The earthquake ravaged nation of Haiti is now facing another challenge, the outbreak of cholera. Cholera is a bacterial illness passed from person to person through consumption of water or food contaminated by human feces. It causes severe diarrhea and vomiting and in some cases can be fatal in as little as eight hours. It can be treated with antibiotics but the most effective treatment for the majority of patients is rehydration. Oral or intravenous fluid replacement of the minerals and water lost due to the disease is effective in the vast majority of the cases.
The source of the illness is unknown at this time. There were no cases of cholera known to exist in Haiti prior to the January 12 earthquake. Since the illness can produce mild symptoms or even none at all, someone who was infected could have easily brought the illness into Haiti in late September or early October. The Centers for Disease Control (CDC) have this to say about the Haiti situation:
“Cholera had not been documented in Haiti for decades so cholera outbreaks were considered unlikely in Haiti immediately following the earthquake in January, 2010. 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 with Vibrio 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.”
The Pan American Health Organization (PAHO) is the regional arm of the World Health organization. It reports that as of 6 pm on Sunday, October 24, 2010, there were 3,015 cases of cholera reported in Haiti and 253 related deaths. The majority of the cases are in the north-central Artibonite department and prior reports indicate that most of those ill had consumed unpurified water from the Artibonite River.
There have been reports of cholera cases in other northern and central areas of Haiti, and a handful of cases in the capital of Port-au-Prince. At this point, all the cases seem to have originated in the area of the original outbreak and do not constitute the spreading of the outbreak.
The cases in Port-au-Prince are of great concern. There are about 1,350 internal refugee settlements due to the damage from the earthquake, holding about 1.3 million Haitians. Conditions are crowded and many of the camps are subject to flooding. The International Red Cross is working in 30 camps to educate its residents about cholera, proper sanitation and hygiene. Other agencies have responsibility for other camps and are performing similar tasks.
The World Health Organization reports over 190,000 cases of cholera world-wide in 2008, nearly all from Africa. There are three oral cholera vaccines being investigated but none have been approved by the food and Drug Administration in the United States. Cholera is one of a very few illnesses recognized to cause pandemics in modern times. The seventh known cholera pandemic began in 1961 and continued through the 1990’s. Many sources consider that pandemic to be continuing to this day.