Cholera in children in Karachi from 1990 through 1995: a study of cases admitted to a tertiary care hospital.

Although cholera is an endemic disease in Bangladesh, India and other countries, it was never a significant cause of gastroenteritis in Pakistan before 1988. Since then, cases of cholera are identified each year, both in adults and children in Pakistan. In order to see the contribution of Vibrio cholerae as a cause of gastroenteritis in children, we reviewed the cases of cholera admitted in the pediatric ward of the Aga Khan University Hospital, Karachi, Pakistan. Of 4346 children hospitalized with gastroenteritis during 1990 through 1995, 348 children (8%) were confirmed to have cholera. The youngest child with cholera was seven days old. The mean age was 31 +/- 34 months. The cases of cholera were received from all over the city. Most cases were due to Vibrio cholerae Ogawa biotype ELTOR but the new strain, i.e., Vibrio cholerae 0139 was isolated in 14% cases in 1994. The sensitivity of Vibrio cholerae has also changed. In 1994, the organisms were resistant to commonly recommended antibiotics, i.e., tetracycline, ampicillin and erythrocin but sensitive to ceftrioxone, cefixime, ofloxacin and nalidixic acid. Adequate measures to improve hygiene and sanitation and supply of safe potable water is needed to prevent any future epidemic of cholera in the city.