SEP report ; vol. 5, no. 2, June 1971
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SEP report ; vol. 5, no. 2, June 1971

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    • Alternative Title:
      Cholera in West Africa : comparison of the intradermal and subcutaneous routes of cholera vaccine administration (preliminary report)
    • Journal Article:
      SEP report
    • Description:
      Since El Tor cholera, Ogawa serotype, was introduced into Guinea in August of 1970, cholera disease has been reported from 13 West African countries. Cholera had not been recognized in West Africa since 1894, nor had its known spread been so extensive The countries which have officially reported cholera are Guinea, Sierra Leone, Liberia, Mali, Ivory Coast, Ghana, Upper Volta, Togo, Dahomey, Niger, Nigeria, Cameroon and Chad. The progress of this disease as it moved from west to east can be seen in Figure I. (Data not yet available from Chad.) Its spread followed basically one of two routes, the coast bordering the Gulf of Guinea or the Niger River. Thus, water (although in a different sense than the common source water-borne outbreak described by Snow at the Broadstreet Pump in London in 1854) played a major role in the dissemination of cholera. In both of these areas, water serves as the major transportation and communication link within and between countries. In the coastal area, the fishermen and traders who ply the coast without respect to international borders gradually brought the disease eastward approximately 1,750 miles over a five month period. Along the Niger River, the mode of spread by fishermen and travelers was similar, the rat e of spread faster and the effect the same. Once cholera was introduced into a given region or village, multiple factors such as the availability of a safe water supply, the cooking practices, and the level of personal hygiene and community sanitation influenced the effect of the importation.
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