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The outbreak was first recognised on 17 April 2000. As of 26 June 1,596 cases of watery diarrhoea have been reported - a figure based on inpatient and outpatient records from the Pohnpei Hospital together with data provided by community-based dispensaries. Nine deaths have been associated with the outbreak. Vibrio cholerae has been isolated by the Pohnpei Hospital and confirmed as the Ogawa serotype. Of these suspected cholera cases, 954 meet the World Health Organization case definition for cholera.2 The epidemic is consistent with an initial point-source outbreak at a large funeral at Kitti, followed by a mixture of person-to-person transmission and additional point source outbreaks in a clockwise direction around the island.
Up to 27 June 2000, 368 (92%) of the 399 admissions to hospital, and 625 (80%) of 777 outpatient and emergency department presentations with acute watery diarrhoea, met the WHO case definition for cholera. Of the hospitalised cases, 40% were male, with adults more commonly infected. There appeared to be a bimodal distribution, with highest rates in males in the 65-74 year age group, and in females 20-24 years or over 75 years old.
Of the 777 non-hospitalised suspected cholera patients, 50% were male and 119 were less than five years of age. Due to possible multiple outpatient visits by the same patient, together with recording and data entry errors, the figures for non-hospitalised cases need to be treated with caution.
1. Information provided by the Federated States of Micronesia Department of Health via the Pacific Public Health Surveillance Network, 30 June 2000.
2. For surveillance purposes, in an epidemic situation, the case definition for suspected cholera is a person five years of age or greater developing acute watery diarrhoea.
This article was published in Communicable Diseases Intelligence Volume 24, No 6, June 2000.