Washington, DC, Oct. 22, 2010 – Good afternoon, thank you for taking the time to come to this press briefing on Haiti.
An outbreak of cholera in the Artibonite region of Haiti has resulted in more than 1,500 cases and 138 deaths since Tuesday, according to reports received by the Pan American Health Organization or PAHO. These are preliminary figures and we expect them to change.
Specimens from hospitalized patients were rapid-tested by Haiti's national laboratory in Port au Prince and were subsequently confirmed to be actually cholera in this lab, which is supported by CDC.
The reported cases and deaths have come primarily from areas where there was no direct damage from the earthquake, but where there are vulnerable populations living in impoverished situations.
We do not know yet if cases are occurring in the temporary settlements housing people who were displaced by the January 12th earthquake. We are diligently looking for any additional cases, particularly in these vulnerable communities.
Cholera is transmitted through fecal contamination of water and food. In places where there is infrastructure damage, the lack of safe drinking water and poor sanitation and hygiene can increase the risk of cholera, as well as numerous other diarrheal diseases.Fortunately, cholera is easily treatable, and if patients are given oral rehydration salts promptly to replace lost fluids, they can nearly always be cured.
In a small percentage of people, cholera can cause very severe dehydration potentially leading to death. In these cases, intravenous administration of fluids is needed to save the person's life.
Outbreaks can be mitigated and deaths can be reduced through several measures that are effective with community participation. Human practices in personal hygiene and food preservation have a major impact on the occurrence and severity of outbreaks.
So really the bottom line in response to this current situation, is to minimize the number of people infected through mitigating measures such as frequent hand washing, personal hygiene, safe water use and food preparation, while at the same time minimizing the number of deaths through effective case management that prevents severe dehydration.
Cholera is considered an immediate health risk after disasters only when it is already present in the affected area. No cases of cholera had been reported in Haiti for some time, so we were not expecting to see the disease based on previous experience.
Surveillance was, however, monitoring for clusters of acute diarrhea, and up to now we had not seen clusters of acute diarrhea of this size.
The preliminary case fatality rate is over 9 percent, but this is likely to change.
In support of the local and national response, PAHO has mobilized epidemiologists and other experts from its office in Port au Prince and from other countries to help investigate and manage the outbreak. This includes experts with experience in cholera.
PAHO is also ready to provide the needed supplies identified by the Ministry of Health.
PAHO currently has medicines and supplies in stock at the PROMESS warehouse near the Port-au-Prince airport including 750,000 packets of oral rehydration salts-enough to treat 100,000 cases of moderate diarrhea-and enough intravenous (IV) fluids to treat 4,000 cases of severe diarrhea. PROMESS also has 300,000 courses of antibiotics. Haiti will need more supplies as cases continue to emerge. PAHO is working very hard to ensure sufficient supplies will be made available as we see more cases.
PAHO is collaborating with health cluster partners, including the Cuban medical mission, MSF, Minustha, OCHA, USAID, USCDC, UNICEF and other governmental and non governmental organizations to respond to the outbreak.
PAHO is also coordinating closely with health officials in the U.S. and Canada, including with HHS, the State Department, the CDC, NIH, the FDA, and USAID and in Canada, with Health Canada, PHAC, and CIDA.
I will stop there and answer any questions that you may have.