Haiti resurging epidemics: Its potential to transition to endemic status

Abstract

The island nation of Haiti had been Cholera free for over a century prior to the 2010 earthquake which left over 1 million inhabitants homeless, when a key community water source became inadvertently contaminated with the causative organism, V. cholerae (El Toro strain 01) soon after the earthquake. The infectious organism was apparently transmitted via well intentioned Nepalese aid workers visiting the Island. During the 2010-2018 outbreak, over 819,000 people were treated for cholera, resulting in nearly 10,000 deaths. With assistance from the CDC, the U.S. Agency for International Development, and implementing partners including the Pan American Health Organization to further expand epidemiologic and public health initiatives, Haiti was once again declared cholera free in February 2022, having no new cases for over 3 years; however, by Sept 2022 new cases were once again reported, ultimately affecting over 20,000 additional mostly Haitian residents, geographically centered around the Port au Prince area, and in 285 additional deaths from the second wave of the Cholera epidemic. This was followed by over 1150 additional deaths by mid-December 2023 and the designation as a Grade 3 Emergency Hazard Status by the WHO. Because of the high potential for asymptomatic carriers of cholera to develop following a widespread epidemic, additional public health strategies must be vigorously employed including widespread immunization to control and minimize the continued impact of the endemic on community, regional and global wellbeing and hopefully prevent the next epidemic from occurring in Haiti or from spreading to surrounding islands and distant jurisdictions.