October 2010 marked the beginning of the outbreak of cholera in Haiti. As of late last month, the disease has caused almost 4,000 deaths and has infected over 190,000 individuals.\n
The reason this outbreak has received so much attention is the fact that Haiti has not had a cholera outbreak of this magnitude for almost half a century.\n
Researchers took stool samples from two clinically diagnosed cholera patients and compared the genetics of the baterical cause of cholera to other cholera outbreaks. These other outbreaks included a 1991 outbreak in Peru, a 1971 outbreak in Bangladesh, and a more recent 2008 outbreak in the same area.\n
Researchers found the most silimiarities between the H1 strand taken from the patients in Haiti to the M4 strand of the 2008 outbreak in Bangladesh.\n
But how could the same strain that infected Bangladesh in 2008 currently be infecting Haiti in 2010, thousands of miles away?\n
The first cases of cholera in Haiti were close to the 320km river that forms a natural border between Haiti and the Dominican Republic.\n\nAlong one of the tributaries to this river, a UN base was reported to have been dumping waste into the river. Human waste is the main transmission vector for cholera.\n\nThe base consisted largely of soldiers from Nepal.\n
And cholera is endemic in Nepal.\n
And Nepal is not too far away from Bangladesh.\n
The hypothesis that the soldiers from Nepal brought the strain of cholera to Haiti is further augmented by the fact that the UN does not require its peacekeeping forces to be tested for cholera if they are not showing symptoms.\n\nHowever, you can still carry cholera and be asymptomatic.\n\nThe Nepalian base has since released reports showing that the fecal matter they were dumping into the river did not contain cholera, and have also reported that none of the soldiers have exhibited the symptoms of cholera.\n
The outbreak began in October of last year. The outbreak has since been brought under control. However, the exact source of the Haitian cholera outbreak has not been determined.\n
The Origin of the Haitian Cholera Outbreak Strain
The Origin of the Haitian Cholera Outbreak Strain The NEW ENGLAND JOURNAL of MEDICINE N Engl J Med 2011;364:33-42 NEJM.ORG 9 Dec 2010
According to the Haitian Ministry of PublicHealth and Population, as of January 24 2011, there have been 187,343 diagnosed cases of cholera and 3,778 deaths.
Haiti has not had a cholera outbreak for over 50 years.
The mutation of cholera isolated in Haiti mostresembled a strain isolated in Bangladesh in 2008.