{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T04:18:13Z","timestamp":1791087493022,"version":"4.1.0"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[1997,6,1]],"date-time":"1997-06-01T00:00:00Z","timestamp":865123200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[1997,6]]},"abstract":"<jats:p>Between 23 August and 15 December 1990 an epidemic of cholera affected \nMozambican \nrefugees in Malawi causing 1931 cases (attack rate=2\u00b74%); 86% of \npatients had arrived in \nMalawi &lt;3 months before illness onset. There were 68 deaths \n(case-fatality rate=3\u00b75%); \nmost deaths (63%) occurred within 24 h of hospital admission which may \nhave indicated \ndelayed presentation to health facilities and inadequate early rehydration. \nMortality was higher \nin children &lt;4 years old and febrile deaths may have been associated with \nprolonged IV use. \nSignificant risk factors for illness (<jats:italic>P<\/jats:italic>&lt;0\u00b705) in two \ncase-control studies included drinking river \nwater (odds ratio [OR]=3\u00b70); placing hands into stored \nhousehold drinking water (OR=6\u00b70); \nand among those without adequate firewood to reheat food, eating \nleftover cooked peas (OR=8\u00b70). Toxigenic <jats:italic>V. cholerae<\/jats:italic> O1, \nserotype Inaba, was isolated from patients and stored household \nwater. The rapidity with which newly arrived refugees became infected \nprecluded effective use \nof a cholera vaccine to prevent cases unless vaccination had occurred \nimmediately upon camp \narrival. Improved access to treatment and care of paediatric patients, \nand increased use of oral \nrehydration therapy, could decrease mortality. Preventing future cholera \noutbreaks in Africa \nwill depend on interrupting both waterborne and foodborne transmission \nof this pathogen.<\/jats:p>","DOI":"10.1017\/s0950268896007352","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T13:23:42Z","timestamp":1027776222000},"page":"207-214","source":"Crossref","is-referenced-by-count":73,"title":["Epidemic cholera among refugees in Malawi, Africa: \ntreatment and transmission"],"prefix":"10.1017","volume":"118","author":[{"given":"D. L.","family":"SWERDLOW","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"MALENGA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"BEGKOYIAN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"NYANGULU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"TOOLE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. J.","family":"WALDMAN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. N. D.","family":"PUHR","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. V.","family":"TAUXE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[1997,6,1]]},"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268896007352","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,2]],"date-time":"2019-09-02T16:19:22Z","timestamp":1567441162000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268896007352\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,6]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1997,6]]}},"alternative-id":["S0950268896007352"],"URL":"https:\/\/doi.org\/10.1017\/s0950268896007352","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[1997,6]]}}}