Communicable Diseases and Health Analysis
Official case count exceeds 9,000, but conditions are ripe for many thousands more
Washington, D.C., November 9, 2010 (PAHO) — If Haiti’s cholera epidemic follows a pattern similar to the last cholera epidemic in the Americas, it could produce tens of thousands of additional cases over the next several years, said Dr. Jon K. Andrus, Deputy Director of the Pan American Health Organization (PAHO) during a press briefing today.
As of yesterday, Haiti’s Ministry of Health was reporting 9,123 hospitalized cholera cases and some 583 deaths. These include 73 cases reported in Port-au-Prince.
Other organizations are also reporting cases, and PAHO is working with the Haitian government to integrate the additional numbers into the official surveillance system. Andrus emphasized, however, that “the case numbers are not as important as the underlying trends, and our top priority is treating the sick and preventing new cases.”
Flooding caused by hurricane Tomas will likely contribute to a surge in the number of cholera cases in Haiti.
Also of concern—though not unexpected—are cases being reported in the country’s capital, Port-au-Prince, which is home to some 3 million people.
Even before the earthquake last January, the city had inadequate water and sanitation infrastructure and crowded living conditions in many areas. Now, conditions in the city are “very ripe for rapid spread of cholera.”
“We have to prepare for a large upsurge in cases,” Andrus said. “We have to be prepared with all the resources that are needed for a rapid response.”
The last cholera epidemic in the Western Hemisphere began in Peru in 1991 and spread to some 16 other countries, from Argentina to Canada. In Peru alone, the epidemic produced more than 650,000 cases over six years.
Adjusting for population size, a similar pattern would produce upwards of 270,000 cases in Haiti, Andrus said.
“We have to think about and plan for the long term,” he added. “The bacteria have a foothold in the rivers and the water system, so it will be there for a number of years.”
PAHO is working with other U.N. agencies, the Haitian Ministry of Health, and nongovernmental partners to get both medical supplies and prevention messages to people throughout Haiti, including in remote villages.
Nongovernmental partners such as Doctors without Borders and Partners in Health are providing medical treatment for cholera victims and helping to set up special cholera treatment centers in affected areas, including the capital.
Andrus acknowledged that, given the growing numbers of cases, “the system is going to be stretched.” Meeting this challenge will depend on “how flexible and innovative people are to manage the situation” in hospitals and health facilities.
He also said that the cholera epidemic need not interfere with the Haitian general elections scheduled for Nov. 28.
“There is no reason to expect the elections to have a negative impact on the cholera epidemic,” said Andrus, “And in fact, the Ministry of Health is planning to use the occasion to disseminate prevention messages to the population. It will help prevent the spread of infection.”