Fear amid Haiti cholera progress

A woman with her young child at hospital in Saint-Marc (22 October 2010)Aid agencies say basic hygiene steps can stop the spread of cholera

The numbers of people killed by cholera in Haiti appears to be slowing, with only six new deaths reported in the past 24 hours, the government says.

A total of 259 people are now known to have died from the disease, the head of Haiti’s health ministry said.

Three hundred new infections have been recorded, taking the total to 3,342.

But aid agencies and the UN remain concerned that the disease could spread further, and are boosting prevention efforts in Haiti’s quake-hit capital.

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The disease is seen as a serious threat to 1.3 million earthquake survivors living in tent camps near the Port-au-Prince.

There are also major concerns for the city’s slums, which made up some 80% of Port-au-Prince even before the earthquake struck, the United Nations says.

Five cholera cases were detected on Saturday in Port-au-Prince, but they were quickly diagnosed and isolated. Another 20 suspected cases are under investigation, medical aid organisation Medecins Sans Frontieres (MSF) told the BBC.

Haiti has not seen a cholera outbreak for 100 years and many people are said to be frightened by the news of the outbreak and unsure of what steps to take to avoid the disease.

Poor sanitary conditions make the camps and slums vulnerable to cholera, which is caused by bacteria transmitted through contaminated water or food.

Cholera causes diarrhoea and vomiting leading to severe dehydration, and can kill within 24 hours if left untreated. It is easily treated through rehydration and antibiotics.

The director general of Haiti’s health department, Gabriel Thimote, confirmed on Monday that the rate of increase in cholera deaths had slowed.

However, the number of infections had increased by 10% since Sunday, rising from 3,015 to 3,342, and aid agencies insisted they would remain on alert.

Haiti cholera map

“To be honest, I believe the death toll will increase in the coming days,” said Harold Paul, regional emergency manager for UK aid organisation Christian Aid.

“My sense is that in two weeks the situation will be under control. The death toll will increase in Artibonite, but seems to be contained in Plateau Central. But in Port-au-Prince, let’s wait and see.”

Michel Van Herp of MSF, medical advisor to the organisation’s teams working in Haiti, said 400 people remained in hospital in Saint-Marc, the town at the centre of the Artibonite outbreak.

CholeraIntestinal infection caused by bacteria transmitted through contaminated water or foodSource of contamination usually faeces of infected peopleCauses diarrhoea, vomiting, severe dehydration, and can kill quicklyEasily treated with antibiotics; not usually fatalCholera ‘difficult to predict’ BBC details on Cholera

Another 150 people were being treated in hospital in the town of Mirbalais, along the Artibonite river, he said.

While he conceded that most infections were in the Artibonite region, Dr Van Herp said MSF would remain on alert.

“We are preparing ourselves for the worst case scenario, which is a cholera outbreak in the whole country,” he told the BBC.

Previous experience responding to cholera in Latin America in the early 1990s suggested that the disease could spread easily across large areas and could incubate for a number of days before presenting symptoms, Dr Van Herp said.

In Haiti, UN spokeswoman Imogen Wall said most effort was being directed into setting up dedicated treatment centres and making sure people across Haiti were kept informed of the best ways to stem the spread of the virus.

She cautioned that a temporary lull in the increase of infections did not guarantee the crisis was coming to a quick end.

“One day does not mean anything in terms of spread,” Ms Wall told the BBC.

Cholera patients

The BBC’s Laura Trevelyan: “Cholera spreads at an alarming rate”

The UN’s Office for the Co-ordination of Humanitarian Affairs was managing the mass distribution of soap and other basic hygiene items, including bucket with lids to prevent clean water becoming contaminated, she said.

But the UN remained concerned that areas outside of its post-earthquake emergency remit, including the slums of Port-au-Prince, were especially vulnerable to infection.

While diarrhoea is endemic in Haiti, cholera remains unfamiliar to most people, Ms Wall said. Simple precautions including the use of soap in hand-washing were not familiar to most people.

“Everyone has heard about cholera now, but we need to keep pushing the message,” she added.

The worst-hit areas of the outbreak are Saint-Marc, Grande Saline, L’Estere, Marchand Dessalines, Desdunes, Petite Riviere, Lachapelle, and St Michel de l’Attalaye.

A number of cases have also been reported in the city of Gonaives, and towns closer to the capital, including Archaei, Limbe and Mirebalais.

This is the first time in a century that cholera has struck the nation, which has enough antibiotics to treat 100,000 cases of cholera and intravenous fluids to treat 30,000, according to the UN.

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