Cholera to linger in Haiti for years to come

Published 16 November 2010

Worldwide, poor sanitation that spreads cholera and other gut infections accounts for 2.4 million deaths a year, and 6.6 per cent of all life-years lost to disease and disability; the current cholera crisis in Haiti offers a grim example: cholera deaths are climbing sharply in Haiti, after the infection reached the capital, Port-au-Prince, as feared; epidemiologists who have studied other outbreaks predict that hundreds of thousands of Haitians will be stricken by the infection over the next few years as cholera takes hold in the country

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Genetic tests in the United States show the bacteria had a single origin and most closely match strains prevalent in south Asia. They could have arrived in produce or a ship’s ballast water, as they did in Peru, says Luis Gerardo Castellanos, an epidemiologist at PAHO.

Cholera, though, is most frequently spread by infected people who never develop symptoms. Haitians have blamed a military camp in Mirebalais, sixty kilometers north-east of Port-au-Prince, housing Nepalese UN peacekeeping troops. Cholera is endemic in Nepal.

Geography and timing seem to support them. The first cholera cases were reported in Mirebalais and further down the Artibonite river in Drouin and Dessalines, and nearby St Marc.

Sewage pipes are reported to lead from the camp to a nearby stream which flows directly into the Artibonite.

Vincenzo Pugliese, spokesman for the UN mission in Haiti, told New Scientist that the government laboratory sampled water from the stream beside the Nepalese base on 22 October, the day after news of the cholera broke. It found no bacteria. An outbreak of cholera in the Nepalese capital, Kathmandu, however, was reported on 24 September. The current contingent in Haiti, says Pugliese, arrived between 8 and 15 October.

However the cholera arrived, Haiti’s poor sanitation did the rest. Worldwide, poor sanitation that spreads cholera and other gut infections accounts for 2.4 million deaths a year, and 6.6 per cent of all life-years lost to disease and disability, calculates Sandy Cairncross of the London School of Hygiene and Tropical Medicine. The unfolding disaster in Haiti, he says, shows why governments should invest more in sanitation.