Health Professionals

Clinical Updates

17 June 2011

Cholera outbreak in Haiti and Dominican Republic, Hispaniola - Update

The outbreak of cholera, first recognised in Haiti on 21 October 2010, is continuing. On 7 June 2011, the Pan American Health Organization (PAHO) reported that 324,299 cases (including 172,482 hospital admissions) had occurred since the beginning of the outbreak to the end of May 2011. In addition, 5,342 deaths from cholera have been confirmed by the Ministère de Santé Public et de la Population, Haiti.

Since early May, an increase in hospitalisations for cholera has been reported in the Port au Prince area together with an increase in registered cases in the Ouest, Gran-Anse, Sud and Sud-Est departments. This increase coincides with the start of Haiti’s rainy season [1]. On 6 June 2011, severe heavy rains fell in the West, including Port au Prince metropolitan area and Nippes [2].

View a map of the area affected by recent flooding.

In the Dominican Republic, 1,329 cases (191 in 2010) including 27 deaths have been confirmed since the beginning of the outbreak to 14 May 2011. Cases have occurred in 27 of the 31 provinces of the Dominican Republic. On 6 June 2011, heavy rains resulted in flooding in Dajabón, Monte Plata, Puerto Plata, Sánchez Ramírez, San Cristóbal, San Pedro de Macorís and Santiago provinces, displacing more than 4,000 people [3].

View a map of the areas affected by recent flooding.

National and international efforts to enhance surveillance and treatment are ongoing [4]. Cholera treatment centres in Haiti are reported to be working at full capacity [4, 5].

Rainfall occurs throughout the year in Hispaniola; in Haiti the heaviest rains usually occur between April and May and September and October. In the Dominican Republic heavy rain usually occurs during May and between August and the end of October.

Advice for travellers

The risk of cholera in travellers to Haiti and Dominican Republic is low. To date only one case of cholera associated with this outbreak has been reported in the UK; this was in a traveller who recently returned from the Dominican Republic [6].

All travellers should practise food and water hygiene precautions. In particular, travellers should avoid the consumption of shellfish unless they are sure they have been thoroughly cooked.

Cholera vaccine is not routinely recommended for travellers, but may be considered for those at higher risk such as humanitarian aid workers and those who will have limited access to safe drinking water.

Advice for health professionals: returned travellers

Information for health professionals assessing travellers returned from cholera-affected areas including the Dominican Republic is available from the Health Protection Agency.

References

1. Pan American Health Organization. Epidemiological Alert: Update on the Cholera situation in Haiti and the Dominican Republic 7 June, 2011. [Accessed 17 June 2011]. Available at: http://new.paho.org/hq/index.php?option=com_content&task=

view&id=5554&Itemid=2291

2. United Nations Office for the Coordination of Humanitarian Affairs (OCHA). Haiti: flooding situation. Report No.1.7 June, 2011. [Accessed 17 June, 2011]. Available at: http://reliefweb.int/sites/reliefweb.int/files/resources/Full_

Report_1097.pdf

3. Dominican Republic: Floods Location Map. 6 June, 2011. [Accessed 17 June, 2011]. Available at: http://reliefweb.int/node/406434

4. International Federation of Red Cross and Red Crescent Societies. Haiti and the Dominican Republic: Increase in cholera cases. Information Bulletin No.2. 13 June, 2011. [Accessed 17 June 2011]. Available at:  http://reliefweb.int/sites/reliefweb.int/files/resources/IB13062

011.pdf

5. Pan American Health Organization. EOC Situation Report. Cholera outbreak in Haiti. 3 June, 2011. [Accessed 17 June, 2011]. Available at: http://new.paho.org/disasters/index.php?option=com_content

&task=view&id=1423&Itemid=1

6. Health Protection Agency. Cholera outbreak in Haiti and Dominican Republic (Hispaniola). Health Protection Report 2011: 5(24): news. Available online at: http://www.hpa.org.uk/hpr/infections/travel.htm#chlr

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