CAREC Cholera Alert October 22, 2010

Cholera (Vibrio cholerae 01) was recently confirmed among persons in the Artibonite province of Haiti, a rural part of the country that has absorbed thousands of refugees since the earthquake in January 2010.  So far, PAHO has been informed that more than 1,500 cases of severe diarrhoea and at least 138 deaths have been reported.  PAHO has mobilized epidemiologists and other experts from its office in Port-au-Prince and from other countries to help local and national authorities assess and deal with the event.

Cholera is a disease caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae.  An acute intestinal infection, it causes severe watery diarrhoea and vomiting, and can quickly lead to severe dehydration and death.  Most cases can be treated with oral rehydration salts, though more severe cases need hospitalization with intravenous fluids and appropriate antibiotics.  The goal of treatment is to keep up with fluid loss caused by diarrhoea and vomiting.

CAREC Member Countries are urged to increase surveillance for possible cholera cases.  Recommended activities include ensuring that the appropriate medical staff are familiar with the symptoms and management of cholera and that the general public is aware of the risk of cholera if they have recently travelled to Haiti.  Additional guidance will be provided regarding laboratory diagnosis of cholera. At this time CAREC recommends testing no more than 6 patients per week that meet the clinical case definition for cholera, including specimens from persons who have been hospitalized or have died.

Please note that the following resources are attached for your reference and will be available on the CAREC website:  http://www.carec.org :

• PAHO Press Release on the Cholera Outbreak in Haiti (October 21, 2010)

• WHO Fact Sheet on Cholera (June 2010)

• Cholera Section, A Caribbean Communicable Disease Surveillance Manual for Public Health Action, CAREC (October 1999)