Cholera outbreak in Haiti 2010

The current situation with regard to the cholera outbreak  in Haiti is that over 4100 people are currently infected and around 300 people have died as a result of the infection. At present the infection is continuing to spread with the possibility that the capital Port-au-Prince will see cases very soon. There are as of Wednesday a further 174 suspected cases reported. The main focus for the authorities is now control, with the supply of clean water and good sanitation a priority as these are the main routes for the spread of the disease. From a treatment perspective it is now vital to have enough IV fluids available and enough treatment centres to be able to support the people who are already unwell. It would appear that the strain of cholera currently active in Haiti appears to be the 01 strain according o reports.

So what is cholera?

Cholera is an acute diarrhoeal disease caused by a bacterium called Vibrio cholerae that gets into the body by eating or drinking contaminated food or water. One of the problems is that quite a high percentage of people do not actually get infected by the disease but do shed the organism back into the environment. This is a potentially important source of the infection and one of the reasons why this type of infection is so prevalent after a situation that causes the disruption of safe water supplies and sewage disposal. Up the 80% of affected people can generally be supported and treated with oral rehydration salts quite successfully. Help that can be immediately dispensed to the population would include information on hand washing and its value, proper control of sewage and waste material along with the boiling of water of use of chemical treatments for potentially potable water including the use of chlorine tablets. It should also be remember that food should be eaten only after being cooked or at least peeled. Again remembering that washing of non cooked food should also be carried out only in water that has been treated and stored correctly to prevent contamination.

Why has this occurred now ?

This is a difficult question to answer definitively. It might be due to recent changes in temperature and salinity in the local rivers that have made infection possible. This situation can also be made possible if an algal bloom is present, common when temperatures rise. It has been known for sometime that cholera to be carried by some algae and copepods which can then be ingested by the human host in water and possibly initiating an infection. This has been recognised as an established route of infection in the marine environments around Bangladesh and a similar chain of events may account for the current outbreak in Haiti.

One interesting piece from the NPR Health blog examines the possibility that the non Haitian strain of cholera that is active in the region might have been bought in by peace keepers from other countries. It should be noted, as reported in the blog, that the UN have tested peacekeepers and have not found the organism present.

Authorities now need to keep vigilant to see where the infection develops next.