Deadly Cholera Strikes Haiti, But Not in Earthquake Area

WASHINGTON, DC, October 22, 2010 (ENS) – A cholera outbreak in Haiti has claimed 138 lives and sickened more than 1,500 other people, the World Health Organization, WHO, said today. The bacterial disease is occurring in Artibonite province, which is not an area directly affected by the devastating earthquake of January 12.

WHO’s regional division, the Pan American Health Organization, said today that it has received laboratory confirmation of cases of cholera in Artibonite province, and is responding to help the Haitian Ministry of Health.

“It is likely that the outbreak will continue to spread, but with adequate provision of services, mortality can be maintained at very low levels,” PAHO Deputy Director Dr. Jon Andrus said today.

Cholera victim arrives at St. Marc Hospital for treatment, October 22, 2010. (Photo courtesy Charles Henri Baker for President of Haiti 2010)

PAHO has mobilized epidemiologists and other experts from its office in Port-au-Prince and from other countries to help local and national authorities assess and deal with the event, which is the first time cholera has appeared on the island of Hispaniola, shared by Haiti and the Dominican Republic.

Doctors Without Borders/Medecins Sans Frontieres medical teams immediately traveled to the affected areas, which are north of the capital Port-au-Prince, along the Artibonite River, between the cities of Saint-Marc and Mirebalais. Teams are treating patients and implementing necessary measures to prevent the outbreak from spreading.

At the request of the Haitian government, the humanitarian community has begun responding. Medical teams have been mobilized, medical supplies are being provided to the local hospital, including 10,000 boxes of water purification tablets, 2,500 jerry cans, and the same number of buckets and hygiene kits are being distributed.

PAHO is collaborating with partners including the U.S. Centers for Disease Control, U.S. Agency for International Development, the UN Office for the Coordination of Humanitarian Affairs, Doctors Without Borders, and other nongovernmental organizations to combat the outbreak.

WHO spokesperson Fadela Chaib told reporters in Geneva today, “We are concerned at the speed with which [this illness] has spread.”

Cholera is an disease caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. An acute intestinal infection, it causes severe watery diarrhea and vomiting, and can quickly lead to severe dehydration and death.

Most cases can be treated with oral rehydration salts, though more severe cases need hospitalization with intravenous fluids and antibiotics. The goal of treatment is to keep up with fluid loss caused by diarrhea and vomiting.

Haitian Presidential candidate Charles Henri Baker holds a container of rehydration fluids being infused for a cholera victim at St. Marc Hospital, October 22, 2010. (Photo courtesy Charles Henri Baker for President of Haiti 2010)

“With good case management, we can prevent people from dying, perhaps only fewer than one percent of cases,” said Dr. Andrus.

“However, in areas where there is no good way of ensuring patients remain adequately hydrated, death rate or case fatality ratio may rise substantially, closer to 50 percent,” he said. “Ultimately, we want to prevent cases by implementing sound water and sanitation measures, then when cases occur, prevent them from succumbing to severe dehydration.”

On January 12, a powerful 7.0 earthquake devastated Haiti, causing massive loss of life, catastrophic building damage, and unimaginable human suffering.

The Government of Haiti estimates 220,000 people lost their lives and over 300,000 people were injured. The earthquake crippled Haiti’s infrastructure, and eight hospitals were destroyed and 22 seriously damaged in the three regions most affected.

In the weeks and months after the earthquake, more than 1.5 million internally displaced Haitians settled in temporary sites throughout Port-au-Prince and beyond.

Despite dangerous living conditions, no large scale disease outbreaks have emerged in Port-au-Prince, PAHO said in its latest situation report on October 4.

By the end of January, two weeks after the earthquake, 396 international health agencies had arrived in Haiti to provide a diverse range of services. The mechanism by which these entities were coordinated was the PAHO/WHO led Health Cluster, which led targeted post-disaster interventions, identified gaps in health coverage and promoted global health standards.

Health Cluster partners collaborated on projects addressing acute health needs and pervasive threats associated with crowded and unhygienic living conditions.

The Centers for Disease Control, the Haitian Ministry of Health, and PAHO/WHO established a system of disease surveillance using fixed health facilities and mobile clinics, which helped pick up these cases.

Health Cluster reports a stock of 300,000 courses of antibiotics currently available to treat cholera cases.

Today, of the two million people affected by the earthquake, 1.3 million remain displaced in 1,354 spontaneous settlement sites across the country.

“The challenge for Haiti will be to ensure all severe infections are adequately cared for,” Dr. Andrus said. “One of the benefits of the response to the earthquake is that most people feel that citizens have better access to health services. This access will need to be further enhanced in the initial phases of this outbreak.”

“Community mobilization and education on washing hands and safe water will be critical to stopping transmission,” Dr. Andrus said. “The strong partnership that exists should go a long way toward achieving that end.”

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