“The cholera strain in Haiti is evolving, researchers reported Thursday, a sign that it may be taking deeper root in the nation less than two years after it appeared and killed thousands of people,” the Associated Press/USA Today reports. “The study released by the U.S. Centers for Disease Control and Prevention indicates that the bacterium is changing as survivors acquire at least some immunity to the original bug, which apparently was imported from Nepal,” the news service writes (Daniel, 5/5). “The evolution of the cholera strain was expected and typical of the disease, according to the CDC,” CBS Miami notes (5/4).
Efforts To Fight Cholera In DRC Need To Include Sanitation, Waste Facility Improvements, Behavior Change, UNICEF Official Says
A cholera epidemic that began in January 2011 in the Democratic Republic of Congo (DRC) is continuing because of “poor hygiene, lack of awareness of the population about transmission mechanisms, very limited access to protected and monitored water sources and lack of sanitation infrastructure,” according to Nona Zicherman, chief of emergency operations in DRC for UNICEF, IRIN reports. Since the beginning of the epidemic, more than 30,000 cholera cases have been identified and more than 700 people have died of the disease since June 2011, the news service states. Zicherman “noted that emergency and medium- and long-term interventions to limit the spread of cholera needed to be developed,” including disinfecting contaminated areas, monitoring water sources, changing behaviors related to hygiene, and constructing water supply and sanitation facilities, according to IRIN (4/30).
“A campaign to introduce new childhood vaccines to Haiti will save tens of thousands of lives over the next decade, [CDC Director] Dr. Thomas Frieden told [NPR’s health blog ‘Shots’] at the end of a two-day tour of the beleaguered country,” the blog reports. “Frieden was part of a delegation to Haiti that included his boss, Health and Human Services Secretary Kathleen Sebelius,” according to the blog, which notes, “When the U.S. delegation arrived, a different vaccination campaign had just gotten started — a pilot project to immunize against cholera” (Knox, 4/17). According to another article in “Shots,” “U.S. health officials have been cool to that pilot project behind the scenes,” but Sebelius expressed support for the project.
IRIN examines how local Zimbabwean farmers’ usage of water containing raw sewage to irrigate their crops poses a risk of disease transmission to people who consume the vegetables. In the capital Harare, less than half of the raw sewage produced is treated before being sent back into tributaries, according to IRIN, which notes, “In a recent report, Harare mayor Muchadeyi Masunda said 60 percent of the capital’s residents did not have access to clean water, and 10 percent relied on boreholes and unprotected wells.” Since a cholera outbreak in 2008, UNICEF and other international donors have been helping Zimbabwean municipalities treat their water, but the UNICEF program is winding down, leaving some unsure whether local authorities “can go it alone,” IRIN writes (4/16).
“A year and a half after cholera first struck Haiti, a tiny portion of the population on Thursday began getting vaccinated against the waterborne disease that has infected more than 530,000 Haitians and killed more than 7,040,” the New York Times reports (Sontag, 4/12). The pilot project, which will reach only one percent of Haiti’s population, “aim[s] … to show that it’s possible to give the required two doses over a two-week period to desperately poor and hard-to-reach people,” NPR’s health blog “Shots” writes. “If it works, the plan is to convince the Haitian government, deep-pocketed donors and international health agencies to support a much bigger campaign to vaccinate millions of Haitians at highest risk of cholera,” according to the blog (Knox, 4/12).
In this New York Times opinion piece, columnist Tina Rosenberg examines a global rise in cholera cases, writing, “The World Health Organization estimates that there are between three million and five million cases of cholera each year, and between 100,000 and 120,000 deaths. New and more virulent strains are emerging in Asia and Africa, and the WHO says that global warming creates even more hospitable conditions for the disease.” However, “[c]holera should not be a terror. It is easy to treat if you know how,” she writes.
“The toilet is a magnificent thing. … Unfortunately it is an impractical luxury for about two-thirds of the world’s seven billion people because it relies on connections to water and sewerage systems that must be built and maintained at great expense,” a Bloomberg editorial writes. “About 40 percent of all people, an estimated 2.6 billion of them, have no access to even a minimally sanitary facility, according to the World Health Organization,” and “[t]he result is illness and early death. Diarrheal diseases, including those linked to improper sanitation, are the second largest killer in the developing world, taking two million lives annually,” the editorial continues.
In a monthly bulletin (.pdf) on the humanitarian response in Haiti, the U.N. Office for the Coordination of Humanitarian Affairs said that an increase of new cholera cases has been recorded in the western and northern parts of the country and “that Haitian health officials recorded 77 new cases a day for the whole country in early March, when the rains began,” the Associated Press/USA Today reports. “The new cholera cases come after a steady decline since June of last year when aid workers saw peaks of more than 1,000 cases on certain days,” the news agency writes.
In this Reuters opinion piece, finance blogger Felix Salmon responds to a New York Times (NYT) article published on Monday in which journalist Deborah Sontag examines the global response to Haiti’s cholera epidemic. He writes, “There’s no doubt that Haiti’s cholera epidemic was massive and tragic, and that the response to it could have been better, in an ideal world. But Sontag barely attempts to address the question of why the response was suboptimal. … Rather, [she] spends a huge amount of effort tracking down, on the one hand, purely anecdotal stories of individual Haitians who were exposed to the disease, and on the other hand, the detailed story of whether and how the outbreak could be traced back to a group of Nepalese peacekeepers on the island.”
The New York Times examines the global response to Haiti’s cholera epidemic, writing that while “[m]any health officials consider the cholera response ‘pretty remarkable,’ as John Vertefeuille, the Centers for Disease Control and Prevention’s director in Haiti, said … [o]thers … believe the bar for success was set too low and more lives could have been saved.” The newspaper continues, “[A]s the deaths and continuing caseload indicate, the world’s response to this preventable, treatable scourge has proved inadequate.”