Haiti had not experienced a cholera epidemic in over a century. The January 2010 earthquake changed that.
In the wake of the destruction and misery, cholera paid a visit. By October 2010 an epidemic had been identified. By six weeks later 91,770 cases had been reported, 43,243 of whom had been hospitalized – this from a country a little smaller than my home state of Ohio.
In response, the CDC developed a free 50-page downloadable training manual:
Haiti Cholera Training Manual: A Full Course for Healthcare Providers
at: http://www.cdc.gov/haiticholera/pdf/haiticholera_trainingmanual_en.pdf.
Here are a few highlights:
- Without laboratory examination to detect the Vibrio cholerae bacterium (a gram-negative rod), the diagnosis must be made clinically (according to symptoms only).
- Transmission occurs through contaminated water or food (not person to person). Contamination of water with feces from infected individuals is the usual cause, although the organism can live in warm coastal waters as well.
- Profuse watery diarrhea may rapidly produce dehydration, electrolyte loss with muscle cramping, acidosis, vomiting, and death.
- Although this is a bacterial infection, the mainstay of treatment is oral (or IV) rehydration therapy. If using IV fluids, Ringer’s Lactate is preferred.
- Moderate to severely ill patients should receive antibiotic therapy to help decrease diarrhea volume and duration (doxycycline 300 mg x 1 dose; or azithromycin 1gm x 1 dose; or tetracycline or erythromycin 500 mg 4x daily x 3 days)
- Avoid anti-diarrheal medicines, which may prolong cholera infection.
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- Haiti Cholera Epidemic Could Sicken 779,000 This Year (nlm.nih.gov)
With apologies to the CDC, we know how to prevent and treat cholera. What went wrong in Haiti was a massive failure to deal with a corrupt government. The government of Haiti taxed all the emergency supplies coming into the country. They stole supplies and forced the aid to stay in storage instead of getting it to those who needed it. They interfered with the process of bringing aid at every turn including putting people in jail who did not bow to the criminal government. Does anyone really think we don’t know how to treat cholera? The UN failed massively in Haiti and crime and corruption won massively. Where did the money go? No doubt many former Haiti government officials are living on yachts off the coast of Southern France. As so often happens the government was THE problem.