But this is not actually just worrying about nothing. Although cholera has not been seen for many years in Taiwan, neighboring Japan and Korea have already seen more than one hundred cases of late. Outside Asia, cholera is causing trouble everywhere.

Spreads Far and Wide: On January 23 the first case of cholera was reported in Lima, Peru, after which the epidemic spread rapidly. Within the short space of two weeks it had spread 2,000km along the coast, and every country in Central America had been affected. By September, cases had spread to many countries in Africa and Asia. The number of countries in the world proclaimed infected areas reached forty-three.

According to World Health Organization statistics, last year there were 70,080 cases of cholera world-wide. By August this year, Peru alone had announced more than 230,000 cases, with already more than 2,000 proving fatal. The spread is alarming.

The Amazonian area of eastern Peru, with its humid and insanitary conditions, is really a hotbed for the spread of cholera. Medical data for that area shows that insufficient measures against contagion have lead to a fatality rate of 25 percent among the local inhabitants. What alarms the inhabitants of Taiwan is that there has already been fatal case in Japan and four in Korea. Will Taiwan follow?

Past statistics show that there was a cholera outbreak in Taiwan in 1982, amounting to 383 cases of infection and 24 fatalities. In 1972 there were 61 suspected cases and in 1982 there were a number of cases of acute enteritis which, although there was no proof of cholera, were suspected by medics to include cholera-related cases.

Once Every Ten Years: The cholera germ can help dead shellfish to decay without polluting the sea and is thus good for the eco-system. However, the germs build up their toxicity as they are absorbed into the human body and excreted, so that over a certain period of time they become lethal. There are many strains of cholera in nature but when most people are infected they show no apparent difference, just two kinds of symptoms-- vomiting and diarrhoea. This leads to a lack of electrolytes and water in the intestines which in serious cases can be fatal. The time it takes for the toxins to build up means that the disease comes roughly in ten-year cycles.

"When cholera is caught from food and drink overseas, you only need toisolate the carrier to prevent further transmission. But if the toxicity has already built up so that the germs are in a locality's water and food then you really have a major problem," says Liu Cheng-i, head of the Department of Infectious Diseases at the Taiwan Veterans' General Hospital. Every year cases of cholera can be found around the world. Even countries with high standards of prevention have a period of prevalence. Next year is Taiwan's ten-year appointment with cholera, and whether or not there will be another outbreak is a cause for great concern.

Takes your Job Away: An expert on the spread of epidemic diseases at Graduate School of Public Health at National Taiwan University associate professor Chin Chuan-chun, says that our present preventative measures against cholera are very thorough so that any outbreak should not be too serious.

At present the Department of Helth has a policy of controlling contagion by establishing monitoring stations in the 500 health clinics scattered throughout every county. As soon as a case is discovered it will be isolated, thus wiping out contagion. "Cholera has a big effect on a country's image, so if there is an outbreak, the relevant officials will lose their jobs. Nobody dares take it lightly," he jokes.

Although the government has taken good precautions, it is only if everyone has the correct ideas about hygiene to prevent cholera infection -- avoiding raw food and drink, washing hands and implements before and after preparing food--can safety be ensured. If one should happen to produce symptoms of vomiting and diarrhoea then medical help should be sought immediately; if cholera is confirmed then electrolytes should be inected and copious amounts of water taken. To avoid other people losing their jobs--avoid losing your life!