[1] News report
[2] Correction on antimicrobial sensitivity report
******
[1] News report
Date: Tue 26 Oct 2010
Source: The Sydney Morning Herald, Agence France-Presse (AFP) report [edited]
Haiti reported 25 more cholera deaths as UN health officials warned
the epidemic was not over yet amid lingering fears it could still
infiltrate the capital's putrid refugee camps. The cholera outbreak,
the first in Haiti in more than 100 years, may have stabilized in
recent days but the number of new deaths announced on Tuesday [26 Oct
2010] was more than 4 times the 6 reported on the day before.
Overall infections have been increasing steadily and doctor Roc
Magloire of the Haitian public health ministry said the number being
treated in hospitals and clinics had risen over the past 24 hours by
270 to 3612.
So far the poorest country in the western hemisphere has managed to
avoid the nightmare scenario of the epidemic taking hold in the
unsanitary tent cities that cling to the hilly slopes of
Port-au-Prince. Large parts of the capital and other nearby towns
were flattened by January's [2010] 7.0-magnitude quake which killed
250 000 people and displaced 1.3 million.
"At the WHO we think more cases will be found. The most important
thing is prevention," World Health Organization (WHO) spokeswoman
Fadela Chaib told reporters in Geneva. As the toll built, Haiti's
more prosperous neighbor, the Dominican Republic, with which it
shares the Caribbean island of Hispaniola, tightened up border
security to keep the disease at bay.
Officials in Santo Domingo said entry into the country from Haiti
would be severely restricted, and border security increased to ensure
new regulations are complied with.
--
Communicated by:
ProMED-mail
[Although there are reports of the outbreak being under control, it
appears too soon to state this especially with cases being so close
to the devastation in Port-au-Prince. - Mod.LL]
******
[2] Correction on antimicrobial sensitivity report
Date: Tue 26 Oct 2010
Source: Praecipio International [edited]
Update and correction: resistance profile of the 01 cholera strain in Haiti
----------------------------------------------------------------------
Thanks to Haitian officials' rapid response to our query, the
National Laboratory (LNSP) and CDC have officially confirmed the
strain is not resistant to doxycycline. It is sensitive to
doxycycline, ciprofloxacin, and tetracycline but resistant to
ampicillin and cotrimoxazole (trimethoprim-sulfamethoxazole).
--
Communicated by:
James M Wilson V, MD
Haiti Epidemic Advisory System (HEAS)
Executive Director, Praecipio International
Washington-Houston-Port au Prince
[ProMED-mail thanks Dr Wilson for quickly clarifying that the
outbreak organism is resistant to trimethoprim-sulfamethoxazole.
It would be important to know the biotype and phenotype of the
strain. As a short review, the flagellar (H) antigens of _Vibrio
cholerae_ are shared with many water vibrios and, therefore, are of
no use in distinguishing strains causing epidemic cholera. The O
(somatic) antigens, however, do distinguish strains of _V. cholerae_
into 139 known serotypes. Almost all of these strains of _V.
cholerae_ are nonvirulent. Until the emergence of the Bengal (O139)
strain (which is "non-O1"), a single serotype, designated O1, has
been responsible for epidemic cholera.
There are 3 distinct O1 biotypes, named Ogawa, Inaba, and Hikojima,
each of which may display the "classical" or El Tor phenotype. The
biotypes are distinguished by their expression of surface antigens A,
B, and C. Ogawa contains antigens A and B; Inaba antigens A and C;
and Hikojima antigens A, B, and C. The latter serotype is relatively rare.
The determination of the phenotype is based on a number of
characteristics including hemolysis of sheep red blood cells,
agglutination of chicken red blood cells, the Voges-Proskauer
reaction, as well as susceptibility to polymyxin B and to
biotype-specific viral bacteriophages. Hybrid biotypes, so-called
Matlab variants, are also described. These variants are thought to be
more virulent than the usual El Tor phenotype. - Mod.LL]
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