Published Date: 2012-07-17 10:42:55
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2012 (32): Cuba
Archive Number: 20120717.1204509
CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2012 (32): CUBA
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Mon 16 Jul 2012
Source: Miami (FL) Herald [edited]
The numbers on Cuba's cholera outbreak continued to grow over the weekend, with officials reporting 12 new confirmed cases, bringing the total to 170, and 8 new suspected cases in the southeastern province of Granma.
Cuba's Public Health Ministry, in a statement published in the official news media on Saturday morning, 14 Jul 2012, declared that the outbreak was "decreasing," with 158 confirmed cases and 3 deaths confirmed. But the numbers provided by lead Granma province epidemiologist Ana Maria Batista during her appearance Friday, Saturday and Sunday evenings (13-15 Jul 2012) on provincial television showed increases in all the categories.
"The numbers show it is growing," said Santiago Marquez, a physician in the Granma city of Manzanillo, who has watched Batista's nightly reports for more than a week and provided the details to independent journalists in Cuba and El Nuevo Herald.
Batista reported 158 confirmed cholera cases in the province on Friday (13 Jul 2012), 163 on Saturday (14 Jul 2012) -- though her town-by-town breakdown added up to 164 -- and 6 additional cases on Sunday (15 Jul 2012) for a total of 170, Marquez said. She noted on Sun 15 Jul 2012 that 8 new cases of suspected cholera had been reported and that 27 people were hospitalized on Saturday (14 Jul 2012) alone with diarrhea and vomiting, the key symptoms of the disease, according to the physician. More general cases of diarrhea and vomiting, which spike every summer with the rains and heat, rose from 5680 in her Saturday report to 6002 in her Sunday appearance, Marquez reported. About 97 percent of those already have recovered, she added. The number of Granma's 13 municipalities where cholera has been reported rose from 7 to 9, Batista noted.
Appearing with Batista on provincial television on Sun 15 Jul 2012, Deputy Director of Provincial Transportation Jose Mendoza Gonzalez again advised residents to put off unnecessary travel in order to avoid spreading the disease.
Cuban officials have repeatedly assured the public since early July 2012 that the cholera outbreak was under control and that the rising number of confirmed cases was because laboratories need a week or more to confirm a diagnosis of cholera. Dissidents and independent journalists have alleged that the cholera death toll stands at 5 to 15 but that the government has confirmed only 3 to avoid scaring tourists, one of the country's main sources of hard currency. They have also reported cholera cases in Havana, Santiago de Cuba and other parts of the island.
The Health Ministry announcement published Sat 14 Jul 2012 confirmed a few cases had been reported outside of Granma but noted that all were people who had been in the province. It was not clear whether the 158 cases it reported referred to all the island or Granma province alone. Batista has made it clear her numbers are for the province only.
The ministry announcement was only the national government's 2nd comment on the epidemic since 3 Jul 2012, when it confirmed 3 deaths and 53 cases caused by the bacterium _Vibrio cholerae_ but did not use the word cholera. Saturday's (14 Jul 2012) statement did use the word.
Cuba's public health system, once one of the best in the hemisphere and still considered capable of dealing with emergencies, has been battered since the collapse of the Soviet Union's massive subsidies until the early 1990s.
Hundreds of Cuban doctors, nurses and other medical personnel are working in Haiti, where an outbreak of cholera has killed more than 7000 people since 2010.
[Byline: Juan O. Tamayo]
[The numbers continue to grow but vary dramatically related to the source of the data. In most outbreaks of cholera, the number of confirmed cases is relatively small compared to the total number likely infected. The toxigenic _V. cholerae_, serogroup O1, serotype Ogawa, biotype El Tor identified in Cuba is the same as the original Haitian strain, although it has not been reported how similar the isolates are genetically. - Mod.LL
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