Infection is always acquired by swallowing food or water that has been contaminated with the bacteria. The researchers say that reported cases of cholera are probably only a fraction of the actual number of cases because as many as 80 to 90 percent of symptomatic cholera infections may cause only mild diarrhea, and many patients might not seek care. If a patient seeks medical care, the researchers say it is important that a stool sample is cultured on appropriate media. Information cited in the article shows that more than one-million cholera cases have been reported to the Pan American Health Organization as of June 1995 from the cholera epidemic in Latin America. At least 10,000 deaths have resulted from the epidemic.
Cholera is also a significant problem in parts of Asia.
The researchers found that of the 160 cholera cases reported in the U.S. and its territories between 1992 and 1994, the location of exposure was known in 158 cases. The cases were reported in 20 states and Guam. One patient died. Of particular concern to the researchers is the fact that some strains of the cholera are highly resistant to antibiotic treatment, something that wasn't the case in previous years. Cooked foods should be eaten hot.