Cholera in Lao P. D. R.: Past and Present

Lao People’s Democratic Republic (Lao PDR) is a mountainous country in Southeast Asia, situated along the Mekong and bordering China, Vietnam, Cambodia, Thailand, and Myanmar. Cholera epidemics are known to have occurred in Laos during the time of the French colonial era and the Kingdom of Laos period prior to the establishment of Lao PDR in 1975. There are public records of cholera epidemics in 1895 to 1902 of the French era (Monnais-Rousselot, 1999) and in the 1910s, 1953 and 1969 of the Kingdom era (Nakamura and Iwasa, 2008). However, after the establishment of Lao People’s Democratic Republic (Lao PDR), it was presumed that there were no epidemics of cholera and, at the level of both rural and central government, cholera was not sufficiently recognized prior to 1993. Acquisition of pandemic information on cholera was severely restricted, due to the establishment of a socialist state system in Laos and its isolationist state from 1975 to the mid-1980s. Moreover, while diarrhea and/or fever outbreaks caused by unknown pathogens were common in remote areas of mountainous districts equipped with few health resources, case detection or confirmation was quite difficult because almost all the cases had ceased by the time the reports reached the central government. Since these areas had scant populations with a scattered distribution of small size villages, the roads to which they were connected were poor; thus, confirmed diagnoses of the diseases could not be made because the areas could not be accessed easily, and prudent control was not exercised with the