Cólera en Bolívar de 1991 a 1997

Abstract

Cholera, which has been present throughout the centuries in an endemic and epidemic form, continues to be a public health problem. Since 1991, when cholera appeared in our countryfor the first time in this century, the Bolívar department has been one of the most affected on Colombia's Atlantic coast. At that timethedepartment's health authority (Dasalud) asked the Universityof Cartagena's Postgraduate Microbiology Laboratory for technological help in microbiological diagnosis and human resource training. This work, describing inter-institutional cooperation was thus brought into effect with the intention of analysing cholera behaviour in Bolívar's municipalities. From the index case, suspected patient sample collection was begun in Dasalud's five regions. Diagnosis of the disease was based on established clinical, microbiological and epidemiological criteria. Faecal samples, being the means of disease transmission, were processed for isolation and identification in bacteriological and biochemical culture media and for serotyping with specific antisera. From September 1991 to the eighth epidemiological period of 1997, 38 of the 42 municipalities reported 3,470 cases. 94.6% occurred in region 1 and 3; 60.2% occurred in men and 39.8% in women; 79.2% were olderthan 14 years of age; there were 33 deaths. Vibrio cholerae 01 biotype El Tor serotypes lnaba and Ogawa was the microbiological diagnosis in 39.8% of the cases. Vibrio cholerae01 serotype Ogawa, present in the 1995 outbreak, displaced the lnaba serotype which had prevailed in 1991 In 1991 the number of cases was nine times greater than in the 1995 outbreak. In 1997 there was a 45.2% increase in relation to the last two years. Mortality, in its turn, has shown worrying indices from 1992 onwards. The most affected municipalities were: Cartagena, Mahates, Montecristo, María la Baja, Pinillos, Achí, Magangué, Arjona, Turbana, Calamar, Mompox, Santa Catalina, Hatillo de Loba, Carmen de Bolívar, Villanueva, Zambrano, Morales, Talaigua Nuevo and Río Viejo, amongst others.