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Cholera situation update ng os 15112010 dd ad

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  • 1. Cholera Outbreak in Haiti Update November 15 th , 2010
  • 2. Current Situation
    • Health partners in Haiti are preparing for growing number of cases in currently affected areas, as well as in areas not yet affected;
    • The epidemic can spread very fast in the metropolitan area of Port au Prince due to the large number of IDPs camps and lack of access to basic sanitation in slums;
    • Outbreaks in remote rural areas are a special concern, both because they are fewer resources to treat cases and due to the lack of infrastructure to implement cholera prevention;
  • 3. 12,303 796 14,642 hospitalized cases, 917 deaths (MSPP,11/12/2010)
  • 4. Current Situation (b)
    • Case Fatality Proportion:
      • 4% at national level, varies a lot depending of the location, in some locations 6%;
      • Should be < 1% with access to ORCs, UTCs and CTCs and adequate Case Management.
    • The attack rate could be very different depending of the human ecosystem (rural, urban/slums, IDP camps):
      • could be as high as 5% in IDPs camps and slums in cities (Gonaives, Cap Haitien, St Marc)
  • 5. The National Response
    • The National Response Strategy:
    • Aims to protect families at the community level including:
      • health promotion (water / food handling, hand hygiene, how to take ORS at home, school training) ;
      • management of cases at family and community levels;
      • and social communication (messages through print media, TV , radio, SMS);
    • Strengthen primary care centers already operating across the nation;
    • Establish a network of CTCs and strengthen hospitals for treatment of severe cases.
  • 6. Re organization of Health Services
    • Cholera services are being re organized at three levels:
      • CTCs: average capacity of 100-300 beds (10 CTCs for the metropolitan area);
      • CTUs: in or next to health facilities, smaller capacity than CTCs (usually 15-20 beds) can serve as a triage unit preventing hospitals from being overwhelmed;
      • Maintain and strengthen the capacity of Primary Care network with ORCs (roughly 300 nationwide), to treat patients with non-life-threatening conditions.
  • 7. 12,303 796 14,642 hospitalized cases, 917 deaths (MSPP, 11/12/2010)
  • 8. Some of the priority areas for PAHO
    • Surveillance / Risk Assessment : combining indicator based and event based surveillance including information from health partners in order to do a timely mapping of Hot Spots and trigger the response;
    • Case Management : disseminating and training on case management protocols for all levels of health services including dead bodies management;
    • Logistics and supplies : logistics chain for ORS, IV fluids, antibiotics, etc., PROMESS;
    • Information / Communication : media, IHR
    • Collaboration with Health and WASH clusters on water, sanitation, hygiene/health promotion and social mobilization.
  • 9. Conclusions
    • What we know:
    • All the population is naïve to the cholera vibrio;
    • The epidemics will spread to all departments and districts;
    • Vibrio cholerae O:1 has a foothold in the environment and could impact Haiti for a number of years;
    • What we don’t know:
    • How long will it take before reaching the peak of the epidemic?
    • How long this first wave will last?
  • 10. Conclusions (b)
    • Ultimate control of the epidemic in Haiti will depend on the provision of Safe Water for all and access to basic sanitation!
    • Surveillance and preparedness in Caribbean countries with Haitian communities: Dominican Republic, Jamaica, Bahamas, Turk & Caicos….