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Haiti cholera outbreak likely to spread: experts

by Staff Writers
Saint Marc, Haiti (AFP) Oct 22, 2010
The deadly cholera outbreak in Haiti is likely to get much worse, health experts said Friday as relief supplies were rushed to the quake-stricken country in a struggle to ward off an epidemic.

The United Nations said 138 people have died, while aid agencies are sending 300,000 doses of antibiotics and 10,000 boxes of water purification tablets to the impoverished Caribbean nation in a bid to prevent more deaths.

The outbreak of cholera, caused by a bacteria that can lead to fatal cases of diarrhea and dehydration, has not been seen in Haiti in over a century, further complicating containment efforts with at least 1,500 people already infected.

"We expect it to get bigger. We have to expect that and react to it," Jon Andrus, deputy director of the Pan American Health Organization (PAHO), told reporters in Washington.

The outbreak "is likely to get much larger given our experience with cholera... particularly in a population that has really no protective immunity," he added.

The cholera outbreak has been reported around the northern Haitian city of Saint Marc, far from the camps hosting hundreds of thousands of people who lost their homes following the January 12 earthquake which killed more than a quarter of a million people.

Health experts have expressed alarm at the speed with which the outbreak has spread, killing its victims, some of whom reported few symptoms, within 24 to 48 hours.

Health Minister Alex Larsen confirmed the strain of cholera seen in camps north of the capital is "the most dangerous type," and said contaminated river water was seen as the likely source of the bacteria.

Larsen said tests by the World Health Organization confirmed the 01 strain of cholera, which is the most deadly and is responsible for most of the outbreaks around the world.

"We are in a sanitary crisis, this is a new woe for the country which has not seen this disease in the past," Larsen said after a crisis meeting with President Rene Preval.

The outbreak hit as the country still reels from a devastating earthquake in January that left 1.2 million homeless.

The scope of the outbreak has grown rapidly in the past few days though has not yet reached the major displaced persons camps in and around the capital Port-au-Prince.

But officials fear the illness, which is caused by a bacterial infection in the small intestines, could spread quickly in densely populated tent cities that have poor sanitation and meager medical facilities, with the potential of unleashing a public health disaster.

In Geneva, WHO experts said initial tests showed traces of cholera and if confirmed it would mark the first time that cholera has been reported in Haiti for more than a century.

"Although we cannot confirm the nature of this illness until the laboratory results are given to us we are concerned at the speed which which it has spread," WHO spokeswoman Fadela Chaib told journalists.

"We are on maximum alert," said Claude Surena, head of the Haitian Medical Association. "We must mobilize around the clock to help the government deal with this situation."

Catherine Bragg, the UN deputy emergency coordinator, said "The point here is that cholera deaths are preventable, and we are doing everything we can to assist the Haitian authorities to prevent further deaths."

The outbreak is being blamed on the cholera-infected Artibonite river, an artery crossing Haiti's rural center that thousands of people use for much of their daily activities from washing to cooking.

The American Red Cross said the situation was troubling.

"This is not an area directly affected by the earthquake of January 12, but we are concerned about the speed with which this outbreak has spread," said the US relief group, which is working with Haitian health officials.

World Vision emergency response official Estrella Serrano said "if the epidemic makes its way to Port-au-Prince, where children and families are living in unsanitary, overcrowded camps, the results could be disastrous."

The Dominican Republic, which shares the island of Hispaniola with Haiti, said it was stepping up surveillance in light of the outbreak.

According to Bragg there have been no major disease outbreaks in the quake zone even though some of the camps are "truly awful." She said the major humanitarian operation in Haiti would extend well into 2011.



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