[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]


Week 44, 27 Oct - 2 Nov 2013


Cholera - Mexico - Monitoring outbreak 2013

Opening date: 14 October 2013 Latest update: 31 October 2013

Epidemiological summary

As of 28 October 2013, Mexico has reported 176 confirmed cases, including one death, of infection with Vibrio cholerae O:1 Ogawa toxigenic.

The affected areas include the Federal District (2 cases), the state of Hidalgo (157 cases), the state of Mexico (9 cases), the state of San Luis Potosi (2 case) and the state of Veracruz (6 cases).

Eighty-nine of the total confirmed cases are women and 87 are men. Fifty-seven cases have been hospitalised.

An antimicrobial susceptibility test for Vibrio cholerae O1 Ogawa toxigenic was conducted by the Institute of Epidemiological Diagnostics and Reference (InDRE) which demonstrated that the bacterium was susceptible to doxycycline and chloramphenicol, with reduced susceptibility to ciprofloxacin and resistance to trimethoprim/sulfamethoxazole.

The current strain is different from the one that circulated in Mexico during 1991-2001. However, the genetic profile of the bacterium obtained from patients in Mexico presents high similarity (95%) with the strain that is currently circulating in three Caribbean countries (Haiti, Dominican Republic and Cuba).

Investigation results are indicating that river water is the source of contamination for the affected persons in the state of Hidalgo.


ECDC assessment

This is the first sustained autochthonous transmission of cholera recorded in Mexico since the 1991-2001 endemic period. Travellers to Mexico and to the other affected countries in the region (Cuba, the Dominican Republic and Haiti) should be aware of preventive hygiene measures and seek advice from travel medicine clinics prior to their departure, to assess their personal risk.

In addition, physicians in the European Union should consider the diagnosis of cholera in returning travellers from these countries presenting with compatible symptoms. Upon diagnosis, notification to the relevant public health authorities is essential.


ECDC published an epidemiological update on 10 October.