From Epidemiological Weeks (EWs) 4 to 11, an increase in the number of cases of acute diarrhea has been detected in the municipality of São Bento do Una, state of Pernambuco, Brazil, similar to the peak that occurred during the first trimester of last year.
The Pan American Health Organization / World Health Organization (PAHO / WHO) reminds Members States that measures such as restrictions on movement of persons and seizure of goods produced under good manufacturing practices are unnecessary and ineffective to control the spread of cholera. Member States are encouraged to continue surveillance activities and to implement the recommended actions that reduce cholera spreading determinants.
In Haiti,during the fourth EW of 2011 Haiti registered a decrease in the weekly incidence rate at the national level, which went from 13.6 cholera cases per 10,000 inhabitants in EW 3 to 8.1 cases per 10,000 inhabitants in EW 4. At department level, three departments (Artibonite, Grande Anse, Nord and Sud) increased their weekly incidence rate. The in-hospital case fatality rate at the national level in EW 4 of 2011 was 1.0%.
While in the Dominican Republic, the Ministry of Public Health informed that since EW 45 of 2010 to EW 4 of 2011, there were 336 cases confirmed by laboratory and one death that happened in EW 2.
During Epidemiological Week 7 of 2011, at the national level, Haiti registered an increase in the weekly incidence rate, which increased from 5.1 cholera cases per 10,000 inhabitants in EW 6 to 10.2 cases per 10,000 inhabitants in EW 7. This was linked to an increase of 4.2% in the new cases registered as compared to the previous week. At the sub-national level, five departments (Centre, Nippes, Ouest, Sud y Nord) registered an increase in their weekly incidence rate.
While in the Dominican Republic, the Ministry of Health reported a total of 470 laboratory-confirmed cases of cholera, including four fatal cases, since the beginning of the outbreak up to EW 7.
As of EW 44, and at the national level, a total of 544 deaths have been recorded, 57% of which have occurred at the health services level, and 43% at the community level. The daily case fatality rates observed in health services at the national level have ranged from 2.2% to 6.0% (3.8% average). Alternatively, in the department of Artibonite, this rate has ranged from 1.2% to 6.8% (3.5% average). The impact of efforts undertaken to improve case management and access to health services on recorded case fatality rates is being analyzed.
In Haiti, the Haitian Ministry of Public Health and Population (MSPP) case surveillance system eported that as of EW 19 there was an increase in the number of hospitalized patients in Port-au-Prince and the Centre department. This increase coincides with the beginning of the rainy season in Haiti.
While in Dominican Republic, the Ministry of Public Health informs that since the beginning of the outbreak up to EW 20 of 2011 there were 1,329 laboratory confirmed cases (191 in 2010 and 1,138 in 2011), including 27 deaths. The Distrito Nacional and the provinces of Santiago, San Pedro de Macorís, La Romano and the border provinces of Independencia and Elías Piña also registered an increase in cases with respect to the previous weeks.
The Pan American Health Organization / World Health Organization (PAHO/WHO) updated the Cholera outbreaks situation in the Region.
Currently, in Haiti Currently, there are cases and deaths due to cholera in the 10 departments of Haiti. The highest cumulative incidence rate as of EW 48 was observed in the department of Artibonite with 274 cases per 10,000 inhabitants, followed by Nord Ouest and Centre with 149 and 145 cases per 10,000 inhabitants, respectively. These departments also recorded the highest cumulative incidence rates in the previous week.
In Dominican Republic, From EW 46 to EW 48, the Ministry of Public Health of the Dominican Republic recorded 22 laboratory confirmed cholera cases, of which 15 were hospitalized. No deaths were recorded. Also, 2 cases have been considered imported and 20 autochthonous.
Considering the start of the rainy season in Central America and the Caribbean, which increases the risk of transmission for various diseases, including cholera, the Pan American Health Organization/World Health Organization (PAHO/WHO) encourages Member States the continuation of surveillance efforts to detect the occurrence of outbreaks and implementing intervention actions to reduce cholera spread determinants.
The purpose of this Epidemiological Alert is to recall that the orientations of the Organization related to travel and international trade are still in effect.
Regional Office for the Americas of the World Health Organization