In a follow up to a report earlier this month, the cholera outbreak in Mexico has increased significantly in the past week or so, according to the Pan American Health Organization (PAHO).

The PAHO reports that the Mexico International Health Regulations (IHR) National Focal Point (NFP) reported 159 confirmed cases, including one death, of infection with Vibrio cholerae O:1 Ogawa toxigenic.

This up from the 46 cases reported on Oct. 2.

More than nine out of 10 cholera cases are reported from the state of Hidalgo (145 cases or 91.2%), with the remaining cases being reported from the Federal District (2), San Luis Potosi (1), Veracruz (2) and nine from the state of Mexico.

It is reported that the source of contagion is a river that provides the water supply for the local population.

Mexican health authorities say that in the specific case of Hidalgo, a detailed analysis found that “the source of contagion is the pollution of the river, whose water is used by the local population for daily activities like washing food and clothes, for personal hygiene and other uses.”

PAHO reports this is the first local transmission of cholera recorded since the 1991-2001 cholera epidemic in Mexico. The genetic profile of the strain isolated from patients in Mexico presents high similarity (>95%) with the strain that is currently circulating in three Caribbean countries (Haiti, Dominican Republic and Cuba), and is different from the strain that had been circulating in Mexico during more than a decade ago.

According to the Centers for Disease Control and Prevention (CDC), Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae.

An estimated 3-5 million cases and over 100,000 deaths occur each year around the world. The infection is often mild or without symptoms, but can sometimes be severe.

Approximately one in 20 (5%) infected persons will have severe disease characterized by profuse watery diarrhea, vomiting, and leg cramps. In these people, rapid loss of body fluids leads to dehydration andshock. Without treatment, death can occur within hours.

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