Haiti's Cholera Epidemic: When the Unexpected Must be Expected

Abstract

Cholera has been around for centuries but in our modern history there has been a resurgence with at least 7 devastating global outbreaks occurring worldwide in in the last century each claiming thousands of innocent lives. Cholera infects 1.3 to 4 million people around the world, killing 21,000 to 143,000 people annually according to the World Health Organization (WHO). It is thus imperative to research this bacterial disease and come up with ways of shedding light on effective prevention and cure. Cholera is an illness of multi‐causal origin where biological, environmental, social, political, and cultural factors intervene. This disease continues to resurge as a sanitary problem of great magnitude in many countries and emerged in Haiti following the January 12, 2010 magnitude 7.0 earthquake some 16 miles from the capital city of Port‐au‐Prince, where it caused massive damage to roads, buildings, and the environment. Although Haiti is among the poorest countries in the Americas, and its capital city lacked much in the way of modern public sanitation at the time of the earthquake, the country had been cholera free for at least 150 years or more at the time of the earthquake. By mid‐October 2010, the first cases of cholera began to appear, and by the end of the decade would infect some 800,000 Haitians (~10% of the population of Haiti) and approximately 10,000 deaths. The source of the infection was traced to the Artibonite River, a main source of water in Haiti, which was believed to have become unknowingly contaminated by well‐intentioned foreign workers from Nepal following the earthquake. The strain of cholera found in Haiti was similar to the one found in Nepal (CDC). Haiti employed measures of Cholera prevention and eradication efforts including water treatment, sanitation and hygiene measures, education, oral vaccination, and addressing climate variability issues, history, epidemiology, clinical diagnosis, and treatment, monitoring and prevention of this disease to prevent further loss of life. By 2020, no new cases of cholera have been reported for over 12 months, indicating that Haiti may soon be cholera free once again. Results/Conclusion: Effective hygienic conditions, timely medical intervention including supportive care, access to the appropriate antibiotics, availability of clean drinking water, hand washing, and other prevention protocols can help curb the loss of life associated with cholera. Cholera can kill a healthy person within 12 to 24 hours from the onset of diarrhea, as it is quite virulent. The current situation of cholera in the world (particularly in Haiti), and the extensive collaborative relation and the geographical proximity to Haiti makes the epidemiological risk in neighboring countries increase; therefore, immediate action is required in the organization of health services to prevent yet another epidemic.

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“…Thus, due to the serious and often life-threatening illness that SARS-CoV-2 may present to the most vulnerable segments of the population, and the highly contagious nature of its spread, dissemination and infectivity of naïve individuals, the pressure for development of effective antiviral agents, vaccines and other effective measures to contain the virus and its myriad of developing mutations are urgent and cannot and must not be neglected. [40][41][42][43][44][45][46][47]…”

Haiti resurging epidemics: Its potential to transition to endemic status

“…Cholera has been described as a scourge and causation of often fatal illness that has plagued much of human populations from early times; no era of recorded history has been exempt at different times in history, and the mere mention of Cholera continues to cause panic among susceptible populations. [1][2][3][4][5] Now with the 2021 level 7.2 magnitude earthquake in Haiti 6 the question emerges: will Haiti's cholera epidemic return with a new vengeance considering the extensive earthquake damage that has recently occurred, and will Cholera now become and remain endemic in Haiti? Haiti is highly prone to earthquakes, due to its strategic geographic location along a fault line.…”

“…Haiti is highly prone to earthquakes, due to its strategic geographic location along a fault line. 1,2,6 Over the centuries Haiti has encountered numerous earthquakes, some including the 2010 and 2021 earthquakes of 7.0 or greater magnitude. 1 Cholera has been around for centuries, and in the last century has caused at least 7 devastating global outbreaks each claiming thousands of innocent human lives.…”

“…1,2,6 Over the centuries Haiti has encountered numerous earthquakes, some including the 2010 and 2021 earthquakes of 7.0 or greater magnitude. 1 Cholera has been around for centuries, and in the last century has caused at least 7 devastating global outbreaks each claiming thousands of innocent human lives. 3,[5][6][7] Cholera infects 1.3 to 4 million people around the world annually with over 20,000 deaths per year according to the World Health Organization (WHO) statistics.…”

“…The earthquake caused an almost total loss of availability of viable and adequate community and emergency services in 2010, and effectively stretched the healthcare resources well beyond their limits. 1,2 Subsequently, over 819,000 Haitians became ill with cholera during the 8 years following the 2010 earthquake, with nearly 10,000 deaths reported as a result of one of Haiti's main waterways accidentally becoming contaminated with the highly infectious El Toro strain of the cholera organism. [1][2][3]12,13 After a brief cholera-free hiatus from 2018-2021, a resurgence of cholera cases emerged, resulting in over 1100 additional fatalities by late December 2023 and the designation of Haiti as a Grade 3 hazard area, similar to that also occurring in the African nation of Malawi.…”