Hospital outbreaks of cholera transmitted through close person-to-person contact

Three hospital outbreaks of cholera which started in a children's infectious diseases ward in Dar es Salaam in 1977/78, 1981, and 1983 were controlled by bacteriological screening and isolation of infected patients, administration of antibacterial chemoprophylaxis to all at-risk patients and their accompanying relatives, and by reducing overcrowding. The outbreaks in 1981 and 1983 were caused by two distinct multiply antibiotic resistant E1 Tor Vibrio cholerae O1 strains. In these three outbreaks overcrowded conditions facilitated person-to-person transmission of cholera within the hospital. Cholera patients should be nursed separately and high standards of hospital hygiene should be maintained. This is one of the first reports of hospital outbreaks of cholera caused by multiply antibiotic resistant strains.