Cholera Epidemic in Haiti - Essay Example

Cholera Cholera Epidemic in Haiti In Haiti came into the grip of cholera epidemic after it suffered massive earthquakea few months back. Officially, it was confirmed on October 21, 2010. It is important to note that Haiti has never experienced cholera outbreak in last several decades before 2010. Though it is unclear how cholera got its grip in Haiti, it is assumed that water supply lines or storage system facilities must have got infected with Vibrio cholerae organisms during earthquake occurred a few months back. Cholera is a communicable disease usually spreads through contaminated water. When there are no safe drinking water facilities or water gets repeatedly contaminated due to improper sanitation facilities, chances of cholera epidemic increases significantly (Haiti Cholera Outbreak, 2011). History of the Disease Haiti and nearby area suffered massive earthquake in January 2010 killing over 200,000 people. Following the earthquake, over 1 million people were displaced. There was a sudden surge in numbers of people suffering from watery diarrhea and dehydration in and around Haiti. Within a few days, more than 470,000 people were found to be seriously affected from this condition. Of these, 6,631 deaths were reported exclusively due to severe infection. It is perhaps the worst cholera incident reported in the recent times across the world. Even one year after the initial outbreak, cholera continued to spread across the region. Past experiences of cholera outbreak suggest that people around Haiti will continue to suffer from cholera infection for some more times to come. On investigation by the Haiti National Public Health Laboratory, the pathogen Vibrio cholerae was found to be involved in spreading the epidemic in the region (Haiti Cholera Outbreak, 2011). Symptoms Symptoms of cholera can be described as extreme thirst, a dry mouth, irritability, sunken eyes, lethargy, dry skin, no urine output, low blood pressure. For mild cholera infection, not any specific symptoms are observed until watery discharge begins in the person infected with cholera bacteria. Pathophysiology of the Disease Cholera is a diarrheal disease; it causes due to infection by the bacteria called Vibrio Cholerae. Cholera could be fatal if not treated within a few hours of infection. It is a disease that usually spreads from the infected potable water and sometimes from infected food too. Mostly underdeveloped countries are found to suffer from this disease due to improper sanitation facilities or inadequate drinking water treatment facilities. Its detection occurs through stool examination where large numbers of V. Cholerae are found. It has been found that organisms in large numbers get adsorbed to intestinal mucosa. At the beginning of infection, the upper bowel is found full of colonic bacteria and this condition may continue for several weeks depending upon the treatment process. Cholera is dangerous because it causes significant loss of body fluid and electrolytes putting the patient in precarious condition. Usually, fluid loss happens in the small intestine but the protein part in stools is detected very low to the extent of 85 mg/100 ml. Epidemiological Triangle in Understanding Spread of Cholera Source: http://www.ph.ucla.edu/epi/snow/origin_cholera_haiti_epilogue.html The spread of cholera can be explained by applying the model of epidemiologic triangle. The epidemiologic triangle has three corners represented by agent, host and environment. Agent represents microorganism that causes the disease. Host – animal or human being who harbors the disease and finally the environment that facilitates transmission of disease. Epidemic exists when all the three agents, hosts and environment coincide. In case of Cholera outbreak, agent is V. cholera bacteria, which is responsible for the spread of disease. They travel with their hosts. Animals or humans anyone could be hosts of V. cholerae. Humans may have ingested bacteria but may not fall sick; however, continue to secrete the bacteria in their stool. For some reason, when water or food may get contaminated with these bacteria, they also provide a powerful breeding environment. Cholera bacteria are usually found in coastal waters where they attach with copepods. Thus, they move with their hosts and spread to any corner. They do not spread on personal contacts. Certain food sources such as raw fruits, vegetables, seafood are good sources of cholera bacteria. Stagnant water is a good source for growth of cholera bacteria; thus, they serve as potential environment for spread of cholera (Mayo Clinic, 2014). Factors behind Spread of Disease Stagnant water when used without proper treatment can infect the person with cholera. It has been observed that public wells, usually in rural areas, could be a major source for causing cholera infection. Improper sanitation facility is another major cause for spreading cholera. Undercooked seafood such as shellfish originating from locations prone to cholera bacteria can easily spread the disease. Similarly, raw fruits and vegetables carry significant risk in spreading the disease. Cooked food when stored at room temperature for a long time can get contaminated and serve as a good medium for the proliferation of cholera bacteria (Cholera, 2014). The Status of the Disease As per World Health Organization (2014), in 2013, worldwide total number of cholera cases decreased when compared with 2012. Mostly, developing countries in Asia and Africa are prone to cholera outbreaks due to poor sanitation and drinking water facilities. Usually, developed countries do not face threat of cholera outbreaks. Africa is a major breeding region for cholera cases; in 2013, above 43% of the cholera cases were reported from there. Around 93 percent to 98 percent of the total cholera cases during 2001 through 2009 were reported from only African continent. The following graphics depict the number of cases between 1990 and 2013 in different continents. Source: http://www.who.int/gho/epidemic_diseases/cholera/cholera_005.jpg?ua=1 Healthy People 2020 Goals While Healthy People 2020 enlists 10-year national objectives with an aim to improve the health of all citizens in the US, Cholera elimination, as a disease, does not figure in the list of major objectives. The reason being there are rare cases of cholera in the US. In 2010, only 23 cases of cholera were registered in the US and most of them got infection during their travel to Hispaniola. Between 1965 and 1991, only 5 cases, on average were reported in the US. Even after 1991, incidents of cholera were not due to any local causes but mostly were imported by patients from Latin American countries during their travel to those countries (Centers for Disease Control and Prevention, 2014). References Centers for Disease Control and Prevention (2014). Emerging Infectious Diseases. Retrieved December 3, 2014 from http://wwwnc.cdc.gov/eid/article/17/11/11-0808_article Cholera (2014). Mayo Clinic. Retrieved December 3, 2014 from http://www.mayoclinic.org/diseases-conditions/cholera/basics/causes/con-20031469 Haiti Cholera Outbreak (2011). Cholera in Haiti: One Year Later. Retrieved December 3, 2014 from http://www.cdc.gov/haiticholera/haiti_cholera.htm Hendrix, T.R. (2014). The Pathophysiology of Cholera. Retrieved December 3, 2014 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1749961/?page=9 Healthy People 2020 (2014). Immunization and Infectious Diseases. Retrieved December 3, 2014 from https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases Read More