Epilogue

Abstract

In January 1991, epidemic cholera appeared explosively in villages, towns, and cities along the Peruvian coast. In the following year, the epidemic spread swiftly throughout Latin America, challenging the health infrastructure of the entire Western Hemisphere. It resembles the great urban epidemics of nineteenth century Europe and the United States in its intensity, and is spreading with late twentieth century velocity. Mortality rates have been low because of widespread use of fluid replacement therapy, including oral rehydration solutions (ORS). The extraordinary numbers of patients needing emergency treatment, however, have strained the resources of many Ministries of Health. The economic impact of many countries has been substantial. Tourists hesitate to visit areas affected by epidemic cholera, and exporters encounter concern that foodstuffs in international trade could transport cholera. We confront this new cholera epidemic with tools to understand and control it that have been under development for many years. The epidemic brings new challenges and the opportunity for rapid advances in knowledge of the organism and in the means to limit the number of infections it causes.