Cholera in a Paris resident with no history of travel. A case report

BACKGROUND: Cases of imported cholera are frequently observed, but cholera almost never occurs in subjects who have never travelled to an endemic area. In the last 30 years, 4 cases have been reported. We report an indigenous case diagnosed in Paris in September 1996. CASE REPORT: The patient was hospitalized for severe dehydration and acute renal failure. Cultures of a fecal specimen grew Vibrio cholerae O1 Ogawa serotype. An epidemiological study was conducted to identify the vehicle and mode of contamination and suggested that this case was associated with the consumption of fresh sorrel imported from West Africa. No other cases were identified in contacts of the patient. DISCUSSION: Asymptomatic carriage of V. cholerae is rare. However, air travel has allowed people to arrive in non-endemic areas during the incubation period. The agent may also be transported in contaminated foods. Cholera should be suspected in all adults presenting acute watery diarrhea with severe dehydration. History taking should also look for risk exposure and these patients should be systematically asked about possible exposures.