Occurrence of Vibrio cholerae in municipal and natural waters and incidence of cholera in Azerbaijan.

Cholera, a waterborne disease caused by Vibrio cholerae, is an autochthonous member of the aquatic environment and predominantly reported from developing countries. Technical reports and proceedings were reviewed to determine the relationship between occurrence of V. cholerae in natural waters, including sources of municipal water, and cases of cholera in Azerbaijan. Water samples collected from different environmental sources from 1970 to 1998 were tested for V. cholerae and 0.73% (864/117,893) were positive. The results showed that in April of each year, when the air temperature rose by approximately 5°C, V. cholerae could be isolated. With each increase in air temperature, 6-8 weeks after, impact on cases of cholera was recorded. The incidence of cholera peaked when the air temperature reached >25°C during the month of September. It is concluded that a distinct seasonality in cholera incidence exists in Azerbaijan, with increased occurrence during warmer months.