Epidemiology of eltor cholera in rural Bangladesh: importance of surface water in transmission.

In order to define the role of water used for drinking, cooking, bathing, and washing in the transmission of Vibrio cholerae biotype eltor infections in an area with endemic cholera, surveillance was initiated in neighbourhoods with a culture-confirmed cholera index case and others with index cases with non-cholera diarrhoea as controls. In neighbourhoods with cholera infection, 44% of surface water sources were positive for V. cholerae, whereas only 2% of surface sources were positive in control neighbourhoods. Canals, rivers, and tanks were most frequently positive. There was an increased risk of infection for families using water from culture-positive sources for drinking, cooking, bathing, or washing and for those using water sources used by index families for drinking, cooking or bathing.…