Cholera kills 1,555 in Nigeria, says U.N.

Lagos, Nigeria (CNN) -- A cholera outbreak in Nigeria has killed more than 1,500 people, the United Nations said Tuesday.

It is the worst cholera outbreak in Nigeria in recent years. The number of cases is three times higher than last year and seven times higher than in 2008, the United Nations Children's Fund said.

The outbreak has led to 40,000 cases in Nigeria and resulted in 1,555 deaths, UNICEF said. Women and children account for four of every five cases, the agency said.

The disease's spread seems to have been largely contained in Nigeria, where new cases are still being reported in parts of the country, particularly the northeast, the United Nations said.

Read more here: http://www.cnn.com/2010/WORLD/africa/10/26/nigeria.cholera/index.html?hpt=T1

Dominican Republic Seals Border With Cholera-Plagued Haiti

Oct. 26) -- The Dominican Republic has sealed its border with Haiti following the deaths there of more than 250 people in a sudden, devastating outbreak of cholera .

The announcement came Monday as the Dominican government bolstered military patrols along the 130-mile border with Haiti and U.N. troops fired tear gas to disperse a throng of Haitians trying to cross into the northwest town of Dajabon, reported the English-language Dominican Today.

Thousands of Haitian merchants and shoppers were turned back Monday by Dominican authorities on the border near Dajabon after a traditional bi-national market was canceled because of the epidemic, the Latin American Herald Tribune reported.

Read more here: http://www.aolnews.com/world/article/dominican-republic-seals-border-with-cholera-plagued-haiti/19689705

About cholera:

from the Mayo Clinic:
Cholera is a bacterial disease usually spread through contaminated water. Cholera causes severe diarrhea and dehydration. Left untreated, cholera can be fatal in a matter of hours.

Contaminated water supplies are the main source of cholera infection, although raw shellfish, uncooked fruits and vegetables, and other foods also can harbor cholera bacteria.

The bacterium that causes cholera, Vibrio cholerae, has two distinct life cycles - one in the environment and one in humans.

Cholera bacteria in the environment
Cholera bacteria occur naturally in coastal waters,

snip

Cholera bacteria in people
When humans ingest cholera bacteria, they may not become sick themselves, but they still excrete the bacteria in their stool and can pass cholera disease to others through the fecal-oral route.

Risk factors
Malnutrition.
Reduced or nonexistent stomach acid
Household exposure. ... if you live with someone who has the disease.
Compromised immunity.
Type O blood.... people with type O blood are twice as likely to develop cholera
Raw or undercooked shellfish


See Selene's post here: viewtopic.php?f=20&t=2584&p=32050&hilit=cholera#p32050 on cholera treatment at home.

(I have to do some digging and see if cholera has reared its head in the GOM area....)

Whoa! I never heard that before. How interesting!

Where Did Haiti's Cholera Come From?
09:25 am
October 30, 2010

by Richard Knox

Scientists with the US Centers for Disease Control and Prevention have Haitian cholera bacteria under their microscopes, and are looking for molecular "fingerprints" that might tell them where the bug came from.

Dr. Eric Mintz, the CDC's chief detective for diarrheal diseases, says he isn't sure of the answer yet.

snip

"it's possible we will see a strain we've never seen before."

snip

CDC laboratory work so far has established that the Haitian cholera strain is one that's been identified in Latin America, Asia and Africa.

Mintz says it may be impossible to determine exactly where the Haitian strain came from. But "if a strain of cholera was [already] here, it would have caused an explosive epidemic" before now, Mintz says. "Likely it came from somewhere else."

Mintz says it may never be known where the Haitian strain came from.

Complete article here: http://www.npr.org/blogs/health/2010/10 ... era-strain

CHOLERA - HAITI (05): (ARTIBONITE)
**********************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] News report
[2] Correction on antimicrobial sensitivity report

******
[1] News report
Date: Tue 26 Oct 2010
Source: The Sydney Morning Herald, Agence France-Presse (AFP) report [edited]
<http://news.smh.com.au/breaking-news-world/haiti-reports-25-new-cholera-deaths-20101027-172ln.html>


Haiti reported 25 more cholera deaths as UN health officials warned
the epidemic was not over yet amid lingering fears it could still
infiltrate the capital's putrid refugee camps. The cholera outbreak,
the first in Haiti in more than 100 years, may have stabilized in
recent days but the number of new deaths announced on Tuesday [26 Oct
2010] was more than 4 times the 6 reported on the day before.

Overall infections have been increasing steadily and doctor Roc
Magloire of the Haitian public health ministry said the number being
treated in hospitals and clinics had risen over the past 24 hours by
270 to 3612.

So far the poorest country in the western hemisphere has managed to
avoid the nightmare scenario of the epidemic taking hold in the
unsanitary tent cities that cling to the hilly slopes of
Port-au-Prince. Large parts of the capital and other nearby towns
were flattened by January's [2010] 7.0-magnitude quake which killed
250 000 people and displaced 1.3 million.

"At the WHO we think more cases will be found. The most important
thing is prevention," World Health Organization (WHO) spokeswoman
Fadela Chaib told reporters in Geneva. As the toll built, Haiti's
more prosperous neighbor, the Dominican Republic, with which it
shares the Caribbean island of Hispaniola, tightened up border
security to keep the disease at bay.

Officials in Santo Domingo said entry into the country from Haiti
would be severely restricted, and border security increased to ensure
new regulations are complied with.

UN probes base as source of Haiti cholera outbreak
By Associated Press ,

MIREBALAIS, Haiti (AP) — U.N. investigators took samples of foul–smelling waste trickling behind a Nepalese peacekeeping base toward an infected river system on Wednesday, following persistent accusations that excrement from the newly arrived unit caused the cholera epidemic that has sickened more than 4,000 people in the earthquake–ravaged nation.

snip

Haitians are increasingly turning their attention to its origins: How did a disease which has not been seen in Haiti since the early 20th century suddenly erupt in the countryside?

http://topnews360.tmcnet.com/topics/ass ... tbreak.htm

Are you KIDDING ME? WHAT????? This is INSANE!

This just never, ever, ever, ever should have happened. My goodness, these poor folks were already stressed without the earthquake due to the extreme poverty.

Add to the earthquake a quickly approaching storm and active cholera on the ground.... Thoughts and prayers for Haiti, folks!

U.N. says Haiti cholera protests may be politically motivated

Port-Au-Prince, Haiti (CNN) -- The United Nations stabilization mission in Haiti condemned the violent clashes that broke out Monday in two cities in the northern part of the country, charging that the riots may be politically motivated.

"The way in which the events unfolded leads to the belief that the incidents had a political motivation, aimed at creating a climate of insecurity on the eve of the elections," the U.N. mission, known by the acronym MINUSTAH, said in a statement Tuesday.

http://www.cnn.com/2010/WORLD/americas/11/16/haiti.cholera/index.html?hpt=T2

Haiti cholera outbreak spreads to Dominican Republic

The cholera outbreak in Haiti has spread to the Dominican Republic and that nation has issued a maximum health alert, its health ministry said.

The first confirmed case is a 32-year-old Haitian construction worker who returned to the Dominican Republic last Friday with symptoms of the intestinal illness, the health ministry said.

http://news.blogs.cnn.com/2010/11/17/haiti-cholera-outbreak-spreads-to-dominican-republic/?hpt=T2

Cholera Confirmed In Florida Woman Who Traveled To Haiti

Thursday, November 18, 2010

"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 New York Times reports.

The woman experienced diarrhea and dehydration upon her return from Haiti's Artibonite region and then spent five days in the hospital. "She is expected to recover fully," the newspaper writes. There are several other suspected cholera cases – that are "not believed to be connected to the verified patient" – in other parts of the state, according to the New York Times. The Florida Department of Health is investigating (Goddard, 11/17). "New cases are expected in Florida, because the state has about 241,000 Haitian-born residents, many of whom travel back and forth frequently, particularly since the Jan. 12 earthquake," the Miami Herald notes

full article here:
http://globalhealth.kff.org/Daily-Repor ... Haiti.aspx

Re: cholera in Haiti

excerpt from longer article:
NPR Blog Looks At Why Oral Cholera Vaccine Has Not Been Used To Combat Haiti's Outbreak

NPR's "Shots" blog examines whether the two existing oral cholera vaccines "that cost as little as $1 a dose" could help treat and prevent death in the Haitian outbreak. ..... the discussion was dropped after experts learned there were only 500,000 doses of the vaccine available in the world. Young children require three doses, while others require two doses. "There just wouldn't have been the supply. The question is: Who would you vaccinate?" Andrus said.

In addition, "[m]any public health experts say you can't use cholera vaccine during an epidemic to contain it. It moves too fast, they say. There are three infected-but-asymptomatic people for every obviously sick person, so you can't tell whom it's too late to vaccinate. It takes several weeks to vaccinate susceptible people and achieve effective immunity," according to "Shots."

snip

..... using vaccines to limit the disaster would require a massive increase in production of the two vaccines – Dukoral, made by a Dutch company, and Shanchol, a newer vaccine made by an Indian firm, Shanthal, that last year announced it was ready to turn out five million doses." Though bulk quantities of Shanchol could be shipped, it would take "uncharacteristically fast footwork by the World Health Organization," in addition, the vaccine has not been "prequalified," which is a required approval for the vaccine to be purchased by agencies like PAHO (Knox, 11/17).


http://globalhealth.kff.org/Daily-Repor ... Haiti.aspx
The Kaiser Daily Global Health Policy Report is published by the Kaiser Family Foundation. © 2010 Henry J. Kaiser Family Foundation. All rights reserved.

Cuban doctors battle to control cholera outbreak
By Patrick Oppmann, CNN
updated 9:42 AM EDT, Fri July 13, 2012

Manzanillo, Cuba (CNN) -- At first the Cuban doctors thought they were dealing with an outbreak of food poisoning.

The patients that arrived for treatment in mid-June at hospitals in Manzanillo had all gone to the same birthday party held at a house in the hilly countryside on the perimeter of the eastern Cuban city.

The sick had eaten shrimp at the party and doctors thought that meal might be the cause for the patients' heavy vomiting and diarrhea.

Then more people began walking into hospitals with similar symptoms.

But they had not attended the party.

"They started coming in a few at a time," said Julio Cesar Fonseca Rivero, the director of the Celia Sanchez Manduley Hospital, the largest in the region. "The first day five came, and then eight. That's not normal, that five people would come with the same symptoms. The most critical days were when there were 30 to 32 patients who arrived in a single day."

A sudden spike in cases of diarrhea is not unusual for Manzanillo's hospitals that treat the surrounding rural communities. There residents often live without indoor plumbing and in the summer months endure the scorching heat and heavy rains.

This summer had already been particularly hot with heavy rains that caused outhouses to flood into several drinking wells.

Still, doctors suspected they were dealing with something they hadn't seen before.

"We became alarmed with the number of cases arriving. We usually see one or two cases of diarrhea each day," said Dr. Oyantis Matos Zamora, who oversees a clinic on the edge of the city that attends to rural residents.

The symptoms some patients exhibited -- the rapid onset of watery diarrhea and dehydration — had also not been seen in generations.

"The way that the outbreak developed and the appearance of other similar cases in the region, we realized this was a problem of a different magnitude," said Dr. Manuel Santin Peña, Cuba's national director of epidemiology.

The "problem" was cholera.

Cuba's last cholera outbreak occurred over a century ago. Although eradicated in many countries, the disease, according to the World Health Organization, still infects between 3 million and 5 million people each year, killing between 100,000 and 120,000.

In Manzanillo the outbreak has taken on a name of its own. There it's simply referred to by residents as "el evento."

So far "el evento" has taken three lives and infected at least 110 people, said Santin. He said doctors were waiting on test results for tens of other possible cases but said so far fewer than 30% percent of suspected cases had been shown to be cholera.

snip

Read more here: http://www.cnn.com/2012/07/12/world/americas/cuba-cholera-doctors/index.html?hpt=hp_bn2

In my opinion it is all about hygiene and keeping things 'clean'

Why it happens is the issue to solve, not just combating the pathogen.

Very bad thing to have happen, and lose people to such disease!