Posts Tagged ‘Dominican Republic’

Case of UN cholera reaches Florida from Haiti while UN “spins” information

November 18, 2010

UPDATE from Operational Biosurveillance:

Current official stats are more than 18,382 cases and 1,110 fatalities.  This includes more than 1,800 cases in Port au Prince with over 30 fatalities.

  • Conservative estimates therefore suggest 75,000 cases of cholera in Haiti to-date, the majority of which were subclinical.
  • In some areas of Haiti, we have confirmation that in-patient statistics are under-reported by as much as 400%. In many areas of Haiti, we are documenting outbreaks that are not being accounted for in the official statistics.  We therefore estimate the upper bound of estimated case counts to be 250,000.
  • We are now pursuing answers to the question of uptake by indigenous zooplankton and spread along oceanic currents that pass west of the Gonave Gulf, which is where the Artibonite River discharges, north and west along the northern Cuban coastline and north to the waters east of Florida.
  • Tomorrow is Vertieres Day, where we may see some degree of population mixing, particularly in the north.  It is unclear at this time to what degree the recent violence will affect observance of the holiday.  Holidays are opportunities to spread disease further as populations intermingle.

As noted by HEAS one week ago and yesterday officially acknowledged, cholera is in the  Dominican Republic.  We expect to see medical clinic inundations inside DR in the near future.

As expected, Florida has reported a case of cholera in a returned traveler.  There will be more cases in the United States; we believe it likely more cases are inside the US unreported.  Implications for the United States are neglible.

The cholera introduced into Haiti by the UN has spread not only into the Dominican Republic but also to Florida through a traveller from Haiti. Diplomats have confirmed that the disease has come with UN troops from Nepal where the disease is endemic. It is unlikely to spread in the US since the propagation of cholera is through water or food that is contaminated by the bacterium Vibrio cholerae.  For an epidemic, the source is often the feces of infected people. The New York Times reports:

The first known case of cholera in the United States linked to the outbreak in Haiti was confirmed Wednesday by health officials who said a southwest Florida woman contracted the disease while visiting family in a region at the heart of Haiti’s epidemic.

The Florida Department of Health was investigating several suspected cases of the disease elsewhere in the state. They were not believed to be connected to the verified patient, who sought treatment this month at a hospital emergency room in Collier County. The woman spent five days in hospital after developing diarrhea and dehydration, classic symptoms of cholera, following her return from Haiti, where she had spent time in the Artibonite region. She is expected to recover fully.

“We are lucky in the state of Florida, and the U.S. generally, to have a very sound infrastructure for our food, water and sewage,” said Rob Hayes, spokesman for the Florida Department of Health. “With that in place, and with our aggressive public health practices, we are not concerned about this being a significant public health threat.”

The situation is more dangerous in the Dominican Republic where conditions are more conducive to the spread of the disease. In Haiti official reports give over 1100 deaths and over 18,000 infected.

There are reports that the actual number of cases may be being grossly under-reported.

On November 14, Operational Biosurveillance said it confirmed statistics of up to 400% undercounting.

“We now have nearly 60k cases shedding pathogen into the environment. We believe the true statistic to be closer to more than 100k based on the degree of under-reporting. It is extremely difficult to estimate the true scale of this epidemic now. (It’s) grossly uncontrolled, uncontained, (and) has exceeded public health capacity to investigate and assess every site reported and every sample received.”

It seems that political considerations are now leading to all information being subject to political “spin”.

  1. For reasons of not upsetting the Nepalese Government and to defuse the local anger, the UN officially denies that the cholera originated with the troops from that country.
  2. With elections due in Haiti in just two weeks all information about the cause of the outbreak and the extent of the spread is being down-played to avoid further exploitation by some politicians and further riots.

Haiti – till now – had been free of cholera for over a hundred years. No doubt the priority now must be to treat those infected and contain the spread of the disease. But UN processes are clearly wanting and the sooner they come out of “denial” and address their own methods and processes the better.

UN cholera spreads from Haiti to Dominican Republic

November 17, 2010
Map of Haiti

Haiti: image via Wikipedia

After diplomats confirmed yesterday that the cholera outbreak in Haiti had been brought in by UN personnel from Nepal, cases have also been detected in the neighbouring Dominican Republic.

While the UN is still denying that its troops from Nepal have introduced the disease, it seems that they are carrying out some mis-judged PR exercise in the face of the following:

  1. the cholera strain found in Haiti is that which is endemic in Nepal,
  2. the UN military camp has had cases,
  3. Haiti has not seen cases of cholera for over 100 years until this outbreak, and
  4. the disease has broken out even in areas which were not affected by the earthquake on 12th January.

It would be quite wrong to blame the poor Nepalese soldiers who face endemic cholera at home but it is certainly an indictment of UN systems and processes that over 1000 have died in Haiti which has not seen cholera for over 100 years.

The BBC reports:

The Dominican Republic has detected its first case of cholera, following the outbreak of the disease in neighbouring Haiti last month.

The patient is a Haitian migrant who had recently returned from his homeland, the health minister said.

The Dominican authorities had stepped up border controls and health checks to try to stop cholera from spreading from Haiti. More than 1,000 Haitians have died of the disease.

Dominican health minister Bautista Rojas said the patient, a 32-year-old Haitian construction worker, was being treated in isolation in the eastern town of Higuey.

Like Haiti, the Dominican Republic had not had a confirmed case of cholera in more than a century until this year.

In Haiti, the government says 1,034 people have died and the disease is still spreading rapidly. The epidemic has provoked fear and anger in Haiti. The country was already struggling to recover from a devastating earthquake in January which killed about 230,000 people in and around the capital Port-au-Prince and shattered its already poor infrastructure. On Monday two people died during violent protests against UN peacekeepers, whom some Haitians accuse of bringing cholera into Haiti. At least one of the men was shot dead by the UN troops.

The UN has said there is no evidence to support allegations that cholera was brought into Haiti by peacekeepers from Nepal, where the disease in endemic.

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