Friday, December 10, 2010

Cholera on Hispaniola

For the past month, the Dominican Republic and Peace Corps have been busy confronting the recent cholera outbreak. Cholera is a bacterial infection of the small intestine spread through water and food contaminated with feces that carries the bacteria Vibrio Choleri.

The main symptom is severe diarrhea that is the color of rice water. Additionally, cholera is often not accompanied with pain or fever, which sets cholera apart from other types of diarrheal illnesses. If left untreated it can kill a person in 24-48 hours though dehydration however, as Peace Corps has explained, if treated with rehydration fluids early (a mixture of salt, sugar, and purified water), the bacteria will pass through the body and no medicine or other treatment is needed.

Cholera was first confirmed in Haiti on October 21, marking the first time in the last century that Vibrio Choleri has been found on the island (CDC). What I have read is that the bacteria was brought to Haiti through post-earthquake aid that Haiti received from Nepal. Vibrio Choleri can survive on food 5 days and up to 10 days in colder temperatures too, so it indeed seems possible that foreign aid could have carried it here. Quite an unexpected consequence of receiving help…

In other countries cholera is endemic and has become a somewhat normalized illness that people have learned to live around. The reason why is it such a big deal now is because cholera is new on Hispaniola and the population has no knowledge what so ever on how to prevent and treat the illness. Additionally, there are neither solid waste treatment plants nor proper plumbing for the majority of both Haiti and the DR. Because of this the DR and the Peace Corps are working hard to makes sure the population can recognize the illness and know how to prevent and treat it through hourly radio announcements, television announcements, and charlas (informative talks) in the clinics, hospitals and schools throughout the country.

Since Peace Corps issued volunteer consolidation in the beginning of November in order to inform all the volunteers at once about the illness and how to educate our communities, I have seen the death toll in Haiti jump from 200 to 2,000 and the number of reported cases jump from 1,000 to 91,000 (CDC). Further reported by the CDC earlier this week is that the case-fatality ratio is 2.3%, meaning that in the 91,000 cases, 2.3% of these people have died. This seems like a relatively low percentage but between November 27 and December 3, there were 41 deaths per day on average (CDC).

In the Dominican Republic the government has been slow to announce the cholera cases, no doubt due to the threat this would have to the tourism industry, the number one source of income for the country. Just to give you an idea, the news announced the first case of cholera in the DR in a region in the East of the country (probably 2 hours away from me) on November 16th. However, the host brother of a fellow Peace Corps volunteer in the central region of the country had already been diagnosed with cholera. It took the public radio and TV a few weeks to announce the cholera cases in her region. What we do have publicly announced as of Tuesday is that there are 22 cases in the DR (Dominican Today). None have been in my community or anywhere in the providence of Hato Mayor, where I am living. Gracias a dios!

Very complete and most current update on cholera in Haiti done by the CDC:

Most recent article regarding DR cholera from Dominican Today, a good DR news source in English:

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