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21 Jan 2013

Cholera - Cuba - Monitoring outbreak (ECDC/CDTR, January 21 2013, edited)

[Source: European Centre for Disease Control and Prevention (ECDC), full PDF document: (LINK). Edited.]


Cholera - Cuba - Monitoring outbreak

Opening date: 4 July 2012 Latest update: 11 January 2013


Epidemiological summary

In June and July 2012, the communicable diseases surveillance system in Cuba recorded an increasing trend in diarrhoeal diseases, which were thought to be caused by high temperatures and heavy rains.

In Granma province, around 1 000 patients were reported to have been treated for gastrointestinal infections and among them 85 were confirmed to be infected with Vibrio cholerae.

Three of the confirmed cholera cases have died. Control measures were put in place and on 27 August 2012, the Cuban Ministry of Public Health declared the outbreak to be over.

Another 47 cases were confirmed in the aftermath of hurricane Sandy (October 2012), in the provinces of Santiago de Cuba, Camag├╝ey and Guantanamo.

By the end of 2012, the cumulative number of cases reached 500. On 6 January 2013, the Cuban public health authorities notified an increase of acute diarrheal diseases in Havana. As of 14 January 2013, 51 cases of cholera have been confirmed in the capital and were subtyped to be Vibrio cholerae toxigenic serogroup O1, serotype Ogawa, biotype El Tor.

In response to the outbreak, the Cuban authorities are strengthening public health eduction to raise awareness among the population with an emphasis on hand hygiene and safe food and drinkable water consumption.

Websources: Official press release |PAHO update 7 Jan 2013| PAHO update 15 Jan 2013 | ECDC Factsheet | Cuban press release January 2013


ECDC assessment

The report of 51 confirmed cases in Havana, Cuba, raises the risk for European travellers for contracting the disease, compared to the previous rapid risk assessment in July 2012 taking into account that half of the tourist arrivals to Cuba is to Havana. However, the overall risk should still be considered low.

Applying suitable preventive hygiene measures plays a key role in the prevention of the disease. Visitors to cholera-endemic or cholera-epidemic countries should always follow appropriate precautionary measures and drink only safe water (bottled water/water treated with chlorine), wash all fruits and vegetables with bottled or chlorinated water before consumption, regularly wash hands, avoid consuming raw sea-food products, and only eat sea food when thoroughly cooked.

Travellers should seek advice from travel medicine clinics to assess their personal risk. Physicians in the EU should consider the diagnosis of cholera in returning travellers from cholera endemic/epidemic countries including Haiti, the Dominican Republic and Cuba presenting with compatible symptoms. Physicians and clinical laboratories need to follow public health guidance on the notification of cholera cases.



ECDC is preparing an updated rapid risk assessment in January 2013.