Cholera Outbreak in Haiti

An outbreak of cholera was confirmed in Haiti on October 21, 2010. Cholera had not been documented in Haiti for decades so cholera outbreaks were considered unlikely in Haiti immediately following the earthquake in January, 2010.

For a cholera outbreak to occur, two conditions have to be met:

(1) there must be significant breaches in the water, sanitation, and hygiene infrastructure used by groups of people, permitting large-scale exposure to food or water contaminated with Vibrio cholerae organisms

(2) cholera must be present in the population.

While it is unclear how cholera was re-introduced to Haiti, both of these conditions now exist.

CDC’s Role in the Cholera Outbreak:

CDC is assisting the Haitian Ministry of Health and its partners with assessments regarding adequate treatment supplies, recommendations on how to manage illness in ill persons, and how to prevent illness in those persons who are well.

These efforts are in coordination with a broader U.S. Government response being led by the United States Agency for International Development (USAID).

Cholera Symptoms and Treatment Recommendations:

Cholera infection is most often asymptomatic or causes a mild gastroenteritis. However, about 5% of infected persons develop severe, dehydrating, acute watery diarrhea.  The first line of treatment for cholera is rehydration. Administration of oral rehydration salts and, when necessary, intravenous fluids and electrolytes in a timely manner with adequate volumes will reduce case-fatality rates to <1%.  Severe cases of cholera should be treated with antimicrobial agents to which the circulating strain is susceptible.  Antimicrobial treatment is not recommended for mild cases of cholera and should never be used as “chemoprophylaxis” to prevent cholera on a mass scale.

Decreasing Your Risk:

The risk for cholera is very low for people visiting areas with epidemic cholera. When simple precautions are observed, contracting the disease is unlikely. All people (visitors or residents) in areas where cholera is occurring or has occurred should observe the following recommendations:

• Drink only bottled, boiled, or chemically treated water and bottled or canned carbonated beverages. When using bottled drinks, make sure that the seal has not been broken. To disinfect your own water: boil for 1 minute or filter the water and add 2 drops of household bleach or ½ an iodine tablet per liter of water.

• Avoid tap water, fountain drinks, and ice cubes.

• Wash your hands often with soap and clean water.

• If no water and soap are available, use an alcohol-based hand cleaner (with at least 60% alcohol).

• Clean your hands especially before you eat or prepare food and after using the bathroom.

• Use bottled, boiled, or chemically treated water to wash dishes, brush your teeth, wash and prepare food, or make ice.

• Eat foods that are packaged or that are freshly cooked and served hot. Do not eat raw and undercooked meats and seafood or unpeeled fruits and vegetables.

• Dispose of feces in a sanitary manner to prevent contamination of water and food sources.