The 2010 Haitian earthquake was a catastrophic quake, with an epicenter near the town of Léogâne, approximately 25 km west of Port-au-Prince, Haiti’s capital. Cholera cases became an immediate epidemic since October when a cholera strain was confirmed in Haiti, causing the first cholera outbreak in Haiti in at least 100 years. Now, current projections regarding the eventual size and extent of cholera in Haiti may greatly underestimate the potential number of cases. Will Japan also see the rise of a national epidemic under similar circumstances?
Regarding Haiti in particular, Jason Andrews, MD, of the Massachusetts General Hospital Division of Infectious Diseases says:
“Our findings suggest that more resources are needed than may be currently planned. The number of cases is currently falling, but this is the natural history of an epidemic, and cholera may continue to exact a significant toll over the next year as it becomes established in Haiti.”
The aftermath of the Haitian earthquake, which largely destroyed the country’s already inadequate water and sewer systems, set the stage for the cholera outbreak. The initial U.N. projection of a probable 200,000 cases during the first year was soon raised to 400,000 cases, but those estimates were based on rough estimates of 2 to 4% of the population being infected.
New research out of The University of California San Francisco, says that U.N. projections were not based on known patterns of infection and disease progression. Nor did they take into account the asymptomatic nature of some infections, the potential impact of vaccination or treatment, and the immunity that develops in those who recover from the disease.
Andrews continues:
“While each intervention alone may have a limited impact on the epidemic, our analysis suggests that a combination of approaches may avert a substantial burden of disease. There are broader issues pertaining to poverty, sanitation, housing, crowding and rainfall that will undoubtedly impact the burden of cholera but which our model could not capture. But we hope that our findings might stimulate discussion about the anticipated trajectory of this epidemic and the resources needed to respond to it.”
The head researcher from Harvard University, Andrews, adds:
“We’re encouraged by the track records of many organizations working to support the local public health system. Some of the concerns about a vaccination campaign cite inadequate delivery mechanisms, but organizations like Partners in Health have shown great success in delivering multi-dose vaccines for other diseases after the earthquake. These organizations and the Haitian government will need even more support to address the cholera threat over the coming year.”
The effects of a major natural disaster can last months or even years. In Japan’s case, long after most relief agencies have left the scene, survivors can face new health risks, such as the outbreak of cholera in Haiti months after the quake, when new floods contaminated the water supply in some regions, leading to another outbreak.
As long as a large number of survivors are displaced and living in crowded temporary camps, infectious disease remains a risk, making vaccinations and sanitation measures a key priority according to history.
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Written by Sy Kraft, B.A.