Because of an editing error, a reference to epidemics in European cities in yesterday's report on cholera in Peru was placed in the wrong century. The epidemics took place in the late 19th century. (Published 2/16/91)
LIMA, PERU, FEB. 14 -- A cholera epidemic with more than 12,600 confirmed cases has claimed at least 86 lives, health authorities said today, in a nation whose standards of sanitation and hygiene have fallen to lows unprecedented in modern times.
The outbreak began last month in Chimbote, a fishing city 225 miles north of the capital. It spread rapidly down the coast and into the shantytowns surrounding metropolitan Lima.
Officials in neighboring countries have expressed fears that the disease might spread beyond Peru's borders. There were reports that three people had contracted cholera in Ecuador, and Mexican officials have burned a shipment of Peruvian canned fish.
The government here has launched a campaign to warn people of the dangers. People have been advised, for example, not to eat seviche, marinated raw fish popular here. But the number of cases continues to rise, having doubled in a week.
Cholera, a scourge of European cities in the 1800s, causes severe diarrhea that is much more intense than that caused by other diseases. If untreated, it leads to rapid dehydration, shock and death within days or even hours. If caught in time, however, cholera can easily be treated, as shown by the relatively few deaths so far.
The bacillus that causes cholera is generally spread through contaminated water. The government has closed Lima's beaches and assigned policemen to keep bathers away. Sales of bottled water are soaring.
Housing Minister Guillermo del Solar Rojas, whose department is in charge of Lima's inadequate waterworks, insists Lima's water supply is safe. But the Health Ministry advised Limenos to boil tap water for 10 minutes before drinking it or using it for cooking.
Many of the squatter-occupied shantytowns around Lima do not even have running water. The most recent localized cholera outbreak here has come in Huaycan, a shantytown whose residents often take water directly from the Rimac River, which they also use to do their washing and to dispose of wastes.
The cholera epidemic, which dominates the newspapers and the television talk shows, has focused attention on the decline of hygienic and sanitary standards in Peru. Cholera almost never spreads in communities that have adequate sewers and sewage treatment. Peru has neither.
Dr. Uriel Garcia, a former minister of health who now teaches pathology at the medical school of the private Cayetano Heredia Peruvian University, said cholera epidemics in European cities in the late 20th century spurred governments to build waterworks and sewers.
European Community specialists say the Peruvian cholera epidemic is the first registered in the Western Hemisphere since the early 20th century.
The Peruvian infrastructure has crumbled in recent decades under the pressure of massive migration from the countryside to urban areas, an economic crisis that has left the state nearly bankrupt and industry in shambles, and a persistent campaign of destruction waged by Maoist Shining Path rebels,. Limenos have become accustomed to frequent blackouts and tap water that even in the best of times has a brownish tinge.
Inadequate housing, water and power supplies and sewage treatment all contribute to a high rate of infant and child mortality. Of every 1,000 children born, 86 do not live to the age of 5. Thousands of adults die from treatable injuries -- sustained in auto accidents, for example -- because of the country's shortage of trauma centers.
"We are quite rightly alarmed by nearly 100 deaths from cholera," Garcia said. "But every year nearly 20,000 children die from other diarrheal diseases, and we hear nothing about it."
The cholera outbreak has sparked some criticism of President Alberto Fujimori, who took office last year promising an honest, technocratic approach to Peru's problems. "This government promised . . . jobs, food and health care," said Congressman Esther Moreno of the Socialist Left, one of the opposition coalitions. "They simply have not done what they said they would."
But others credit a governmental educational program with bringing the death rate from cholera below 1 percent. In the early days of the outbreak, 15 percent of those who contracted the disease were dying.
Lima Mayor Ricardo Belmont said he will seek new restrictions on street vendors who sell prepared foods from carts in the central city. Random tests, he said, showed that almost all of the vendors were selling food that showed some kind of bacteriological contamination.
Little is known about how the cholera epidemic began except that the first cases were seen in Chimbote. One theory is that the microbe was brought to Peru by a sailor aboard a Panamanian-flag freighter that docked in Chimbote after visiting ports in Asia.
Government officials are now trying to prevent the disease from spreading throughout Lima, a city of nearly 7 million. Garcia said cholera tends to spread quickly and disappear just as quickly, but it is impossible to say how long it will be a fact of Peruvian life.