{"id":16842,"date":"2015-08-24T00:11:00","date_gmt":"2015-08-24T07:11:00","guid":{"rendered":"http:\/\/live-hakamagwp.pantheonsite.io\/news\/five-years-cholera-threatens-become-endemic-haiti"},"modified":"2021-05-14T09:13:54","modified_gmt":"2021-05-14T16:13:54","slug":"five-years-cholera-threatens-become-endemic-haiti","status":"publish","type":"custom_news","link":"https:\/\/hakaimagazine.com\/news\/five-years-cholera-threatens-become-endemic-haiti\/","title":{"rendered":"Five Years On, Cholera Threatens to Become Endemic in Haiti"},"content":{"rendered":"

T-shirts handed out by aid workers in Haiti read \u201cKolera, li se pa fini\u201d<\/em>\u2014creole for \u201cCholera, it\u2019s not finished.\u201d<\/em><\/p>\n

For\u00a0its entire known history<\/a>, the small island state of Haiti had never seen a single case of cholera. In 2010, that all changed.<\/p>\n

On Tuesday, January 12, 2010 at 4:53 p.m., a magnitude 7.0 earthquake struck just outside the Haitian capital of Port-au-Prince. The quake killed 230,000 people<\/a> and displaced two million more. In the wake of the disaster, aid\u2014and aid workers\u2014flowed into Haiti. And they brought cholera<\/a>\u2014and the diarrhea, vomiting, and deadly dehydration<\/a> it causes\u2014with them.<\/p>\n

Only nine months after the quake, the first cholera outbreak struck Haiti. Now, five years on, leading epidemiologist Afsar Ali<\/a> worries that cholera is becoming endemic<\/a>\u2014that the various cholera strains<\/a> are\u00a0establishing themselves\u00a0in environmental reservoirs that will make them\u00a0difficult, if not impossible, to eradicate.<\/p>\n

\n

The very first time Ali visited Haiti was in August 2010. An expert epidemiologist who has spent much of his life studying cholera in Bangladesh, Ali was brought in to assess the country\u2019s risk of diarrhoeal pathogenic organisms.<\/p>\n

\u201cThe situation was so bad\u2014with people moving in and out, internal displacement, a lot of people coming from other countries, poor public health infrastructure \u2026 that when I came back, I said that it is only a matter of time before cholera hits,\u201d Ali says.<\/p>\n

<\/a>

Dirty, potentially contaminated water stagnates in a drainage ditch in one of the refuge tent cities set up in the wake of the earthquake. Photo by\u00a0Brian Blanco\/ZUMA Press\/Corbis<\/p><\/div>\n

Cholera spreads through contaminated water, and even before the earthquake Haiti\u2019s water and sanitation infrastructure wasn\u2019t in good shape. Two months after the epidemiologist\u2019s arrival, the Haitian government reported the spread of\u00a0Vibrio cholerae O1<\/em>. The start of the cholera epidemic was explosive. Within the first month,\u00a0303 people died and thousands fell ill<\/a>. Within three years,\u00a08,231 had died<\/a>\u00a0and hundreds of thousands were hospitalized. The disease has since spread to neighboring countries, including the Dominican Republic and Cuba.<\/p>\n

\n

By 2013 and 2014, the number of cholera cases in Haiti finally started to drop. The declining caseload was a cause for optimism; yet Ali still doesn\u2019t think the country is in the clear, noting the threat of complacency\u2014a position echoed by many of the aid organizations working in the region.<\/p>\n

Ali\u2019s stance stems from more than just the precautionary principle\u2014his worry is based on a new understanding of how cholera is transmitted.<\/p>\n

<\/a>

The bacterium that causes cholera, Vibrio cholerae<\/em>,\u00a0can sometimes form a biofilm, making it resistant to decontamination. Photo by\u00a0Callista Images\/cultura\/Corbis<\/p><\/div>\n

There are two schools of thought on how cholera spreads: the standard view, that transmission is predominately human-to-human, through fecal-contaminated water. And another view, one that is gaining weight as evidence accumulates: that cholera can persist in the environment, independent of human contamination.<\/p>\n

Rita Colwell,<\/a>\u00a0a much-lauded environmental microbiologist, has done much of the work to develop this idea. Colwell has found microorganisms thriving around the world. She\u2019s found cholera in oceans, isolated lakes, and rivers untouched by fecal contamination. Colwell\u00a0has also found cholera in Haitian waters. Ali\u2019s research fits in with the second view. Using Haiti as a case study, Ali is asking: can cholera exist without human\u2013to-human transmission?<\/p>\n

Between Gressier and Leogane, two communities dissected by the Momance River, Ali and his team have spent the past three years monitoring 14 environmental sites, collecting samples of the water, and the plants and animals in the river, looking for traces of the water-borne bacteria. Contrary to prevailing expectations, the team has been isolating even more\u00a0Vibrio cholerae<\/em>\u00a0bacteria from aquatic sites across Haiti.<\/p>\n

\u201cWe have so many strains collected over the years [that we] simply cannot say that cholera is not present in Haiti\u2019s aquatic reservoirs,\u201d he says.<\/p>\n

\n

Ali\u2019s research has far-reaching implications. The Haitian government has recently launched a US $2.2-billion, 10-year plan to eradicate cholera. If it turns out that cholera has become endemic, the coming fight may be even more difficult than expected.<\/p>\n

\u201cWhen cholera becomes endemic, when it has established its aquatic reservoir in a country, it is extremely difficult to eliminate. And our study is clearly finding that we are heading in that direction,\u201d he says.<\/p>\n

Correction: This story\u2019s headline was updated for clarity.<\/p>\n","protected":false},"excerpt":{"rendered":"

Ongoing investigations suggest cholera is establishing itself in the environment.<\/p>\n","protected":false},"featured_media":12585,"menu_order":0,"template":"","format":"standard","meta":{"_acf_changed":false,"om_disable_all_campaigns":false,"footnotes":""},"categories":[],"tags":[],"acf":{"hero_video_url":null,"hero_video_caption":"","deck":"Ongoing investigations suggest cholera is establishing itself in the environment.","authors_group":[{"by_group":"by","contributors_group":[15476]}],"word_count_override":"","podbean1":"","podbean2":"","redirect":"","geolocation":{"address":"18.572854, -72.28030","lat":18.572854,"lng":-72.2803},"related":[17032,16763],"twitterimage":18743,"facebookimage":18743,"twitterdescription":"","edited":"","factchecked":"","code":"","no_old_story_flag":""},"_links":{"self":[{"href":"https:\/\/hakaimagazine.com\/wp-json\/wp\/v2\/news\/16842"}],"collection":[{"href":"https:\/\/hakaimagazine.com\/wp-json\/wp\/v2\/news"}],"about":[{"href":"https:\/\/hakaimagazine.com\/wp-json\/wp\/v2\/types\/custom_news"}],"version-history":[{"count":3,"href":"https:\/\/hakaimagazine.com\/wp-json\/wp\/v2\/news\/16842\/revisions"}],"predecessor-version":[{"id":35141,"href":"https:\/\/hakaimagazine.com\/wp-json\/wp\/v2\/news\/16842\/revisions\/35141"}],"acf:post":[{"embeddable":true,"href":"https:\/\/hakaimagazine.com\/wp-json\/wp\/v2\/news\/16763"},{"embeddable":true,"href":"https:\/\/hakaimagazine.com\/wp-json\/wp\/v2\/news\/17032"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/hakaimagazine.com\/wp-json\/wp\/v2\/media\/12585"}],"wp:attachment":[{"href":"https:\/\/hakaimagazine.com\/wp-json\/wp\/v2\/media?parent=16842"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hakaimagazine.com\/wp-json\/wp\/v2\/categories?post=16842"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hakaimagazine.com\/wp-json\/wp\/v2\/tags?post=16842"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}