fp Turks and Caicos

As officials in Haiti scramble to contain a deadly outbreak of cholera, local government is doing its part to protect the country from this preventable disease.

While the threat to the TCI is minimal, the Ministry of Health and Human Services says it is working closely with the Pan American Health Organization (PAHO) and the Caribbean Epidemiology Centre (CAREC) to monitor the situation and potential threat to the country.

And the Public and Environmental Health Board recently announced preventative measures against mosquito-borne dengue fever, which is on the rise in the Dominican Republic. Symptoms include a sudden fever with headache, muscle and severe joint pains and rash.

“The TCI, with the Environment Health Department at the forefront, has instituted pre-emptive vector control measures, including aerial spraying and a public awareness campaign advocating removal of potential mosquito breeding utensils from around homes, dump sites and vacant lots,” the board said.

In Haiti, doctors and aid workers have been scrambling to rein in a cholera outbreak in central Haiti that has killed 140 people, while warning that the crisis probably likely get worse in a country where tent camps are still teeming with people displaced by the January earthquake.

Cholera causes such severe diarrhea and vomiting that people can die of dehydration in little more than a few hours. It spreads rapidly when infected fecal matter enters the water supply.

The acute bacterial illness, spread primarily through contaminated drinking water, has struck more than 2,000 people throughout the farming valley along the Artibonite River, with the highest number in the port city of St. Marc. Cholera is rarely spread directly from person to person.

Officials feared the disease could reach the capital, Port-au-Prince, 55 miles to the south, where hundreds of thousands of people are living in fetid conditions in the camps. International Medical Corps, based in Santa Monica, says it has confirmed multiple cases of cholera in Croix-des-Bouquets, a suburb of Port-au-Prince.

This is the first outbreak of cholera in Haiti in more than a century. It is unclear whether the massive displacement of people to the Artibonite Valley after the earthquake may have created the unsanitary conditions that allow such a disease to spread. But Haiti’s public water system has long been one of the worst in the world, and health officials have perennially warned of an epidemic.

The World Health Organization says less than half the country uses “improved drinking water sources,” and a 2008 Partners in Health report found that 70 percent of Haitians lacked continuous direct access to clean water.

As preventative measures here, the TCI Ministry of Health says it has taken the following surveillance and disease prevention measures:

1. Increase Environmental Health surveillance at all sea and airports of entry.
2. Require all health care providers to report cases of diarrhea to the Ministry of Health and Human Services on a daily basis.
3. Advise any person that experiences profuse watery diarrhea (three or more liquid bowel movements within a day) and vomiting to seek immediate medical attention from a health care provider.
4. Advise persons that have recently traveled to Haiti or have come into contact with persons that have traveled to Haiti to particularly monitor themselves and family members for signs and symptoms of cholera (profuse watery diarrhea and vomiting).
5. Advise the public to drink proper drinking water, bottled water or drink only water that has been boiled or treated with chlorine or iodine.
6. Advise the public to institute proper hygiene measures (clean water source selection, household and latrine sanitation, and correct hand washing and food preparation practices).
7. Advise the public to avoid travel to Haiti until the cholera outbreak is under control and the ministry puts out a notice to that fact.

The ministry says it will continue to monitor the situation and keep the public informed of new developments and recommendations. All inquiries regarding this public advisory are to be directed to Dr. Rufus Ewing, Chief Medical Officer/Director of Health Services.

Cholera kills between 100,000 and 120,000 people worldwide every year, often in regional epidemics. This month, an outbreak in central Africa has killed 1,879 people. The disease was absent from the Western Hemisphere until 1991 when it killed nearly 3,000 people in Peru and spread throughout Latin America.

Jon Andrus, deputy director of the Pan American Health Organization, said the disease was relatively simple to treat, with drinkable salt solutions that help rehydrate patients and reduce the risk of severe diarrhea. The best way to prevent infection is to keep food and water clean and wash hands often.

He said Haitians may be more vulnerable to widespread infection because they lack resistance to the disease. It was unclear how the bacterium was introduced after so long an absence.

Andrus said the first “suggestion” of the disease emerged Sunday, with reports of an abnormally high number of diarrhea cases in the area. It was later determined to be cholera.

He said his group was sending epidemiologists from Port-au-Prince and outside Haiti to deal with the outbreak.