N Engl J Med. Responding to Cholera in Post-Earthquake Haiti

[Giuseppe]

Responding to Cholera in Post-Earthquake Haiti (N Engl J Med., extract, edited)


[Source: NEJM, full text: <cite cite="http://www.nejm.org/doi/full/10.1056/NEJMp1012997?query=OF">Responding to Cholera in Post-Earthquake Haiti ? NEJM</cite>. Extract, edited.]

Perspective

Responding to Cholera in Post-Earthquake Haiti

David A. Walton, M.D., M.P.H., and Louise C. Ivers, M.D., M.P.H.

December 9, 2010 (10.1056/NEJMp1012997)


The earthquake that struck Haiti on January 12, 2010, decimated the already fragile country, leaving an estimated 250,000 people dead, 300,000 injured, and more than 1.3 million homeless. As camps for internally displaced people sprang up throughout the ruined capital of Port-au-Prince, medical and humanitarian experts warned of the likelihood of epidemic disease outbreaks. Some organizations responding to the disaster measured their success by the absence of such outbreaks, though living conditions for the displaced have remained dangerous and inhumane. In August 2010, the U.S. Centers for Disease Control and Prevention (CDC) announced that a National Surveillance System that was set up after the earthquake had confirmed the conspicuous absence of highly transmissible disease in Haiti.

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[Ronan Kelly]

Re: N Engl J Med. Responding to Cholera in Post-Earthquake Haiti

from the paper above;

...

The reported numbers of cases and deaths, though shocking, represent only a fraction of the epidemic's true toll. We have seen scores of patients die at the gates of the hospital or within minutes after admission. Through our network of community health workers, we have learned of hundreds of patients who died at home or en route to the hospital. In the first 48 hours, the case fatality rate at our facilities was as high as 10%. Though it dropped to less than 2% in the ensuing days as the health system was reinforced locally and patients began to present earlier in the course of disease, mortality will most likely climb as the disease spreads and Haiti's fragile health system falters.

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http://www.nejm.org/doi/full/10.1056/NEJMp1012997?query=OF&