infection imported from nearby nations. The resi stance to commonly used antibiotics for treatment of cholera and the g ood response to ciprofloxacin suggest including fluoroquinolones among the drugs of first choice in geographical areas involved in the circu lation of resistant strains of V. cholerae O1.