# 5016
While reports coming out of Haiti no doubt lag several days, and are likely incomplete as well, the rising death toll (at least for now) seems to be slowing.
The World Health Organization has issued a new update – Dated October 28th – which includes details of the WHO/PAHO response.
Despite the combined resources being mounted against this public health emergency, a good deal of uncertainty remains over the course and resolution of this outbreak.
The experience of Peruvian cholera epidemic of 1991, when hundreds of thousands were infected, suggests that Cholera can be a difficult foe to overcome.
Note: Crof at Crofsblog continues to cover the Haitian situation better than anyone in Flublogia. I’d recommend stopping by his site several times each day for the latest reports.
Cholera in Haiti - update
28 October 2010 -- As of 27 October, the Ministry of Health in Haiti (MSPP) reported 4 722 cholera cases including 303 deaths. The departments reporting confirmed cases are Artibonte (76.5%), Central (22.9%), Nord-Est, and Nord.
Priorities of the Government of Haiti's National Response Strategy to the Cholera Epidemic are to protect families at the community level, to strengthen primary health care centers already operating across the nation, and to establish a network of Cholera Treatment Centers and designated hospitals for treatment of severe cases.
The strains of Vibrio cholerae 01 Ogawa isolated in Haiti and tested by the National Public Health Laboratory (LNSP) and the US Centres for Disease Control and Prevention (CDC) showed resistance to the following antibiotics: trimethoprim-sulfamethoxazole, furazolidone, nalidixic acid, and streptomycin. The strains are sensitive to tetracycline, doxycycline and ciprofloxacin. Full genetic sequencing of the strains is ongoing.
PAHO/WHO Response
Relief efforts continue as the government, MINUSTAH (The UN Stabilization Force in Haiti), UN agencies and NGOs continue to provide assistance in a growing number of locations. PAHO coordinates these efforts with other UN agencies, and with health officials in WHO Member States from the Region and beyond.
WHO continues to mobilize international experts in the areas of epidemiology, risk communication, case management, laboratory, water and sanitation, logistics, and LSS/SUMA (humanitarian supply management system) to Haiti and also to the Dominican Republic.
Additional medical supplies including 50, 000 intravenous fluids (Ringer’s Lactate), and 10 diarrhoeal disease treatment kits sufficient to treat 400-500 severe cholera cases have been purchased with funding from the international corporation, expected to arrive shortly in Haiti.
PAHO and US CDC experts are working together on improved surveillance and reporting of cases, analysis of water samples from rivers and other water sources, and monitoring of antibiotic resistance.
To support the Haitian Ministry of Health's planning efforts and the contingency planning for the Dominican Republic, PAHO is working with the US CDC to develop modelling scenarios to project the dynamics and likely spread of the outbreak . However, even with the best modelling efforts, it will not be possible to accurately predict the course of the epidemic.
WHO does not recommend any restrictions in travel and trade between countries or between different regions of a country experiencing cholera outbreaks. Travellers do not require proof of cholera vaccination, nor is there a need to screen travelers by means of rectal swabbing or faecal analysis. There is no need to establish quarantine measures at the border, a measure that diverts resources and may hamper cooperation between institutions and countries.
FOR MORE INFORMATION
WHO cholera Fact sheet
PAHO Responds to Cholera Outbreak in Haiti
The Pan American Health Organization (PAHO) website
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