Haitian Cholera Cases

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    http://www.alertnet.org/db/blogs/344...2-105456-1.htm

    More bad news for this troubled country, just awful. God help them.

    Quote from www.alertnet.org
    We woke to disturbing news on Thursday. Our friends at Partners in Health told us droves of people were arriving at St Marc, sick with diarrhea, and that they were dying from dehydration at an alarming rate. The question was clear, could we mobilize to provide clean water to an area suspected of having Haiti's first major cholera outbreak in decades?

    Our staff immediately began loading our trucks with equipment. As we drove the two hours to St Marc emails on my phone showed the death toll was climbing steadily. Everyone was nervous.

    We arrived at St Marc hospital to a horror scene. I had to fight my way through the gate as a huge crowd of worried relatives stood outside, while others screamed for access as they carried dying relatives into the compound. The courtyard was lined with patients hooked up to intravenous (IV) drips. It had just rained and there were people lying on the ground on soggy sheets, half-soaked with feces.
    Cholera Outbreak | Haiti News | Epidemic

    Quote from www.globalpost.com
    Fathers became nurses and children lay side by side with grandparents as a deluge of violently sick cholera patients overwhelmed the staff at St. Nicholas hospital in this small Haitian town.

    Desperate family members held up IV bags for the hundreds of patients lying on the floors of every corridor and hospital room available. All suffered from severe diarrhea and vomiting, some patients laid their heads in basins of water for relief from fevers that drenched their clothes with sweat.

    “I’ve talked to all of my colleagues who are Haitian and they’ve never seen anything like this, on this scale, before,” said Koji Nakashina, an American doctor with Partners in Health, who was working at the hospital on Thursday. “There’s still a lot coming in.”
    (hat tip crofsblogs)
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    Haiti: Operational Biosurveillance

    Quote from biosurveillance.typepad.com
    Multiple Sites, Multiple Suspect Cases of Cholera Inside Port-au-Prince; Collapse of Medical Grid in St Marc

    We had tremendous hope of at least stalling entry of cholera into Port-au-Prince, but ground reports now suggest our worst fears may be realized. Multiple clinics now have reported suspect cases of cholera, reaching as far now as Petionville.

    In St Marc, we have confirmation of a collapsed medical grid now- not just a single hospital facility (St Nicholas). Multiple international NGOs now are converging to bolster the grid, but with Port-au-Prince now reporting multiple suspect cases in multiple sites there is tremendous uncertainty how much resource will be needed... and where.

    Two Suspect Cases of Cholera Seen at HUEH / PAP General Hospital From Artibonite Valley

    Two women were seen at HUEH/PAP General Hospital this morning and released into the community without isolation for private laboratory testing to confirm they have cholera. This is indicative of a dangerous pattern of efflux of Artibonite inhabitants now into Port-au-Prince seeking care as the St Marc medical grid collapse has reached public awareness. PROMESS warehouse is reportedly refusing to release medical supplies and materiel to treat patients without laboratory confirmation of cholera. While this makes sense from the viewpoint of managing the inevitable influx of anxious well, it may inhibit providing life-saving treatment in a timely manner to patients who may die within hours. This latter point may be a focus of social outcry if not managed carefully.

    (hat tip crofsblog for continual coverage)
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    I've got a few friends on the ground in Haiti and they say it is really bad, and going to get worse. According to them, there is so much UN bureaucracy that very little aid nor useful infrastructure makes its way to the people who so desperately need it.

    My heart has been hurting for them and for all of Haiti.
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    Cholera Outbreak --- Haiti, October 2010

    Quote from www.cdc.gov
    An outbreak of cholera is ongoing in Haiti. On October 21, 2010, toxigenic Vibrio cholerae O1, serotype Ogawa, biotype El Tor was identified by the National Laboratory of Public Health of the Ministry of Public Health and Population in Haiti. Identification of the isolate was confirmed by CDC. Antimicrobial susceptibility testing of selected V. cholerae O1 isolates conducted at the National Laboratory of Public Health and at CDC demonstrated susceptibility to tetracycline (susceptibility to this drug predicts doxycycline susceptibility), ciprofloxacin, and kanamycin; and resistance to trimethoprim-sulfamethoxazole, furazolidone, nalidixic acid, sulfisoxazole, and streptomycin.

    As of October 27, a total of 4,722 cholera cases with onset during October 21--27 and 303 deaths had been reported in Haiti (1). Most cases have been reported from Artibonite Department (1), a rural but densely settled area with several small urban centers. In addition, probable cases have been identified elsewhere in Haiti, including Ouest Department, where the capital city of Port-au-Prince is located.
    (hat tip Avian Flu Diary)

    H5N1: Haiti: 900 treated in 2 days in cholera outbreak

    Quote from crofsblogs.typepad.com

    In Port-au-Prince, 34 people suffering from diarrhea presented at MSF facilities in the city. Cases of acute watery diarrhea that did not involve cholera have not been uncommon in Port-au-Prince since the Jan. 12 earthquake. MSF teams have treated many people with acute watery diarrhea in the intervening months.

    Regardless, MSF has a 20-bed cholera treatment centre in place and is undertaking necessary measures and preparations at its Port-au-Prince facilities for any additional patients who arrive with cholera-like symptoms. Confirming cholera requires lab testing, but the treatment for cholera and acute watery diarrhea are the same, beginning with rehydration.

    ...MSF has treated almost 2,000 people for acute watery diarrhea in the last few days. Two additional cholera treatment centres are being constructed in the capital and another is being built in the town of Leogane.
    Last edit by indigo girl on Oct 29, '10
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    Cholera Vaccine Isn't the Answer for Haiti

    Cholera Vaccine Isn't The Answer For Haiti : Shots - Health News Blog : NPR

    Quote from www.npr.org
    ...with cholera, by the time the disease shows up, 80 percent of people are carrying it — but without any symptoms.

    "The horse is out of the barn," Andrus says, "so you can't determine with any accuracy where that bacterium is circulating...You already have transmission outside your ring."

    There are other reasons why cholera vaccination isn't recommended during an outbreak. It requires two doses in most people, and three in young children. Keeping track of who's been vaccinated and getting them back for a second and third dose presents enormous logistical problems and a lot of personnel. And even with all that effort, it still takes three weeks at the least for immunity to build in the body, Andrus says.
    (hat tip Avian Flu Diary)
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    Tomas becomes hurricane off Caribbean

    Possibly more bad news for Haiti:

    Quote from news.smh.com.au
    Hurricane Tomas is barrelling towards eastern Caribbean islands after it downed power lines and damaged homes in Barbados as a tropical storm.

    It was forecast to head toward Jamaica while threatening to unleash heavy rains in the southern portions of the Dominican Republic and Haiti, which is struggling to recover from a devastating earthquake and to cope with a recent cholera outbreak.
    (hat tip crofsblog)
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    Haiti - Epidemic : Projection 100,000 people infected, Government strategy

    Haiti - Epidemic : Projection 100,000 people infected, Government strategy - HaitiLibre.com, Haiti News, The haitian people's voice

    Quote from www.haitilibre.com

    Taking the latest figures (provisional assessment) of the Ministry of Health dated of October 29, 2010, 4.714 people are hospitalized and suffering from cholera (25% of people with symptoms), this means that at least 14,000 people are infected "without getting sick" and are as many mobile vectors of the disease, which can potentially infect thousands of others (for 7 to 14 days, the duration of the total elimination of the bacillus of cholera).

    We better understand the concern of health organizations, both local and international efforts and the considerable resources deployed, far beyond the Artibonite. On this subject, the Ministry for the Public health, revealed its strategy to respond to a national epidemic based on an assumption of 100,000 infected people (over one year.) requiring health services in Port-au-Prince and in the Artibonite (200,000 in the country).
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    Haiti Liberte: Hebdomadaire Haitien / Haitian weekly

    Quote from www.haiti-liberte.com
    “They are doing exactly the wrong thing,” said Dr. Manolo Castro. “When you bring cholera victims into a hospital, especially one with poor conditions, you stand a good chance of infecting all the patients in that hospital.”

    In 1990, a cholera epidemic struck the Zambian town where Dr. Castro was a teacher at a hospital as part of a Cuban medical mission. Soon there were some 6,000 cholera victims. The hospital’s Zambian director packed up his family and fl ed. The Cuban Embassy and Zambian government asked Dr. Castro to step in to help the panicked population. Dr. Castro went to the Public Health Ministry’s office in town and with them identified a local stadium where they could quarantine hundreds of cholera patients. Within a few weeks, Dr. Castro’s team of six Cuban and six Zambian doctors had brought the outbreak under control.

    “It is essential to isolate cholera victims from other patients, especially where there is poor sanitation,” said Dr. Castro, who helped squelch another cholera outbreak when stationed in the Cape Verde islands in 1994. “The government should also stop all traffic and travel between the affected area and those not affected. Otherwise, the disease is going to spread.”
    (hat tip crofsblog)
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    H5N1: Haiti: 501 cholera deaths as of November 4

    Quote from crofsblogs.typepad.com
    Haiti: 501 cholera deaths as of November 4

    Thanks to Ansel Herz for tweeting a report from the Ministry of Public Health and Population. Dated Thursday, November 4, it gives a cumulative total of 7,359 hospitalized cholera cases and 501 deaths.
    Hurricane Tomas batters Haiti with heavy rains and gusting winds | Partners In Health

    Quote from www.pih.org
    In the capital city of Port-au-Prince, heavy rains pounded settlement camps where millions of displaced Haitians have been living since the January earthquake. PIH operates health clinics that serve four of these settlements, including the large camp Parc Jean-Marie Vincent.

    "The living conditions are inhumane at the camp in Parc Jean-Marie Vincent," reported PIH Chief of Mission in Haiti Louise Ivers. "Displaced persons, having no other option but to stay out the storm in their flimsy shelters are today struggling with the persistent steady rain and the mud and flooding in the bottom of their dwellings." The clinical team continued to provide services at Parc Jean-Marie Vincent throughout Friday at a mobile clinic and pharmacy.

    In the Artibonite Region, which has been battling a deadly cholera outbreak since October, the PIH team reports high winds and heavy rains, including flooding in Gonaives and the coastal town of Grande Saline, where PIH provided cholera relief by helicopter last week in collaboration with UN Humanitarian Air Support. Teams of community health workers continue to carry out outreach activities to educate local communities about cholera and distribute oral rehydration salts and water purification tablets, where possible.
    (hat tip crofsblog)
  13. 0
    All of the following links are taken from croftsblog. He is doing an amazing job covering this epidemic.

    Haiti - Epidemic : Latest Assessment, an explosive situation - HaitiLibre.com, Haiti News, The haitian people's voice

    Quote from www.haitilibre.com
    The last official assessment of the Ministry of Health published yesterday but dated of November 7, showed 9.123 people infected with cholera and "hospitalized" and 607 deaths. That published today, which refers to November 8, indicates 9.971 hospitalized (+9.29% between November 7 and 8) and 643 deaths (+10.30%). For many reasons, inter alia the hierarchical delay in the report of the cases, the zones which were not evaluated yet, delays in the confirmation of cholera etc... these figures can not reflect the reality of the day.

    From the information we have, it is reasonable to assume, as of today, the number of people with symptoms of cholera reported, could be between 12,000 and 15,000 reported cases and deaths between 845 and 1,050.

    According to the World Health Organization (WHO), approximately 75% of those infected with V. cholerae, have no symptoms, although the bacterium is present in their faeces for 7 to 14 days after infection and was eliminated in the environment where it can potentially infect other people. This could, from short-term projections, representing between 30,000 and 50,000 people carrying the disease (no symptoms) with the capacity to transmit cholera to others.
    Cap Haitien, Bas Limbe, Limbe: IDIS Cat 5 - Haiti: Operational Biosurveillance

    Quote from biosurveillance.typepad.com
    I made a visit to both Limbe hospitals yesterday and brought more supplies to Bord de Mer Limbe clinic (Haiti Village Health) where I ended up staying night due to huge volumes of rain and assisting with cholera patients here. Even with the rain (likely causing many to never make it) clinic is seeing 5-10 patients a day. 6 to the hospital this morning one of whom died. Late last night we were at (Hospital) Bon Samaritan which is overflowing with patients. The last two days had been crazy and they were hoping to set up a second tent today to accommodate increased patient load.

    The situation at the other Limbe hospital (Government hospital St Jean) was worse. We brought a patient there only to discover that a huge tent and building full of patients was being attended by no one. There was no doctor or nurse present, dry IV bags, and when we asked how a doctor could be reached no one really knew. All patients from the clinic are now being routed to Bon Samaritan after stabilization with IV or oral fluid and the hospital has said to send them along no problem.

    Also had another report from Clinic Ebenezer who said they were overrun with patients and on their last box of saline. Staff have been overwhelmed and they are looking for nurses.
    BBC News - Cholera death toll in Haiti passes 600

    Quote from www.bbc.co.uk
    The death toll from cholera across Haiti has risen to 644, as aid workers fight to contain the spread of the disease in the capital, Port-au-Prince.

    At least 10,000 people suffering from cholera are in hospitals across the country.

    Doctors in Port-au-Prince say they are alarmed at the speed at which new cases are emerging.


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