Cholera update

As the cholera outbreak in Haiti continues, it seems likely that the disease will become endemic there. This tragedy for the Haitian people has regional implications as well, with potential for rapid spread to neighboring countries. There are two recent notable papers in Annals of Internal Medicine, one modeling the outbreak and one editorial about the complex prevention challenges there. Safe potable water, sanitation, and vaccine delivery for prevention; rehydration and antibiotic therapy for treatment--all require infrastructure that doesn’t yet exist in Haiti.

Photo credit to Ramon Espinosa of the Associated Press

Cholera in New York City

I know it isn't Friday, but strictly speaking this is a fecal-oral post and not just a feces post.  Three cases of cholera were recently confirmed in NYC residents returning from a Dominican Republic wedding.  NYC typically sees 1 case/year of confirmed cholera.  All three people fully recovered without hospitalization, so no hospital infection prevention issues in this incident.  Even if a patient was admitted, transmission in hospital would be extremely unlikely.  Even then, something to be aware of.

Link:  NY Times story 2/5/2011

Cholera in Haiti

A horrendous development, poised to get much worse if the epidemic begins spreading in Port-au-Prince. The preconditions for a massive outbreak are present, namely limited access to safe potable water and proper sanitation, both of which require an intact infrastructure. Over a million people are still living in tent camps around Port-au-Prince, with minimal or no sanitation.
While media attention is appropriately focused on Haiti, this should also serve as a reminder that cholera outbreaks occur regularly throughout the world, most commonly in sub-Saharan Africa, where Nigeria is now in the midst of a huge outbreak. These outbreaks typically receive very little media attention.