Published Date: 2011-09-20 14:23:01
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2011 (29): HAITI, DR
Archive Number: 20110920.2856
CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2011 (29): HAITI, DOMINICAN
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Mon 12 Sep 2011
Source: Voice of America [edited]
With much of the island nation still lacking safe water and sanitation
systems, an outbreak of cholera continues to grip Haiti, affecting
more than 439 600 people since it was 1st detected in 2010.
The medical and public health response has been effective in limiting
deaths associated with the disease, with the rolling 14-day case
fatality rate holding steady at below one percent of the cases
Date: Wed 7 Sep 2011
Source: New York Times Editorial [edited]
A cholera outbreak has killed more than 6000 people in Haiti since
October 2010 and is far from under control. More than 420 000 people
have been sickened since the disease emerged in a rural area north of
Port-au-Prince, apparently after sewage from an encampment of UN
peacekeepers contaminated the Artibonite River.
Cholera is preventable and easily treated, but containment has been
stymied by the chronic deficiency, or utter absence, of clean water
and sanitation systems in Haiti, particularly in the countryside,
where cholera hit 1st and hardest. The cholera mortality rate in
Haiti's vulnerable Southeast region was 5.3 percent in July 2011.
Access to proper treatment could keep that rate below one percent.
Cholera victims are among the many casualties of the unfinished
rebuilding of Haiti, still choked by rubble and political paralysis.
Haiti's new president, Michel Martelly, a political novice, has been
unable to form a government. Donations have lagged, construction plans
are stuck on drawing boards and hundreds of thousands are in
displaced-persons camps, hot spots of disease and suffering.
A UN report in August  warned that money and manpower are
running short. Staff members assigned to cholera treatment centers was
decreasing, it said, as "humanitarian partners are gradually reducing
their operations." In many areas, nongovernmental health organizations
are handing treatment facilities over to the Health Ministry, which
lacks capacity to support them. The ministry, like practically every
government agency, was flattened in the quake and has barely benefited
from the flow of aid. Controlling this epidemic requires building up
the public sector, which is the only hope for Haitians after
charitable aid dries up.
[An interactive map of the cholera situation in Haiti is available
from HealthMap at http://www.healthmap.org/haiti/. - Sr.Tech.Ed.MJ]
Date: Mon 5 Sep 2011
Source: Florida Center for Investigative Reporting [edited]
In 2011, there have been 1681 confirmed cases of cholera and 56 deaths
in the Dominican Republic as of 18 Jun 2011, according to the General
Directorate of Epidemiology of the Dominican Ministry of Public
Health. Those fears are most acute in border provinces such as
Independencia, according to the Ministry of Public Health.
While cholera raises alarms, however, diarrhea is a much more common
health problem. A nuisance in the USA, diarrhea causes half the deaths
of children under age 1 in the Dominican Republic, according to the
Pan American Health Organization.
And in places like Independencia, the problems are even worse. A
little more than 21 percent of children in the province contracted
diarrhea over a 2 week period, compared to 14.7 percent of children in
the rest of the country, according to the 2007 Demographics and Health
Report by the Dominican Center for Social and Demographical Studies.
The mortality rate in the province was 44 deaths per 1000 children
under 5 in 2007, compared to a national rate of 36 percent, according
to The Dominican National Office of Statistics.
[The outbreak of cholera on the island of Hispaniola has continued
although not at the same rate as initially. What is decreasing even
more so is the attention paid to the outbreak. Haiti, in particular,
had at best a poorly effective sanitation system before the earthquake
in 2010 destroyed whatever there was. No doubt, _V. cholerae_ will
persists there for a prolonged time with exacerbation during the rainy
season. - Mod.LL
The HealthMap/ProMED-mail interactive map of the Dominican Republic
can be seen at http://healthmap.org/r/0XtB. - Sr.Tech.Ed.MJ]