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More than 10 years old cholera strain claims hundreds of lives in Haiti

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Less than a year after the Haitian government announced the eradication of cholera in the country, the disease has returned to thousands of people.

The country has recorded 13,672 cases and 283 deaths since early October, according to a WHO report released on December 13.

The last cholera outbreak in Haiti began in 2010. Now, in correspondence from the New England Journal of Medicine, experts say the cholera strain currently causing another outbreak in Haiti is related to, and likely a descendant of, the 2010 strain.

According to the World Health Organization, the current outbreak was first reported on October 2 after three years of no reported cases of cholera. Between October 2010 and February 2019, there were 820,000 cholera cases and 9,792 deaths in the country in a large nationwide outbreak.

In February 2022, the Haitian government announced the eradication of cholera.

Cholera causes severe dehydration and is spread through unclean water. Cholera is spread when a person swallows water or food contaminated with a bacterium called Vibrio cholerae. Symptoms include watery diarrhea and dehydration. Most cases are not severe, and the World Health Organization has said that with appropriate treatment, less than 1% of those who get sick die. However, if left untreated, the disease can kill a person very quickly.

Treatment involves rehydrating patients with a solution taken orally or intravenously. The World Health Organization currently uses three oral vaccines to prevent cholera.

The World Health Organization maintains a stockpile of these vaccines, and on December 12, the organization shipped about 1 million doses of one of these vaccines, called Euvichol, to Haiti. More cholera vaccines are expected to arrive in Haiti in the coming weeks.

The massive outbreak began in 2010 following a deadly earthquake in January of that year that is estimated to have killed more than 300,000 people. United Nations forces from Nepal arrived in Haiti in early October of that year.

Before being sent to Haiti, a cholera outbreak occurred in Kathmandu, where the troops were training before being sent. 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 from where the troops were camped.

In 2011, a UN team of experts determined that the outbreak started at a UN camp, and while it was not explicitly stated that the troops had brought cholera from Nepal to Haiti, it was said that the Haitian and Nepalese strains “matched perfectly”. .” “. In 2016, the UN finally acknowledged its role in the spread of the epidemic, although it did not bear legal responsibility for this.

Scientists still don’t know how cholera reappeared in Haiti after three years of no reported cases.

In a recent correspondence published in the New England Journal of Medicine, researchers proposed three hypothetical reasons why cholera might flare up again. First, cases of cholera may have been going on since 2019, but those cases have faded from view and cases are now on the rise again due to a lack of clean water and sanitation combined with low population immunity. Second, it could remain in ecological reservoirs such as rivers or estuaries, where the organism could survive outside the human host for several days.

A third reason is that during the 2010 outbreak, cholera may have spread to other countries in Latin America, and one of those countries may have reintroduced it to Haiti.

However, experts say this third option is unlikely, in part because other countries in the region have not reported recent cases of cholera.

Regardless of the cause of the new cases, the researchers said: “These findings, along with the resurgence of cholera in many parts of the world despite available tools to combat it, point to the need to redouble efforts to control and prevent cholera.”

Source: Science Alert

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