Cholera--still a major health problem.

The recent outbreaks of cholera in several states of Malaysia serve as a timely reminder that cholera is still amajor public health problem in Malaysia. According to the Minister of Health, in 1991 alone there were 504 cases of cholera with 5 deathsl . Malaysia is not alone in facing this old adversary. Cholera is endemic in many countries inAsia andAfrica. In a recent survey of diarrhoea in Bangladesh, cholera was the most common enteropathogen detected, accounting for 39% ofall enteric pathogens2• Even in the United States, approximately 1 case a week is being reported, although the maj ority of cases were acquired during international traveP. In late January 1991, cholera made its first appearance in South America in the 20th century. The epidemic started in Peru but spread rapidly throughout most of Latin America. By March 1992, there were already 450,000 cases with over 4,000 deaths4,5.