Cholera has been reported in all of Latin America except Uruguay. Cholera cases were first recognized in Peru in the last week of January 1991 and by the end of 1995 had affected a total of over 1,000,000 people throughout countries in Latin America. Cholera has been reported in a small number of U.S. residents traveling to several Latin American countries. However, the risk of infection to the U. S. traveler is very low, especially for those who follow the usual tourist itineraries and stay in standard accommodations. Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae.
Most infected persons have no symptoms or only mild diarrhea.
However, persons with severe disease can die within a few hours after onset due to loss of fluid and salts through profuse diarrhea and, to a lesser extent, through vomiting if not properly treated. Cholera is transmitted by ingestion of contaminated food or water through municipal water supplies, ice made from that water, foods and beverages bought from street vendors, and vegetables irrigated with fresh sewage. Travelers should not assume municipal water in affected areas is safe to drink, even if the local information is reassuring. Previous experience in other cholera epidemics and other epidemiological investigations also suggest that raw and undercooked seafood are important in the transmission. It is particularly important to avoid raw or undercooked seafood.