Cholera Update: December 6th, 2010

Summary

The Ministère de la Sante Publique et de la Population (MSPP) reported today that the cumulative number of hospital visits and deaths due to cholera, as of December 3, is 91,770 and 2,071 respectively. 43,243 people have been hospitalized due to cholera. The in-hospital case fatality rate for the whole country is 3.3%.

For Port-au-Prince, the cumulative number of hospital visits and deaths due to cholera is 12,566 and 185 respectively. 4,452 have been hospitalized. The in-hospital case fatality rate for Port-au-Prince is 4.0%.

In the last days, there were pacific demonstrations in Port-au-Prince, which did not pose significant obstacles to the response to the outbreak. But the security situation remains uncertain. The results of the presidential and parliamentary election will be announced Wednesday, December 8.

Estimated Cholera Cases and Needs

The number of cholera cases continues to grow, but a smaller proportion of people who become ill are now dying from the disease, according to data released this week. In the first weeks of the cholera epidemic, which began in late October, the proportion of hospitalized patients dying of cholera in some departments was as high as 9 percent. In the latest reports from Haiti’s Ministry of Health, that figure is down to 3.5 percent.

PAHO/WHO’s Deputy Director, Dr. Andrus, and other public health experts believe that numbers significantly underestimate the true toll of the epidemic because of gaps in case reporting. Epidemiological modeling carried out by PAHO/WHO and the U.S. Center for Disease Control and Prevention (CDC) for planning purposes projects an estimated 400,000 cases over the first 12 months, with as many as half those cases occurring in the first three months of the epidemic.

Haiti’s Ministry of Health is developing plans, with support from PAHO/WHO and other U.N. agencies, to increase the number of Cholera Treatment Centers (CTC), Cholera Treatment Units (CTU) and ORP (Oral Rehydration Posts). The final number of planned centers, units and posts will be announced soon.

Haitian authorities are also expanding efforts to promote prevention and treatment at the family and community levels through public education and by providing chlorination tablets and oral rehydration salts.

Health Partners Response

According to Health Cluster Members in Haiti, as of December 3, 54 CTCs and 102 CTUs are now operational across the county with further scaling up required. CTC are larger units, with an average of 50 beds, and some reaching hundreds of beds. CTU are smaller units, usually attached to existing health facilities. It is estimated that the bed capacity of these centers is 4,681 and 1,222 respectively.

In the light of an apparent reduction of number of severe cases in certain Northern Departments, there is now consideration to moving resources form existing CTC to CTC installed in areas of greater demand. If this trend is confirmed, important resources can be reallocated to other areas, particularly human resources.

On December 3, The United Nations Secretary General, Mr. Ban Ki-moon, made an urgent appeal for funds to respond to the cholera outbreak in Haiti. During a General Assembly debate on Haiti, he stressed that the UN appeal for 174 million dollars made last month has only been 20 percent funded and urged the donors to contribute more.

Cholera Key Facts

Cholera is an acute diarrheal infection caused by exposition, ingestion of food or water contaminated with the bacterium Vibrio cholerae 0:1. Provision of safe water and sanitation is critical in reducing the impact of cholera and other waterborne diseases.

Up to 80% of cases can be successfully treated with oral rehydration salts.

There are an estimated 3-5 million cholera cases and 100,000-120,000 deaths due to cholera every year around the world.

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