Haiti battles cholera epidemic, nearly 200 dead

[chobolan]

Haiti battles cholera epidemic, nearly 200 dead

By Joseph Guyler Delva
PORT-AU-PRINCE | Sat Oct 23, 2010 3:35am EDT

PORT-AU-PRINCE (Reuters) - Quake-hit Haiti and its aid partners fought on Friday to stem a cholera epidemic that has killed nearly 200 people and sickened more than 2,000, and officials expect to see more cases before it is contained. Although the main outbreak area was north of Port-au-Prince, which bore the brunt of the January 12 earthquake, humanitarian agencies were on high alert to prevent the disease from spreading to crowded survivors' camps in the capital.

The cholera epidemic was the worst medical emergency to strike the poor, disaster-prone Caribbean nation since the devastating earthquake that killed up to 300,000 people. It was also the first cholera epidemic in Haiti in a century, the World Health Organization said. But no confirmed cases were reported in Haiti's rubble-strewn capital, where 1.3 million quake homeless are living in tent cities. Health teams were closely monitoring the survivor camps and oral rehydration liquids were being prepared for quick use.

The Pan American Health Organization, the regional office for the WHO, said it had deployed medical teams, medicines and clean water to the outbreak zone around Saint-Marc in the central Artibonite region, and to the Central Plateau to deal with more cases of the virulent diarrheal disease. If left untreated, it can kill victims in hours through dehydration. "We expect it to get bigger, we have to expect that," PAHO Deputy Director Jon Andrus told a briefing in Washington.

He said the Dominican Republic, which shares the island of Hispaniola with Haiti, should be alert to the risk of cholera spreading across the border. U.N. officials, citing updated figures from Haitian authorities late on Friday, said 196 deaths had been recorded. They also said a total of 2,634 Haitians had been stricken with cholera as of Friday evening.

'HORROR SCENE'

One humanitarian worker who visited the main hospital in Saint-Marc called it a "horror scene." "The courtyard was lined with patients hooked up to intravenous drips. It had just rained and there were people lying on the ground on soggy sheets, half-soaked with feces," David Darg of the U.S.-based humanitarian organization Operation Blessing International, wrote in an account published on the Thomson Reuters Foundation's AlertNet website. Darg said villagers in the countryside around Saint-Marc were begging for clean water.

The central region is Haiti's breadbasket and took in tens of thousands of fleeing survivors from the January quake. Besides medicines and rehydration fluids, the United Nations and aid agencies were rushing clean drinking water and chlorine to purify water to affected areas. "Now the emphasis has to be on treatment, containment and potentially mass vaccination," Dr. Peter Hotez, president of the Sabin Vaccine Institute and chair of the George Washington University Department of Microbiology, Immunology, and Tropical Medicine, told Reuters.

He said PAHO needed to consider the viability of an anti-cholera vaccination program in Haiti. The U.S. government Centers for Disease Control and Prevention said it was sending a team of epidemiologists, health communicators and a cholera laboratory expert to assist the Haitian authorities in fighting the outbreak. "We are just at the beginning," Rob Quick of the CDC's Waterborne Diseases Prevention Branch said.

It was not clear whether the outbreak would affect the presidential and legislative elections scheduled for November 28 but Haitian Health Minister Alex Larsen appealed to candidates in cholera-affected areas to suspend public rallies. "Unless the epidemic really gets out of control and incapacitates a huge part of the country, I would think that elections would go on as scheduled," Hotez said, noting that cholera was not transmitted by person-to-person contact but through contaminated water and food.

Announcing a national emergency prevention program, Larsen urged people to wash their hands, not eat raw vegetables, boil all food and drinking water, and avoid bathing in and drinking from rivers. The Artibonite River, which irrigates all of central Haiti, was believed to be contaminated. Larsen urged people not to panic, saying the deadly dehydration caused by cholera could be easily treated by drinking boiled water mixed with sugar and salt.

(Additional reporting by Stephanie Nebehay in Geneva and Pascal Fletcher and Tom Brown in Miami; Writing by Pascal Fletcher; Editing by Stacey Joyce)

 

[chobolan]

A Haitian resident suffering from cholera waits for medical treatment at a local hospital in the town of Saint Marc October 22, 2010.

Hospital workers carry the body of a resident who died of cholera at a local hospital in the town of Saint Marc, October 22, 2010.

A Haitian resident suffering from cholera waits for medical treatment at a Local Hospital in the town of Saint Marc October 22, 2010.


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[chobolan]

Haitians suffering from cholera wait for medical treatment at a local hospital in the town of Saint Marc October 22, 2010.

A Haitian resident suffering from cholera waits for medical treatment at a local hospital in the town of Saint Marc October 22, 2010.

Relatives of Haitians suffering from cholera wait for news outside a local hospital in the town of Saint Marc October 22, 2010.


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[chobolan]

A Haitian resident collects water next to a local hospital where people affected by cholera are being attended to,
in the town of Saint Marc October 22, 2010.

A Haitian resident suffering from cholera is covered by flies as he waits for medical treatment at a local hospital
in the town of Saint Marc October 22, 2010.



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[yellow people]

Haiti cholera toll tops 200, five cases in capital


Haiti cholera toll tops 200, five cases in capital

By Joseph Guyler Delva
PORT-AU-PRINCE | Sat Oct 23, 2010 10:05pm EDT

PORT-AU-PRINCE (Reuters) - The death toll from a cholera epidemic in Haiti topped 200 on Saturday and fears of it propagating in the crowded, earthquake-ravaged capital increased after five cases were detected in the city. U.N. officials stressed that the five cases, the first confirmed in the capital since the epidemic started, were people who had become infected in the main outbreak zone of Artibonite north of Port-au-Prince and had subsequently traveled to the city where they fell sick.

"They were very quickly diagnosed and isolated," U.N. humanitarian spokeswoman Imogen Wall told Reuters, citing information from Haitian health authorities. "This is not a new location of infection." But prevention measures and surveillance were being increased in Port-au-Prince, with its squalid sprawling slums and about 1.3 million survivors of the January 12 earthquake packed into tent and tarpaulin camps. All are highly vulnerable to a virulent diarrheal disease like cholera.

With more than 2,600 cholera cases reported and experts predicting the numbers will rise, Haitian and international medical teams are working desperately to isolate and contain the epidemic in the Artibonite and Central Plateau regions, north of the rubble-strewn capital. It is the worst medical emergency to strike the poor, disaster-prone Caribbean nation since the earthquake killed up to 300,000 people and is also the first cholera epidemic in Haiti in a century.

Haitian health officials told a news conference on Saturday that 194 people had died from cholera in the Artibonite region, the main outbreak zone, with 14 other deaths in neighboring Central Plateau, where a prison was among places affected. The total number of cases had reached 2,674. Cholera, transmitted by contaminated water and food, can kill in hours if left untreated, through dehydration. But it can be treated easily with oral rehydration salts or just a simple mix of water, sugar and salt.

TV and radio adds in Creole recommended that treatment to the population. Besides rushing doctors, medicine and water supplies to the affected areas, Wall said the U.N. and aid agencies were identifying sites in Port-au-Prince where any cholera patients could be treated in tent clinics, separate from hospitals. "If we have cases in Port-au-Prince, the only way to contain them is to isolate them," Wall said. "Obviously, preventing the disease spreading to the city is an absolutely paramount concern right now," she said.

'NO SAFETY CORDON'

Daniel Rouzier, chairman of the Board of Trustees of U.S.-based charity Food for the Poor, earlier told Reuters he had learned of the five cholera cases at private clinics in the capital. "It was not originally in the geographical area of the camps. Now it is," he said. Rouzier, whose charity has sent water purification units to the cholera-infected central zones, faulted the Haitian government and its aid partners for not moving quickly and effectively enough to contain and isolate the epidemic.

"Right now, it's been over 72 hours. There is no safety cordon," he said. "If the sick had the proper healthcare where they were, they wouldn't have come to this chaotic city." Aid workers in the town of Saint-Marc, in the heart of the Artibonite outbreak zone, have reported the main local hospital overflowing with patients, many lying outside in the compound hooked up to intravenous drips. Haiti is due to hold presidential and legislative elections on November 28 but it is not clear whether the epidemic could threaten the organization of the vote.

In the crowded camps that fill squares, streets, parks and even a golf course in Port-au-Prince, fears of contracting the disease are running high.
"All we can do is pray to God because if we catch this disease in these camps, it will be a real disaster," said Helen Numa, 35. "You can see for yourself how people are living here, packed in like sardines." Haitian Health Minister Alex Larsen has urged people to wash their hands with soap, not eat raw vegetables, boil all food and drinking water and avoid bathing in and drinking from rivers.

The Artibonite River, which irrigates all of central Haiti, is believed to be contaminated. But many in the capital's camps said they did not have money to buy soap and chlorine to apply hygiene measures. "We don't have anything, not even one dollar, because we don't have jobs," said Marjorie Lebrun, 45. "I'm afraid if I and my five children get sick, we could die." Wall said the relief effort in Haiti had enough antibiotics to treat 100,000 cases of cholera and intravenous fluids to treat 30,000. But those would need replenishing.

(Additional reporting by Pascal Fletcher in Miami; Writing by Pascal Fletcher; Editing by Peter Cooney)

 

[Kunoichi]

Haiti cholera toll near 300, disease seen "settling"


Haiti cholera toll near 300, disease seen "settling"

By Joseph Guyler Delva
PORT-AU-PRINCE | Tue Oct 26, 2010 6:05pm EDT

PORT-AU-PRINCE (Reuters) - Deaths from Haiti's cholera epidemic approached 300 on Tuesday, and health experts said the illness would "settle" in the poor Caribbean nation, joining other endemic diseases like malaria and tuberculosis. The week-old epidemic of the deadly diarrheal disease has so far mostly affected the central Artibonite and Central Plateau regions, with an accumulated 295 deaths and 3,612 cases registered to date, Haitian health authorities said.

Although the number of new deaths and cases has slowed slightly from earlier days, a United Nations-led international medical response is fighting to prevent the outbreak from penetrating Haiti's capital Port-au-Prince, which is crowded with 1.3 million homeless survivors of a January 12 earthquake. The epidemic has jolted the Western Hemisphere's poorest nation with another crisis 9-1/2 months after the catastrophic quake that killed more than half a million people.

It also comes a little over a month before the country is due to hold presidential and legislative elections on November 28. Despite the disease outbreak, the polls were still set to go ahead as scheduled, Pierre-Louis Opont, the director general of Haiti's provisional electoral council, told Reuters. Announcing updated case figures at a news conference, the Haitian health ministry's director of epidemiology Roc Magloire said that of five cases previously reported in the capital, only one had been confirmed by laboratory tests to be cholera.

Nevertheless, the U.N., the government, and its foreign aid partners are expecting the disease to spread further in its epidemic phase. They have launched a combined treatment, containment and prevention strategy for the whole country. "The next news for us and for you is when geographically, new pockets of the epidemic ... emerge, in Port-au-Prince or elsewhere," Dr. Michel Thieren, the Pan American Health Organization's (PAHO) top official in Haiti, told Reuters. Suspected cases have been reported in Nord and Sud provinces, but are pending laboratory results.

Thieren said however a slight slowing in the rate of new deaths and cases was being observed in the main outbreak area of Artibonite, which he called encouraging and attributable in part to an aggressive multinational medical response. With the epidemic reestablishing cholera in Haiti after a long absence, the disease would now become endemic, joining illnesses like malaria, tuberculosis and HIV AIDS which have been afflicting impoverished Haitians for years, Thieren said. "It's normal that we should expect a settlement of cholera in Haiti nationwide over the coming months," he added. But it was hard to predict exactly how the epidemic would spread.

DOMINICAN REPUBLIC ON ALERT

The U.N. has said a nationwide outbreak with tens of thousands of cases is still "a real possibility". The international humanitarian operation has rushed doctors, nurses and medicines to the rural central zone straddling the Artibonite River, the suspected source of the disease which is transmitted by contaminated water and food. Special cholera treatment centers are being set up in the main outbreak zone, in Port-au-Prince and elsewhere, to isolate patients. A public education campaign is urging the country's 10 million people to wash their hands regularly with soap, avoid eating raw vegetables, and boil food and drinking water.

If left untreated, cholera can kill in hours by dehydrating victims with severe diarrhea, but if caught early it can easily be treated with an oral rehydration solution -- or a simple mixture of water, sugar and salt. Health Minister Alex Larsen announced the government would train 30,000 health workers to join the anti-cholera campaign across the nation in the coming months. PAHO, the regional office of the World Health Organization, has said there is a "high risk" of the cholera spreading across the border of the island of Hispaniola to Dominican Republic.

The border has not been formally closed but on Monday Dominican Republic authorities canceled the regular farm market normally held in the northern frontier town of Dajabon, and prevented hundreds of Haitians from crossing to attend it. PAHO has also alerted other states in the Caribbean about the epidemic, the first of cholera in the Americas since a 1991 outbreak in Peru, and was seeking resources to fight it from members like Brazil, Cuba, the United States and Canada.

(Additional reporting by Manuel Jimenez in Santo Domingo, Writing by Pascal Fletcher; editing by Jim Marshall)