National Enteric Disease Surveillance : Cholera and Other Vibrio Illness Surveillance (COVIS)
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National Enteric Disease Surveillance : Cholera and Other Vibrio Illness Surveillance (COVIS)

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    • Alternative Title:
      Cholera and Other Vibrio Illness Surveillance (COVIS);COVIS;
    • Description:
      Infection with pathogenic species of the family Vibrionaceae can cause two distinct categories of infection: cholera and vibriosis, both of which are nationally notifiable.

      Cholera is, by definition, caused by infection with toxigenic Vibrio cholerae O1 or O139 and was first reported in the United States in 1832. Infection is characterized by acute, watery diarrhea. An average of 5-10 cases of cholera are reported annually in the United States; most are acquired during international travel, however, on average 1-2 per year are domestically acquired. An increase in the number of cholera cases reported in the United States has occurred when there are cholera outbreaks in the Western Hemisphere, such as Latin America in the 1990s and Haiti in 2010, with almost all attributable to exposures during international travel. CDC annually reports to the World Health Organization all confirmed cholera cases diagnosed in the United States.

      Vibriosis is caused by infection with any species of the family Vibrionaceae (excluding toxigenic Vibrio cholerae O1 and O139), with an estimated 80,000 cases and 300 deaths annually in the United States (1). The most common clinical manifestations are watery diarrhea, primary septicemia, wound infection, and otitis externa. Risk factors for illness include consumption of shellfish, particularly raw oysters, and contact with natural bodies of waters, especially marine or estuarine waters. Vibrios were first recognized as an important pathogen in the United States in the 1970s, and in January 2007, the Council of State and Territorial Epidemiologists (CSTE) recommended that infection with all Vibrio species be nationally notifiable; in 2011 the case definition of vibriosis was expanded to include infection with any species in the family Vibrionaceae (see the ‘Overview of taxonomy’ section for more details).

      The Cholera and Other Vibrio Illness Surveillance system (COVIS) was initiated by CDC, FDA, and the Gulf Coast states (Alabama, Florida, Louisiana, and Texas) in 1988 (3). By the early 2000s, several years before vibriosis became nationally notifiable, almost all states were voluntarily reporting. CDC maintains COVIS to obtain reliable information on illnesses associated with a species in the family Vibrionaceae; we provide this information, which includes risk groups, risk exposures, and trends to regulatory and to other prevention agencies.

      Reference citation: Centers for Disease Control and Prevention (CDC). Cholera and Other Vibrio Illness Surveillance Overview. Atlanta, Georgia: US Department of Health and Human Services, CDC, 2012.

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