On 1 October, 46 confirmed cases of cholera, including one death, were reported by the Pan American Health Organization (PAHO) in Mexico. Of those, two were identified in the Federal District and 44 in the state of Hidalgo. However, media reports mention up to 81 confirmed cases: 77 in the state of Hidalgo, two in the state of Mexico and two in the Federal District, which is the most populated area of Mexico.
Of the cases where information was available, 44% are male and 56% are female, age ranging from two to 82 years old; 30% have been hospitalized.
This is the first sustained autochthonous transmission of cholera recorded since the 1991-2001 endemic period. These infections are caused by Vibrio cholerae O:1 Ogawa toxigenic. The strain is different from the one that circulated in Mexico during the 1991-2001. Genetic testing suggests this strain to be similar to the strain currently circulating in Haiti, Dominican Republic and Cuba.
Travellers to Mexico should be aware of preventive hygiene measures and seek advice from travel medicine clinics prior to their departure, to assess their personal risk. In addition, physicians in the European Union should consider the diagnosis of cholera in returning travellers from Mexico presenting with compatible symptoms. Upon diagnosis, notification to the relevant public health authorities is essential.
In Cuba, according to the same update, 678 confirmed cholera cases, including 3 deaths, have been reported from July 2012 through August 2013. The affected provinces are Camaguey, Granma, Guantanamo, Havana, and Santiago de Cuba. Twelve of the confirmed cases had travelled to Cuba from other countries (two from Chile, two from Germany, three from Italy, one from the Netherlands, two from Spain, and two from Venezuela). The overall risk for travellers is still considered low.