Second cholera case in a week confirmed, also possibly due to raw fish

A 73-year-old woman in Geoje, South Gyeongsang, was confirmed Thursday to have had the second domestic case of cholera in a week, barely two days after a man was anmounced the first in 15 years.

The Ministry of Health and Welfare said in a statement that the woman appears to have caught the disease after eating raw Spanish mackerel at her church on Aug. 14. Undercooked seafood is a main source of the Vibrio cholerae bacterium, which causes cholera.

She had diarrhea the very next day and went to a nearby hospital on Aug. 17. Within a week, the hospital came to the conclusion she had cholera, reported the case to a local health center and had local authorities run an additional test, which confirmed it.

She was discharged from the hospital on Wednesday after making a full recovery, the Health Ministry said, which normally means the end of diarrheal bouts followed by 48 hours of quarantine.

The first patient, who also appears to have been affected by raw fish during a family vacation, has also been discharged. But authorities aren’t clear exactly where he contracted the disease because he spent a day in Tongyeong, South Gyeongsang, and another day in Geoje, eating raw seafood in both places.

If the man became infected in Geoje, however, it would mean both patients contracted cholera in the same southeast coastal city.

As to whether the two incidents hint at a national outbreak of cholera, the Health Ministry said chances for now are “extremely low.”

For one thing, human-to-human infection “isn’t common,” said Jung Ki-suck, director of the Korea Centers for Disease Control & Prevention (KCDC), because in an epidemic, the source of the contamination is usually food or water tainted by the feces of an infected person. Korea’s infrastructure is too developed to allow for that scenario, he said.

Chances of national seawater being contaminated by the virus are also near-zero because with over 700 to 800 examinations held annually, not once have the results been positive in recent years, said Gwak Sook-young, head of the KCDC’s Infectious Disease Control Center.

Authorities suspect that the seafood in both incidents was improperly handled.

“People aren’t cautious enough,” said Jung, director of the KCDC. “At some seafood restaurants, chefs rinse their knives with seawater.

Then you have all these germs, which grow over time to about 100 million bacteria. Knives should be washed with fresh water and meticulously dried under the sun.”

Leaving all possibilities open, health authorities formed emergency task forces to check whether any cholera patients have gone undetected. The seas will also be thoroughly examined for contamination. Teams of government officials have been dispatched to the restaurants the first patient visited in order to check whether the virus was spreading in their kitchens.

The person who provided the second patient with the raw fish at church is also being questioned concerning where he caught the fish and how he handled it before serving.

Down in Geoje, the public scare already seems to be playing out, especially among merchants.

Mr. Choi, the owner of a 21-year-old seafood restaurant, said he had had no reservations during lunch hours on Thursday, a sharp contrast to when he used to have five to six groups around this time of year.

“I run a fish restaurant. There’s no way I can stop selling fish,” lamented Choi. “I’m really concerned things might stay this way.”
But consumers like Ms. Kim, 54, had other thoughts. Visiting from Busan, cholera was the least of her worries.

“I heard cholera had a really low fatality rate,” she said with a shrug. “I’m not that afraid.”

BY LEE SUNG-EUN, WEE SUNG-WOOK [lee.sungeun@joongang.co.kr]