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May 10, 1995

All Vibrio cholerae Infections Are Not Created Equal-Reply

Author Affiliations

University of California, San Diego
Centers for Disease Control and Prevention Atlanta, Ga
Maryland Department of Health and Mental Hygiene Baltimore

JAMA. 1995;273(18):1417. doi:10.1001/jama.1995.03520420029020

In Reply.  —Dr Harris describes three persons with diarrheal illness acquired in Maryland. The only apparent common exposure was consuming crabs harvested from the Chesapeake Bay, and stool cultures grew V cholerae. However, these illnesses were not cholera. The isolates from the three patients were identified as non-O1, non-O139 V cholerae in the Maryland Department of Health and Mental Hygiene laboratory.There are 140 known serotypes of V cholerae. Cholera is caused only by cholera toxin—producing strains of two of these serotypes—V cholerae 01 and V cholerae 0139. Infection with non-O1, non-O139 serotypes can cause diarrheal illness, as can infection with nontoxigenic 01 strains.1 However, these infections are generally less severe, and they do not have epidemic potential. They are properly termed non-01 V cholerae infections, not cholera. Infection with these organisms is not reportable.Cholera is reportable in every state. The Maryland Department of Health and Mental

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