Cholera Confirmed in Haiti: An Update

Cholera Confirmed in Haiti: An Update

Cholera Confirmed in Haiti: An Update

According to the Centers for Disease Control and Prevention (CDC) an outbreak of cholera was confirmed in Haiti on October 21, 2010. Just the word,Cholera strikes fear into the ranks of public health professionals.

Cholera is an acute infection caused by the bacterium Vibrio cholerae. Transmission occurs by fecal-oral contamination through the ingestion of contaminated water and food. Outbreaks of cholera are closely linked to inadequate environmental management (i.e. poor sanitary conditions). Is Haiti at risk for an overwhelming cholera outbreak in the aftermath of the devastating earthquake?

Public health officials previously stated that Haiti was at low risk for a cholera outbreak because the pathogen is not pervasive in the country. According to theThe Centers for Disease Control and Prevention(CDC) for a cholera outbreak to occur, two conditions have to be met: (1) there must be significant breeches in the water, sanitation, and hygiene infrastructure used by groups of people, permitting large-scale exposure to food or water contaminated withVibrio cholera organisms; and (2) cholera must be present in the population.While it is unclear how cholera was re-introduced to Haiti, both of these conditions now exist. Close living conditions in overcrowded tent camps for displaced earthquake victims is also a breeding ground for other food borne-related diseases such astyphoid fever,hepatitis A andhepatitis E.

Contrary to popular belief, cholera outbreaks are not the result of rotting dead bodies after natural disasters. According to the CDC dead bodies rarely spread disease or spark epidemics. Other consequences of a disaster, such as disruption of water and sanitation systems or massive displacement of populations to overcrowded camps can increase the risk of illness and suffering. These conditions currently exist in Haiti.

Cholera is characterized by a sudden onset of acute watery diarrhea that can lead to death by severedehydration andkidney failure. Symptoms of cholera include sudden onset of watery diarrhea, abdominal cramping, vomiting, lethargy, excessive thirst, and low urine output. It has an extremely short incubation period of 2 hours up to 5 days. The majority of infected people do not develop symptoms, however the pathogens remain in their fecal matter for 7 to 14 days, which potentially can infect other individuals if waste is not managed appropriately.

According to theWorld Health Organization(WHO) it can kill healthy adults within hours. Surprisingly the cure for cholera is simple: sugar, water, and salt.

Traditionally populations at risk for a cholera outbreak live in slum communities where basic infrastructure is not available or camps for internally displaced people or refugees in which basic human needs for clean water and sanitation are not available.

Prevention of cholera includes providing clean water and proper sanitation to populations that are potentially affected. Education on the transmission process, good food hygiene and the importance of hand washing are all part of a good intervention strategy to reduce mortality.

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