The acute intestinal infection caused by the bacterium Vibrio cholerae is wreaking havoc in at least four countries in the Americas, and it may soon arrive in Costa Rica. The Ministry of Public Health has been preparing for what officials believe will be an imminent return of cholera across Central America, and two suspected cases were recently ruled out.

As defined by the online health reference site Medscape, cholera is:

an intestinal infection caused by Vibrio cholerae. The hallmark of the disease is profuse secretory diarrhea. Cholera can be endemic, epidemic, or pandemic. Despite all the major advances in research, the condition still remains a challenge to the modern medical world. Although the disease may be asymptomatic or mild, severe cholera can cause dehydration and death within hours of onset.

In October of 2013, public health officials in Costa Rica issued a preventative alert on the possibility of cholera making its way to the country via trade routes that stretch from Mexico to South America. Epidemic prevention protocols have been enacted by La Caja, the Water and Aqueducts Institute and the public universities. La Caja has 22 laboratories across the country that are tasked with sounding the alarm upon the first detection of cholera.

When the high tourist season began in December 2013, an Italian tourist and a Costa Rican man returning from a trip to Guatemala were the first patients suspected of having been infected with cholera. The symptoms in both patients were consistent: Digestive discomfort, deep dehydration, lack of tears, cramps, vomiting, and onset diarrhea that is extremely watery and has a distinctive smell of rotten fish. Fortunately, Irene Rodriguez of national newspaper La Nacion explained that both patients recovered and that no traces of cholera were found.

Still, concern across the Americas over cholera has increased in recent weeks due to the report of a legal complaint filed by human rights attorneys on behalf of the people of Haiti against the United Nations (UN). The suit alleges neglect by the UN for introducing peacekeeping soldiers from Nepal who may have been carriers. The death toll caused by cholera in that nation over the last few years has surpassed 8,000.