WHO Global Alert and Response (GAR) Disease Outbreak News

Cholera in Haiti - update
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As of 27 Oct 2010, the Ministry of Health in Haiti (MSPP) reported
4722 cholera cases including 303 deaths. The departments reporting
confirmed cases are Artibonite (76.5 percent), Central (22.9
percent), Nord-Est, and Nord.

Priorities of the Government of Haiti's National Response Strategy to
the Cholera Epidemic are to protect families at the community level,
to strengthen primary health care centers already operating across
the nation, and to establish a network of Cholera Treatment Centers
and designated hospitals for treatment of severe cases.

The strains of _Vibrio cholerae_ 01 Ogawa isolated in Haiti and
tested by the National Public Health Laboratory (LNSP) and the US CDC
showed resistance to the following antibiotics:
trimethoprim-sulfamethoxazole, furazolidone, nalidixic acid, and
streptomycin. The strains are sensitive to tetracycline, doxycycline,
and ciprofloxacin. Full genetic sequencing of the strains is ongoing.

WHO does not recommend any restrictions in travel and trade between
countries or between different regions of a country experiencing
cholera outbreaks. Travelers do not require proof of cholera
vaccination, nor is there a need to screen travelers by means of
rectal swabbing or fecal analysis. There is no need to establish
quarantine measures at the border, a measure that diverts resources
and may hamper cooperation between institutions and countries.

--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp

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[2] News report
Date: Thu 28 Oct 2010
Source: BBC News [summ., edited]
<http://www.bbc.co.uk/news/world-latin-america-11643348>


Suspected cases of cholera are being investigated in 3 new
departments, health officials in Haiti said on Wed 27 Oct 2010. They
said nearly 300 people were now known to have died in the cholera
outbreak. The UN is investigating allegations that excrement from
Nepalese peacekeepers caused the epidemic.

Sarah Jacobs from the aid organization Save the Children told the BBC
that 174 new cases of cholera were being investigated in the area
around Arcahaie, a village in the northern Port-au-Prince district
and about an hour's drive from the capital.

"These suspected cases are much nearer the capital," Ms Jacobs said
late on Wednesday [27 Oct 2010]. "So if this is actually confirmed as
cholera as we suspect it will be, it means that the cholera has
spread, it's that much nearer to the capital. And that's the thing we
really need to avoid," she added.

So far a handful of cases have been reported in Port-au-Prince, but
they were all people who had contracted the disease in other parts of
the country.

The Pan American Health Organization (PAHO) said health workers were
now investigating suspected cholera cases in 3 more departments,
Nord, Nord-Ouest, and Nord-Est, in addition to the confirmed cases in
Artibonite, Central, and Ouest. At least 292 people had died and more
than 4100 were being treated, PAHO deputy director Jon Kim Andrus said.

Officials from the World Health Organization recommended that Haiti
should prepare for the disease to spread to Port-au-Prince and warned
that the epidemic had not yet reached its peak.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

******
[3] News report
Date: Wed 27 Oct 2010
Source: Biosurveillance.typepad.com [summ., edited]
<http://biosurveillance.typepad.com/haiti_operational_biosurv/2010/10/flash-report-cholera-in-cite-soleil-cholera-haiti.html>


As evidenced in multiple reports by the HEAS [Haiti Epidemic Advisory
System], a clear route of cholera transmission from Artibonite
existed along the coastal highway from Arachaie to Lafito to,
potentially, "Camp Obama" and (of greater concern) Cite Soleil. As
feared, cholera has now been reported in Cite Soleil in a case
without a travel history from Artibonite Valley.

The clinic in Cite Soleil treated a patient this morning that
presented at the clinic with rice water diarrhea and vomiting. It is
the considered diagnosis of the tropical medicine experienced
physician at the clinic that this is cholera.

It was further determined that this individual had not traveled
outside of Cite Soleil. It is of very great concern that the case
history proved that this patient has not been away nor does she ever
travel from her home in Cite Soleil. This transmission occurred in Cite Soleil.