Hospital-Based Epidemiology of Childhood Cholera: A 6-Year Review in a University Hospital in Bangkok, Thailand
Chitsanu Pancharoen MD*, Narut Niwattanakanjana MD**, Jutarat Mekmullica MD***, Voranush Chongsrisawat MD*
Affiliation : * Department of Pediatrics, Faculty of Medicine, Chulalongkorn University ** Department of Pediatrics, Wichianburi Hospital, Petchaboon *** Department of Pediatrics, Bhumibol Adulyadej Hospital
Background : Cholera is the cause of severe acute watery diarrhea. Without proper fluid therapy, severe cholera kills half of the
affected patients. In terms of epidemiology and surveillance, up-to-date information of this disease in each country is essential.
Objectives : To evaluate 1) prevalence, serogroups, serotypes and antimicrobial susceptibility pattern of V. cholerae, and
2) demographic data and clinical manifestation of pediatric patients with cholera.
Materials and Methods : Microbiogical records of children aged 0-15 years with cholera, who were treated at King
Chulalongkorn Memorial Hospital, Bangkok, Thailand, between January 1995 and December 2000 were retrospectively
reviewed. Serogroups, serotypes, and antimicrobial susceptibility of V. cholerae were studied. Medical records of children with
positive stool cultures for V. cholerae were reviewed in terms of demographic data, clinical manifestation of the patients.
Results : Of 11,709 stool culture specimens, pathogenic bacteria were found in 1,745 specimens and 95 specimens (5.4%) were
positive for V. cholerae. V. cholerae O1 and non-O1/non-O139 were found in 52.6% and 47.4%, respectively. Common
serotypes of V. cholorae O1 were Ogawa. Antimicrobial susceptibility of the pathogens to co-trimoxazole, ampicillin,
ceftriaxone, ciprofloxacin and gentamicin were 55.0%, 56.4%, 91.4%, 92.5% and 94.9%, respectively.
Age distribution of the patients ranged from 2 months to 15 years with an average age of 2.92 years. Clinical
manifestations included acute watery diarrhea (92.8%), vomiting (56.4%), fever (37.5%), hypotension (19.6%) and abdominal
pain (3.8%). Stool leukocytes were microscopically detected in 20% of the patients. No patients died in the present study.
Conclusion : Childhood cholera in Thailand still exists. Most patients presented with acute watery diarrhea. Regarding
antimicrobial susceptibility pattern, ceftriaxone and quinolones are appropriate drugs of choice.
Keywords : Cholera, Vibrio cholerae, Children
