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Cholera Is Walking South

Mario Masana Wilson, MD; César Chelala, MD, PhD
JAMA. 1994;272(15):1226-1227. doi:10.1001/jama.1994.03520150100051.
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Since it began in January 1991 in Peru,1,2 the cholera epidemic has steadily expanded throughout the continent. In its expansion south, after reaching Bolivia, cholera has spread to Argentina—initially through the border area between the two countries—and has become a critical health problem in both countries. The special characteristics of the region, and the nature of the interdependencies of the people living on both sides of the border, emphasize the need to lend special attention to that area.

Figure 1 shows the spread of the epidemic from three initial towns in Peru to all the countries in South America, with the exception of Uruguay, as well as Mexico and all Central American countries. The Table shows the total number of cases and the fatality ratio for 1991 through 1993, which range from 606 652 cases in Peru to three cases in Paraguay.3-5 At the end of 1993, 31


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