Health authorities in Haiti, as well as various aid organizations inform that the increase in daily reported cholera cases appears to be slowing down. At least 250 deaths have been reported as well as 3,000 cases of human infection, according to PAHO (PanAmerican Health Organization). Five patients were diagnosed and rapidly isolated in the country’s capital, Port-au-Prince. Conditions in various parts of the country are ideal for the emergence of disease, such as cholera, and their rapid spread, say experts. A devastating earthquake in January this year left a significant proportion of the country’s population without anywhere to live; over 1.3 million are still dependant on tented camps.

Cholera is a bacterial infection which typically spreads through water contaminated with vibrio cholera bacteria. Food that has been in contact with contaminated water may also cause infection. More rarely, human-to-human transmission is also possible. Cholera mainly affects the small intestine, and the patient will have severe watery diarrhea and vomiting, which can lead to rapid dehydration and loss of electrolytes. Cholera can be fatal within hours if left untreated.

Haiti, which is still trying to recover from January’s earthquake, still has many areas with extremely poor sanitary conditions.

MSF (Médecins Sans Frontières, Doctors Without Borders), a global medical charity says it is treating patients with cholera symptoms in the city of Saint Marc.

Federica Nogarotto, MSF emergency coordinator in St. Marc, said:

There are significant numbers of patients in St. Nicholas Hospital in St. Marc, which does not have the capacity to handle a cholera emergency. The most important thing is to isolate the cholera patients there from the rest of the patients, in order to best treat those people who are infected and to prevent further spread of the disease. This will also enable the hospital to run as normally as possible. We are setting up a separate, isolated cholera treatment center now.

Apart from diagnosing and treating infected patients as quickly as possible with oral rehydration solution (ORS) to replace lost fluids from vomiting and diarrhea, MSF says that sick individuals need to be isolated from patients who were already at the hospital before the outbreak began. Some patients are given ORS intravenously because they are too weak or sick to drink. MSF has 20 health care professionals and logistical specialists at St. Nicholas Hospital, St. Marc.

MSF says it has emergency teams in Mirebalais and Petit Riviere – their aim is to assess the local situation and medical facilities and provide support.

An MSF cargo plane with 100 metric tons of water, sanitation supplies and medications arrived last weekend.

MSF says that in order to stop the transmission of cholera, it is vital to:

  • Isolate suspected cases
  • Teach people the importance of hygiene
  • Provide people with soap so that proper hygiene practice is possible
  • Provide safe, clean drinking water

Cholera is easy to treat. The danger of death comes from dehydration and shock. Shock refers to a massive drop in blood pressure which starves the body of oxygen. This is preventable with cheap and simple antibiotics, fluids and oral rehydration solution.

According to the World Health Organization (WHO), about three-quarters of individuals who are exposed to vibrio cholera bacteria have no detectable symptoms. However, they can spread the disease by passing contaminated stools into water. They may also pass on the disease through poor food hygiene.

Over a million cholera bacteria (about the amount found in a glass of contaminated water) are needed to cause illness. For this reason, human-to-human transmission is rare.

The bacteria produces CTX or CT, a potent cholera toxin. CTX binds to the intestinal walls and interferes with the normal flow of chloride and sodium. This makes the body secrete huge amounts of water, resulting in diarrhea, vomiting and rapid loss of fluids and salts (electrolytes).

Sources: WHO, PAHO, MSF

Written by Christian Nordqvist