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Cholera Confirmed in Haiti, October 21, 2010

An outbreak of cholera was confirmed in Haiti on October 21, 2010.  Cholera had not been documented in Haiti for decades so cholera outbreaks were considered unlikely in Haiti immediately following the earthquake in January, 2010.  For a cholera outbreak to occur, two conditions have to be met: (1) there must be significant breaches in the water, sanitation, and hygiene infrastructure used by groups of people, permitting large-scale exposure to food or water contaminated with Vibrio cholerae organisms; and (2) cholera must be present in the population.  While it is unclear how cholera was re-introduced to Haiti, both of these conditions now exist.

Cholera infection is most often asymptomatic or causes a mild gastroenteritis. However, about 5% of infected persons develop severe, dehydrating, acute watery diarrhea.  The first line of treatment for cholera is rehydration. Administration of oral rehydration salts and, when necessary, intravenous fluids and electrolytes in a timely manner with adequate volumes will reduce case-fatality rates to <1%.  Severe cases of cholera should be treated with antimicrobial agents to which the circulating strain is susceptible.  Antimicrobial treatment is not recommended for mild cases of cholera and should never be used as “chemoprophylaxis” to prevent cholera on a mass scale.

As with other causes of acute watery diarrhea, the prevention and control of cholera require surveillance, heightened measures to ensure the safety of drinking water and food, and appropriate facilities and practices for disposal of feces and for handwashing. Although using vaccines to control an outbreak of cholera is complex, oral cholera vaccines are being considered for use among high-risk populations in Haiti.

 

CDC Resources: Haiti Cholera Outbreak — www.cdc.gov/haiticholera
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