Cholera in the United States, 1995-2000: Trends at the end of the twentieth century

To evaluate recent trends in cholera in the United States, surveillance dat a from all cases of laboratory-confirmed toxigenic Vibrio cholerae O1 and O 139 infection reported to the Centers for Disease Control and Prevention be tween 1995 and 2000 were reviewed. Sixty-one cases of cholera, all caused b y V. cholerae O1, were reported. There was 1 death, and 35 (57%) of the pat ients were hospitalized. Thirty-seven (61%) infections were acquired outsid e the United States; 14 (23%) were acquired through undercooked seafood con sumed in the United States, 2 (3%) were acquired through sliced cantaloupe contaminated by an asymptomatically infected food handler, and no source wa s identified for 8 (13%) infections. The proportion of travel-associated in fections resistant to trimethoprim-sulfamethoxazole, sulfisoxazole, strepto mycin, and furazolidone increased from 7 (8%) of 88 in 1990-1994 to 11 (31% ) of 35 in 1995-2000. Foreign travel and undercooked seafood continue to ac count for most US cholera cases. Antimicrobial resistance has increased amo ng V. cholerae O1 strains isolated from ill travelers.