Cholera Outbreak in Haiti Vibrio cholerae is a bacterium that infects the intestines of humans (CDC, 2016). While there are several strains of vibrio cholerae, only two types have been known to cause cholera outbreaks and only one (type O1) is responsible for outbreaks globally (WHO, 2015). Cholera infection is an acute diarrheal disease (CDC, 2016). It is extremely virulent and can affect children and adults with equal severity if left untreated (WHO, 2015). Vibrio cholerae has a short incubation period of 2 to 5 days, an aspect of the disease that leads to severe patterns of outbreaks (WHO, 2015). 80% of individuals infected with the cholera bacterium are asymptomatic (WHO, 2015). However, the bacteria are present in infected individuals’ feces for 1-10 days and are shed back into the environment. Others are at risk for infection when they come in contact with the fecal matter of infected persons (WHO, 2015). Contaminated water is the primary transmission route for cholera (CDC, 2016). Those who do experience symptoms of cholera infection usually experience watery diarrhea, vomiting, and severe leg cramps (CDC, 2016). These symptoms, especially when they’re severe, can lead to extreme dehydration, shock, and death within hours if left untreated (CDC, 2016). Mild cholera is also easily mistaken for other diarrheal illnesses (Harris, et al., 2012). Cholera transmission is associated with a lack of social development, primarily through the disruption or total lack of water and water sanitation systems (WHO, 2015). Populations most at risk are those who live in urban slums and overcrowded camps for people displaced by humanitarian crisis that lack basic infrastructure (WHO, 2015). Surveillance is a key epidemiological concept effecting the fight against endemic and epidemic cholera outbreaks globally. The actual global burden is unknown due to the fact that many cases of cholera are never reported due to infrastructural limitations in areas where cholera is endemic (Ali, et al., 2015). Incidence rates of the disease reported and calculations concerning population percentages effected by lack of water sanitation facilities are used to better estimate the annual number of cholera cases due to underreporting (Ali, et al., 2015). Screening, prevention, and treatment are the key steps needed to control a cholera outbreak such as the one that occurred in Haiti in 2010. Oral vaccinations are available, but often in short supply. For Haiti, research suggests that vaccinating individuals in high-risk areas can greatly reduce the overall impact of cholera in those areas (Chao, Halloran, & Longini, 2011). Once the highest risk areas have been sufficiently vaccinated, then other areas can also receive the oral vaccinations (Chao, Halloran, & Longini, 2011). Due to cholera’s waterborne nature and the lack of proper water sanitation in Haiti, revaccination is recommended for individuals every two years (Chao, Halloran, & Longini, 2011). Cholera prevention efforts also need to address the contaminated water supply. Water filtration and appropriate sewage disposal are both long-term actions that can reduce the incidence of cholera both in Haiti and globally (WHO, 2015). Access to safe drinking water is the key factor that prevented Haiti from avoiding the cholera outbreak following the 2010 earthquake.

References

Ali, M., Nelson, A. R., Lopez, A. L., & Sack, D. A. (2015). Updated Global Burden of Cholera in Endemic Countries. PLoS Neglected Tropical Diseases, 9(6), e0003832. http://doi.org/10.1371/journal.pntd.0003832
Centers for Disease Control (CDC) (2016). Cholera – general information. Retrieved from http://www.cdc.gov/cholera/general/index.html
Chao, D. L., Halloran, M. E., & Longini, I. M. (2011). Vaccination strategies for epidemic cholera in Haiti with implications for the developing world. Proceedings of the National Academy of Sciences of the United States of America, 108(17), 7081–7085. http://doi.org/10.1073/pnas.1102149108
Harris, J. B., LaRocque, R. C., Qadri, F., Ryan, E. T., & Calderwood, S. B. (2012). Cholera. Lancet, 379(9835), 2466–2476. http://doi.org/10.1016/S0140-6736(12)60436-X
World Health Organization (WHO) (2015, July). Cholera. Retrieved from http://www.who.int/mediacentre/factsheets/fs107/en/