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Sir, In Pakistan, almost every individual suffers from diarrhoeal diseases, at least once a year (1). Due to poor living conditions and sanitation practices, people of northern areas of Pakistan face health hazards (2). Rates of parasitic and bacterial gastrointestinal infections are very high, and sometimes, outbreaks occur (3). Two of such outbreaks occurred in 1997 and 1999. This study investigated the referred cholera cases of these two outbreaks in northern areas of Pakistan, including Gilgit, Ghizer and Diamer districts. Faecal specimens of 332 patients with suspected cholera from different localities were cultured within two hours after collection and analyzed (4). Vibrio cholerae El Tor, Ogawa O1, was the main aetiological agent. The table shows the isolation of V. cholerae in 1997 and 1999 from different localities. In 1997 and 1999, the proportion of specimens positive for V. cholerae was 37.35% and 34.94% respectively. No V. cholerae was found from 11 other areas reporting diarrhoeal cases. Two years later, V. cholerae was identified from many of the same areas and from other areas although it was not identified before. One foreign tourist in 1997 and four in 1999 were reported to have gastroenteritis, but cultures from these were negative for V. cholerae.

Vibrio cholerae El Tor, Ogawa O1, as the main aetiological agent of two major outbreaks of gastroenteritis in northern Pakistan.