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Posted November 16, 2010

Cholera outbreak likely to grip Haiti for months

By Marisol Bello, USA TODAY

A cholera outbreak in earthquake-ravaged Haiti that has killed more than 900 people will continue for at least six months, possibly years, experts say.

The outbreak has spread quickly, reaching at least six of Haiti's 10 provinces since it was confirmed Oct. 22, says Donna Eberwine-Villagrán of the Pan American Health Organization. So far, 16,800 people have been hospitalized, but she says the number affected is most likely higher because those who have not gone to a health facility have not been counted.

A child with cholera symptoms is treated Monday at a hospital in Archaie, Haiti. (AP/Ramon Espinoza)

Her group estimates at least 200,000 people will become ill.

Now that the disease has a foothold, it will be nearly impossible to eradicate without permanent access to clean water, says Jeffrey Withey, a microbiologist with the Wayne State University School of Medicine in Detroit.

A massive earthquake in January left 1.3 million people homeless, many crowded in tent camps without plumbing.

"The outbreak will continue for the foreseeable future," Withey says.

A permanent solution in Haiti is far off, especially since government and relief agencies are overwhelmed trying to save people with the disease, says Sophie Delaunay, executive director of Doctors Without Borders USA.

The bacteria is spread through contaminated food or water. Relief agencies and the government have launched a campaign to teach people to drink only clean water, wash their hands with soap and clean water, and dispose of feces properly. Cholera is lethal if untreated. It is relatively easy to treat with rehydration packs of salt or sugar water and antibiotics; even so, Delaunay says, relief agencies do not have enough supplies.

The United Nations Office for the Coordination of Humanitarian Affairs has started a $164 million fundraising effort that includes a proposed $90 million to build permanent distribution systems for clean water.

Complicating the response: riots in several cities Monday by protesters responding to rumors that U.N. peacekeepers from Nepal were to blame for the outbreak. The riots left at least one protester dead and six peacekeepers wounded.

The U.N. Stabilization Mission in Haiti said the protests were linked to the Nov. 28 presidential election.

Robert Quick, an epidemiologist with the Centers for Disease Control and Prevention (CDC) who is in Haiti, says it is likely that the cause of the outbreak will never be known. Global travel and trade make it easy for the bacteria to spread, he says.

The CDC concluded in March that cholera was unlikely to occur in Haiti because the country had not seen an outbreak in at least 50 years.

Afsar Ali, a University of Florida microbiologist who studies cholera in developing countries, was not surprised by the outbreak.

Ali says he went to Haiti in August and saw too many people in crowded, squalid conditions with no access to clean water. He says more surveillance of water sources, particularly in areas outside Port-au-Prince, could have alerted authorities to cholera in the water and an education campaign could have taught people how not to spread the bacteria.

Because the focus was on disaster relief after the quake, he says, "nobody paid attention. Everyone was busy doing other things."

Copyright 2010 USA TODAY, a division of Gannett Co. Inc.

Published Tuesday, November 16, 2010.

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