A new cholera epidemic is killing hundreds of people in Haiti. Scientists think it’s the same strain that was brought into the country by United Nations troops more than a decade ago.

Patients rest on stretchers in the Diquini Cholera Treatment Center in Port-au-Prince, Haiti.Andrés Martínez Casares/Reuters

  • Haiti is experiencing its first cholera epidemic in three years.

  • The country has reported 13,672 cases of the disease and 283 deaths since the beginning of October.

  • The current strain may have descended from the 2010 strain likely brought by United Nations troops.

Less than a year after the Haitian government declared cholera eradicated in the country, the disease is re-infecting thousands. According to a December 13 World Health Organization report, the country has reported 13,672 cases and 283 deaths since the beginning of October.

The latest cholera outbreak in Haiti started in 2010. Now, experts say in correspondence with the New England Journal of Medicine that the strain of cholera currently causing another outbreak in Haiti is related to the 2010 strain. he is probably a descendant.

The current outbreak was first reported on Oct. 2, according to WHO, after three years with no cholera cases reported. Between October 2010 and February 2019, the country reported 820,000 cases and 9,792 deaths from cholera in a massive nationwide epidemic. In February 2022, the Haitian government declared that cholera had been eradicated in the country.

Cholera causes severe dehydration and is spread through dirty water

Cholera is spread when a person ingests water or food that is infected with a bacterium called Vibrio cholerae. Symptoms include watery diarrhea and dehydration. Most cases are not serious, and the WHO has stated that if adequate treatments are available, less than 1% of people who become ill die. However, if left untreated, the disease can kill people very quickly.

Treatment involves rehydrating patients with a solution swallowed orally or pumped through an IV. Currently, there are three oral vaccines used by WHO that can prevent cholera. WHO maintains a stockpile of these vaccines, and on December 12, the organization sent a shipment of about one million doses of one of these vaccines, called Euvichol, to Haiti. More cholera vaccines should arrive in Haiti in the coming weeks.

United Nations troops cause Haiti’s latest cholera outbreak

The massive 2010 outbreak began after a deadly earthquake in January of that year that was estimated to have killed more than 300,000 people. United Nations troops from Nepal arrived in Haiti in early October of that year. Before going to Haiti, there had been a cholera outbreak in Kathmandu, where troops trained before deployment. On October 12, 2010, the first case of cholera was reported in Haiti, in a man who bathed and drank from a river two kilometers away from where troops were encamped.

In 2011, a UN panel of experts determined that the outbreak had begun in a UN camp, and while it did not explicitly state that troops from Nepal had brought cholera to Haiti, it did say that cholera strains from Haiti and from Nepal they were “a perfect match”. In 2016, the UN finally admitted it played a role in the outbreak, while not taking legal responsibility.

Scientists still don’t know why this new cholera epidemic is happening

Scientists are still not sure how cholera resurfaced in Haiti after three years with no cases reported.

In recent NEJM correspondence, the authors proposed three hypothetical reasons why cholera may have resurfaced.

The first is that cholera cases may have persisted since 2019, but these cases have gone under the radar, and now cases are rising once again due to lack of clean water and sanitation along with falling immunity in the population.

The second is that it may have remained present in environmental reservoirs such as rivers or estuaries, where the organism can survive outside human hosts for several days at a time.

The third reason is that cholera may have spread to other Latin American countries during the 2010 epidemic and may have been reintroduced to Haiti from one of these countries. However, the authors say this third option is unlikely, in part because other countries in the region have reported no recent cases of cholera.

Whatever the cause of the new cases, the authors said: ‘These findings, coupled with the upsurge of cholera in several parts of the world despite the tools available to combat it, suggest that cholera control and prevention efforts need to be redoubled.’

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