Cholera outbreak in Haiti

25 October 2010

Information and advice for aid workers in and travelling to Haiti...

There is a severe outbreak of cholera in Haiti which has so far killed over 200 local people.

These cases have occurred in Douin, Marchand Dessalines and zones around Saint-Marc in the Artibonite region. The most affected have been the elderly and the young who are living in poor conditions in temporary camps.

A few cases have been reported from Port- au- Prince. At the time of writing all these cases are people who have come from affected areas. There is a high danger however that outbreaks could occur within the city and spread rapidly.

For people working in these areas it is important to maintain strict hand hygiene and safe food & Water precautions. Cholera and other diarrhoeal illness is spread via the faecal/oral route and therefore thorough hygiene practice will reduce the spread of disease.

Advice for aid workers

A vaccine is available which is used in the UK but is not used or recommended in the USA. It is called Dukoral and is available from InterHealth. The dose is two sachets taken at least one week apart and protection, which is only partial, takes effect about one week after the 2nd dose. This vaccine is not a substitute for careful hygiene, and for the use of oral rehydration solution when a case occurs

Several antibiotics slightly shorten the course of the illness. These include doxycycline 100mg, 3 tablets or capsules taken together, and ciprofloxacin 250mg 4 taken together. Exact recommendations may change if and when the outbreak continues, and other antibiotics or dosages may be recommended.

Aid workers travelling to Haiti, who have concerns or questions should phone InterHealth on 0202 7902 9000. The vaccine and antibiotics are currently available. However these are less important than strict food and water hygiene, and in the extremely unlikely event of becoming infected, immediate rehydration. Past experience shows that aid workers only rarely become infected with cholera.

In our opinion non- completion of the vaccine would not be a contra-indication for going to Haiti, but some aid agencies will draw up their own specific guidelines which should be followed by their staff.

Hesperian's Cholera fact sheet, translated into Kreyòl, and French in cooperation with GrassRootsUnited (thanks Delphine Bedu!) is illustrated, easy to read and available as a free download in English, Spanish, French, and Haitian Kreyòl. It talks about the importance of sanitation, how to identify cholera, and how to make your water safe to drink. Click here to download the fact sheet

Sources of information:
Reuters Alert Net.
NaTHNaC health information sheets
CDC Atlanta, USA
World Health Organization
InterHealth information sheets
Travax