Haiti: Disease flare-up stabilizing

Data suggest cholera’s spread more gradual than earlier feared

— A cholera outbreak that has killed more than 250 people in rural Haiti is stabilizing, health officials said Monday, as aid groups and the government race to prevent it from spreading to the capital’s camps of earthquake survivors.

The outbreak was expected to continue spreading, but aid groups and the government said a drop in the death rate and the number of new cases suggested it could progress more gradually than feared.

“The situation is beginning to stabilize. Since yesterday we have registered only six new deaths,” Health Ministry Director Gabriel Timothee said at a news conference.

Officials said no cases have originated in the capital, Portau-Prince, where authorities fear abysmal hygiene, poor sanitation and widespread poverty could rapidly spread the disease through the sprawling tent slums erected after the Jan. 12 earthquake.

Five patients were diagnosed with cholera in Portau-Prince over the weekend, but officials said they got sick outside the capital.

As part of the effort to slow the spread of the disease,Timothee said, the government has asked for garbage to be removed around the camps of homeless people.

If efforts to keep cholera out of the camps fail, “the worst case would be that we have hundreds of thousands of people getting sick at the same time,” said Claude Surena, president of the Haiti Medical Association. Cholera can cause throwing up and diarrhea so severe it can kill from dehydration in hours.

Robyn Fieser, a spokesman for Catholic Relief Services, said she was confident that aid groups and the Haitian government will be prepared to respond to an outbreak should it occur in the camps. But she stressed that the challenge of preventing its spread is “immense.”

“There are proven methods to contain and treat cholera, so we know what we’re dealing with. The biggest challenge is logistics, that is, moving massive amounts of medicine, supplies and people into place to treat them and prevent the disease from spreading,” Fieser said from the neighboring Dominican Republic.

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Doctors Without Borders issued a statement saying that some Port-au-Prince residents were suffering from watery diarrhea and were being treated at facilities in the capital city. Cholera infection among the patients had not been confirmed, however, and aid workers stressed that diarrhea has not been uncommon in Port-au-Prince since the earthquake.

Aid workers in the nation say the risk is magnified by the extreme poverty faced by people displaced by the quake, which killed as many as 300,000 people and destroyed much of the capital city. Haitians living in the camps risk disease by failing to wash their hands, or scooping up standing water and then proceeding to wash fruits and vegetables.

Timothee said the outbreak has killed 259 people and sickened 3,342.

“We are expecting a gradual spreading of cholera in the country, and the way it will do that is still unpredictable,” said Michel Thieren, an official with the Pan-American Health Organization in Haiti.

Aid workers are coaching thousands of impoverished families how best to avoid cholera. Various aid groups are providing soap and water purification tablets and educating people in Portau-Prince’s camps about the importance of washing their hands.

Aid groups also began training more staff about cholera and where to direct people with symptoms.

The disease had not been seen in Haiti for decades, and many people don’t know about it.

Aid group Partners in Health said hospital management was improving in the city at the center of the initial outbreak, St. Marc, which is about a 60-mile drive northwest of Port-au-Prince. Just 300 patients were hospitalized Saturday, a number that has decreased by the end of each day.

A cholera treatment center in St. Marc is expected to be functional within the week, and efforts were ongoing to make clean water available in rural communities, especially those where rivers were the only source of water.

Information for this article was contributed from San Juan, Puerto Rico, by Mike Melia and David Mc-Fadden of The Associated Press.

Front Section, Pages 4 on 10/26/2010

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