In 1992, the seventh pandemic of Vibrio cholerae O1 biotype E1 Tor continued to spread throughout the world. Sixty-eight countries, representing every region, reported 461,783 cases and 8,072 deaths, yielding a global case-fatality rate of 1.7% (Map 1). A decrease was noted in the reported number of cases (22%) and deaths (58%) in 1992 as compared with 1991, but 9 additional countries were affected. All but 2 of the 21 countries in Central and South America were affected. Reports of 354,089 cases (a decrease of 9.5% from 1991), 2,401 deaths (a decrease of 40%), and a case-fatality rate of 0.68% were received from the Region of the Americas. In Africa, 20 of the 52 countries reported 91,081 cases and 5,291 deaths, a decrease of 41% and 62%, respectively, over 1991. The case-fatality rate of 9.1% in 1991 decreased to 5.8% in 1992. The countries of Asia reported 16,299 cases and 372 deaths (decreases of 67% and 71%, respectively), while 296 cases with 8 deaths were notified from Oceania. Europe reported 18 cases, 14 of which were imported (Table 1). On the whole, the cholera situation in the world during 1992 resembled that of the previous year, in terms of geographical occurrence and reported cases, although the substantial decrease in reported mortality is an encouraging development. While the total number of cases remained relatively stable, important new outbreaks occurred in the Americas, against a background of what increasingly appears to be an endemic situation. In Africa, reported case-fatality rates, although substantially lower than in 1991, continue to be disturbingly high.(ABSTRACT TRUNCATED AT 250 WORDS)