To the Editor.
—The recent article by Dr Besser and colleagues1 recommends a travel history on all patients with diarrhea and dehydration. Physicians in the United States should also be aware that cholera may no longer be limited to the third world.I practice in the rural part of Maryland's Eastern Shore— just 90 minutes from Washington, DC, and Baltimore—and recently treated three people with cholera acquired locally. One was an elderly, homebound man who had been no further than his ground floor for 10 years. He required 500 mL/h of IV fluids to keep abreast of his stool output. A grandson is a waterman and had brought crabmeat to his home a week before the patient became ill.The other two patients were a mother and small child who had eaten cooked crabs bought in a local market. Both did well with outpatient rehydration. Neither patient had been