Among cases imported to Metropolitan France, cholera remains a sometimes serious but rarely le- thal disease. The patients are hospitalized in over three fourth of the cases, 3 days on average after their return. They are increasingly often hospital- ized, increasingly in secondary-care hospitals, and
no longer only in the large basins of immigrant populations, which are the greater metropolitan areas Paris, Lyons, or Marseilles.
The undernotification of detected cholera cases imported to France is unlikely since the confirmation procedure depends on a single, specialized NRC. However, the underdetection of cases with an un- alarming clinical presentation is very likely. Quali- tative limits also relate to the informative level of
notifiable disease data, especially on particular points such as the mode of contamination, the rea- son for and/or the means of travel. Although this study was carried out over a period of 32 years, in- terpretation and extrapolation must be extremely cautious due to the limited number of cases docu- mented for some variables. The conclusions pre- sented here should not be generalized but indicate significant tendencies.
The number of notified cholera cases imported to Metropolitan France has been decreasing over the past three decades. Nevertheless, as the geo- graphical origins of infection become more diverse and the range of patients’ ages widens, the propor- tion of “nonclassical” clinical profiles tends to in- crease. Clinicians in all French hospitals should regard cholera as one of the possible diagnoses when faced with a patient returning from an affected country, especially in children and the elderly, and even with seemingly banal digestive symptoms.