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December 10, 1982

Vibrio cholerae Infections

Author Affiliations

Department of Health and Human Services Atlanta

JAMA. 1982;248(22):2972. doi:10.1001/jama.1982.03330220018019

To the Editor.—  The article entitled "Cholera on the Texas Gulf Coast" (1982;247:1598) failed to make the critical distinction between Vibrio cholerae 01, the cause of epidemic cholera, and non-01 V cholerae, which, until recently, was included in a poorly defined category referred to as nonagglutinating vibrios or non-cholera vibrios. Although these two organisms are biochemically identical and differ serologically only in their ability to agglutinate in O-group 1 antiserum, they should be distinguished because they have different clinical, pathogenic, and epidemiologic characteristics.Clinically, both organisms may produce severe, watery diarrhea. However, unlike most cholera cases, persons with non-01 V cholerae diarrhea may have fever and have blood in their stools.1 Non-01 V cholerae is also associated with infection at extraintestinal sites, eg, the blood, ear, wounds, and the CNS, while V cholerae 01 infects only the gastrointestinal or biliary tract.2Both organisms may cause diarrhea by producing