Saturday, October 23, 2010

Cholera in Haiti

I still follow the aftermath of the Haiti earthquake closely and have continued contact with our Haitian interpreters that I met this year on the Sutter Health Helps Haiti medical mission.  Our physicians and nurses worked in St. Marc, (three hours north of Port-au-Prince) at St. Nicholas Hospital, the epicenter of the new Haitian Cholera outbreak.  Boston based Partners in Health (PIH) runs the hospital there and the villages surrounding the area had been drinking water from the river, that is presumed to be contaminated.   Reports are that the 200 bed St. Nicholas Hospital is overwhelmed with the influx of patients and other areas of Haiti are also showing cases.

The news of the cholera outbreak is not a surprise to me, considering the sanitation problems.  At this writing, over 3,000 people are reported to be sick from Cholera and over 200 have died.

What is Cholera?  Cholera strikes poor countries, where water sources are contaminated and public sanitation is compromised.   The bacteria is Vibrio cholerae and a toxin that the bacteria produces causes an infection in the small intestine that produces watery diarrhea,  vomiting and belly pain.  It is transmitted through contaminated drinking water and food.   The symptoms occur about 5 days after infection and the patient can lose massive amounts of fluid very quickly.   Epidemics spread rapidly in disaster areas because of overcrowding and contagion. 

The treatment for Cholera is rapid re-hydration through inexpensive IV solution powders that are mixed with water.  With treatment, the number of deaths can be reduced to 1%.  Chronic dehydration is common in Haiti to begin with and the rapid fluid loss from Cholera strikes children and older people dramatically if they can't get immediate help.

Cholera is a huge threat of spreading throughout Haiti because the disease has not been seen there for decades, meaning its potential victims have no immunity against the germ.  The last major outbreak of Cholera in the Western Hemisphere was in Peru in the early 1990s.

25 comments:

Paula Dhanda, MD said...

I am leading a medical team to Haiti in November. Thanks for the information.

KM said...

Good article. It is so sad and upsetting to see after just coming back four days before this outbreak from spending a week there as part of a medical team in mostly Gonaives (where 10 cases have been reported) and and then a night in Port au Prince and after getting to know some of the people. It is so shocking to see the lack of sanitation in so many areas.

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