Officials do not expect to find many new cholera cases among passengers and crew members who took a Feb. 14 flight from Buenos Aires to Los Angeles because the incubation period has passed, a top Los Angeles health official said Saturday.
"We can't say that nobody who is presently ill might not have complications," said Dr. Shirley Fannin, director of disease control for the county's Department of Health Services. "I will not say that there will not be another death. But I would say that a new acute illness leading to death is not likely because the five-day incubation period ended last Wednesday."
Eight passengers of the 336 who took Aerolineas Argentinas' Flight 386 from Buenos Aires to Los Angeles are confirmed to have cholera. One victim, Anibal Cufre, 70, died at an Arcadia hospital Tuesday. At least 57 more are confirmed to have symptoms that may indicate cholera.
After the outbreak was confirmed Wednesday, the number of victims increased daily as an emergency team of doctors, nurses, and epidemiologists started tracking down passengers and warning hospitals to be alert to patients with symptoms. The incubation period for the disease is one to five days.
Fannin said health officials are concentrating on "how many pieces of the puzzle we have. Nothing has been leaping out at us in terms of a cause. So, we're consolidating our passenger interview list. We're collecting material. We're doing the shoe-leather things, like interviewing people who claim they have an illness and confirming that it is cholera."
Some of the 57 with symptoms may have diarrhea common to travelers around the world instead of cholera, she said. The prime symptom of cholera is diarrhea that can quickly lead to dehydration, particularly in the very old and young. It is readily treatable with antibiotics, but can lead to death within hours if untreated.
Questionnaires are being handed out to passengers asking them to identify what food and water they consumed and where they consumed it. According to newspaper reports published in Buenos Aires, those who became ill apparently all traveled in tourist class.
A cholera epidemic has been sweeping South America in the last few years, claiming 4,000 lives, 3,000 of them in Peru. Officials in Peru and Argentina have been blaming one another for causing the outbreak. Aerolineas Argentinas officials noted that the flight had stopped in Lima, and has suspended its Peruvian stopovers.
However, the Peruvian caterer that supplied meals for the last leg of the trip, Cocinas de Vuelo Docampo S.A., has denied any responsibility, saying it distributed 2,500 meals for 14 flights that day and none of the other flights experienced problems.
"Pointing fingers gets to be pointless, non-productive behavior," Fannin said. "There are two points to focus on now. One is the potential for someone to be somewhere and be treated without a proper diagnosis. That's primary for passengers.
"The second is international travel. People . . . have a right to expect that their common carriers are going to be safe."
The disease can become endemic in poor settlements where sewage and drinking water mixes. But there is little danger of it being passed among strangers or becoming a problem in countries with safe drinking supplies. The last serious outbreak in Los Angeles is believed to have been during the mid-1800s before the city had sewers.
Anyone who took Flight 386--including those who have no symptoms--are being asked to call county health officials at (213) 725-5411 or (213) 725-5413.