Cholera confirmed for resident of Haiti's capital

[November 09, 2010]  PORT-AU-PRINCE, Haiti (AP) -- The cholera epidemic has spread into Haiti's capital, imperiling nearly 3 million people living in Port-au-Prince, nearly half of them in unsanitary tent camps for the homeless from the Jan. 12 earthquake.

Health authorities told The Associated Press on Monday that tests confirmed a 3-year-old boy who hadn't been out of the city had caught the disease. More than 100 other suspected cholera cases among city residents also were being tested.

The outbreak has already killed at least 544 people in Haiti, Health Ministry Executive Director Gabriel Timothee told the AP.

The boy was tested after being taken to the Bernard Mevs/Project Medishare hospital Oct. 31 suffering from severe dehydration, nausea, vomiting and diarrhea. He was treated with oral rehydration, IV fluids and antibiotics and released.

A stool sample tested by Haiti's national laboratory contained vibrio cholerae 01, the bacteria causing the disease, the chief medical officer, Dr. Antonia Eyssallenne, confirmed to AP in an e-mail. The boy's family had not traveled in more than a year or had contact with anyone from the Artibonite Valley, where the epidemic was first registered and has wreaked its most ferocious damage.

Timothee said many of the patients hospitalized in the capital with cholera are believed to have recently arrived from the Artibonite Valley, an agricultural area where more than 6,400 of Haiti's known 8,138 cases have been recorded.

At least 114 of the people suspected of having the disease in the capital are in the Cite Soleil slum, the expansive oceanside shantytown at the capital's far northeastern edge and its closest point to the valley.

Since its discovery in late October, the disease has spread to half of Haiti's 10 administrative regions, or departments. More than 200 people have been hospitalized in the West department, where Port-au-Prince is located, but no cases of cholera have yet been confirmed within the limits of the capital city.

Cholera had never been documented in Haiti before its appearance last month.

In little more than three weeks it is suspected of infecting tens of thousands of people, though only about a quarter of people infected normally develop symptoms of serious diarrhea, vomiting and fever. Nearly 4 percent of the thousands hospitalized have died, most from extreme shock brought on by dehydration.

Officials are concerned that floods triggered by Hurricane Tomas on Friday and Saturday could exacerbate the spread of the disease, which is transmitted through the consumption of fecal matter contained in contaminated water or food. The release of a dam on the Artibonite River caused the infected waterway to swell Monday, but there were no reports of major flooding.

Living conditions in Port-au-Prince's earthquake camps have "deteriorated as a result of the storm," Boston-based Partners in Health said Monday.

"Standing water, mud, lack of garbage collection, and limited sanitation availability make the camps a potential flashpoint for cholera outbreak," the group said.

Humanitarian groups and Haitian health care workers have been working in Port-au-Prince to prepare for cholera, informing residents about preventative measures such as regular hand-washing and sufficiently cooking food as well as setting up clinics in expectation that the disease would spread to the city.

The origin of the outbreak continues to be a source for debate. Analysis by the U.S. Centers for Disease Control and Prevention has found that the cholera outbreak in Haiti most closely matches a strain of the disease found in South Asia.

Public health experts, including U.N. Deputy Special Envoy to Haiti Paul Farmer, who co-founded Partners in Health, have called for an aggressive investigation into the origin of the outbreak.

They say that should include looking at the unconfirmed hypothesis that cholera was introduced by U.N. peacekeepers from Nepal, a South Asian nation where the disease is endemic. Those peacekeepers are at a U.N. base on a tributary of the Artibonite River, which has been found to be contaminated with cholera.

[Associated Press; By JONATHAN M. KATZ]

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