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Cholera in Haiti, Situation Report

After more than 3 years with no cases of cholera reported in Haiti, on 2 October 2022, the national authorities reported two confirmed cases of Vibrio cholerae O1 in the greater Port-au-Prince area. As of 12 October, the Ministry of Health (MSSP) has reported 47 cases confirmed and 35 deaths in Ouest and Center Departments. See PAHO/WHO Cholera Outbreak in Haiti 2022 - Situation Report 1.

What is Cholera? by Dr. John Venglarcik III, Infectious Disease Cholera is an acute diarrheal illness caused by the bacteria Vibrio cholerae, It is associated with vomiting and significant amounts of watery diarrhea which can lead to shock and death within 24 hours.

Cholera is associated with a lack of access to clean water and poor sanitary conditions. Epidemics of cholera occur throughout Africa, Asia, the Middle East, South and Central America and the Caribbean, often associated with natural and man-made disasters. It is estimated there are 3 million cases of gastrointestinal disease and 100,00 deaths worldwide annually.

Infection with Vibrio cholerae is acquired by ingestion of contaminated food or water as well as person-to-person transmission. Food can be contaminated when handled by an infectious person or by insects which have come in contact with infected feces or fecal-contaminated material. Low levels of acidity in the stomach, as can be seen with treatment of ulcers and reflux, is a risk factor. Breastfeeding has consistently been demonstrated to provide protection to cholera.

The incubation period can range from several hours to three to five days with an average of one to two days. Massive amounts of fluid loss in the stool, as much as 1 to 2 liters per hour for an adult, is the hallmark of severe cholera. The diarrhea is typically painless and the feces is characterized as “rice-water” stool. Vomiting can precede of follow diarrhea.

The essential aspect of treatment is replacement of the fluid losses, which is accompanied by the loss of sodium and chloride (salt). Treatment with an antibiotic is also recommended but is not as critical as fluid replacement. Obviously, clean water is essential. Untreated cholera has a mortality rate of 50 to 70 percent but that number can be lowered to 0.5 percent with appropriate hydration.

Provision of safe water and adequate sanitation is the cornerstone of disease control. Filtering surface water through a sari cloth has been effective in preventing infection from Vibrio cholerae. Prevention with an oral vaccine is possible if administered before the onset of an outbreak. Breastfeeding of infants is essential.

The Story of Cholera: Haitian Creole by Global Health Media Project and Yoni Goodman

This short animated film was produced by the Global Health Media Project (globalhealthmedia.org) in collaboration with Yoni Goodman (yonigoodman.com). It makes visible the invisible cholera germs as a young boy shows how to help the sick and guides his village in preventing the spread of cholera.


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