The Pan American Health Organization says over 9,000 cases of cholera have been reported. If this epidemic is anything like the last one in this continent, we should expect tens of thousands more cases, said Dr. Jon Andrus, Deputy Director of PAHO (Pan American Health Organization). Haitian health authorities reported yesterday 583 deaths so far due to cholera and 9,123 hospitalized patients, 73 of which are citizens of the capital, Port-au-Prince.
PAHO says its focus at the moment is to work with the Haitian government and other organizations in the area to "integrate the additional numbers into the official surveillance system". At the moment it is likely the number of cases are higher, because other organizations also report cases.
Dr. Andrus stressed:
The case numbers are not as important as the underlying trends, and our top priority is treating the sick and preventing new cases.
Hurricane Tomas was mercifully much less damaging and severe than people had expected.
Referring to Hurricane Tomas, Dr. Andrus said:
We have every reason to expect that the widespread flooding has increased the risk of cholera spreading.
Andrus expects a sudden rise in cases over the next few days because of the flooding.
Cholera has reached the capital, Port-au-Prince, a city with 3 million people. Experts said this was practically inevitable and should not come as a surprise. However, that fact that the epidemic has reached the city is of concern.
Port-au-Prince used to have very poor water and sanitation infrastructure before the devastating earthquake struck at the beginning of this year. Conditions are ideal now for cholera to spread throughout the city rapidly.
Andrus said:
We have to prepare for a large upsurge in cases. We have to be prepared with all the resources that are needed for a rapid response.
In 1991, when the last cholera epidemic occurred in the Americas, it started in Peru and made its way to 16 other nations, spanning from Canada to Argentina. Between 1991 and 1997 there were 650,000 cases in Peru alone. Andrus believes that if we extrapolate from what happened then, and make some geographical and population adjustments, Haiti should expect up to 270,000 cases of cholera.
Andrus added:
We have to think about and plan for the long term. The bacteria have a foothold in the rivers and the water system, so it will be there for a number of years.
PAHO says everybody is working to the limit trying to get prevention messages and urgent medical supplies to people throughout the country, including PAHO itself, Haitian health authorities and NGOs (non-governmental organizations). Supplies are getting through to remote villages as well.
Doctors Without Borders and Partners in Health, examples of NGOs, are setting up special treatment centers in the most affected areas, including Port-au-Prince.
Stefano Zannini, Doctors Without Borders head of mission in Haiti, said:
The increasing numbers of cases of suspected cholera in our facilities throughout Port-au-Prince are certainly alarming. Cholera is a highly treatable and preventable disease, especially once symptomatic patients are treated in a controlled, isolated environment like a CTC. The presence of CTCs (cholera treatment centers) in cholera-affected areas can relieve pressure on local hospitals and health structures, greatly reducing the risk of infection among pre-existing inpatients and the wider community.
As the number of cases grows, Andrus predicts things will become more difficult. "The system is going to be stretched."
PAHO says the current epidemic will in no way interfere with the country's general elections on November 28th.
Andrus said:
There is no reason to expect the elections to have a negative impact on the cholera epidemic. And in fact, the Ministry of Health is planning to use the occasion to disseminate prevention messages to the population. It will help prevent the spread of infection.
Source: PAHO, Doctors Without Borders
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