Current status of cholera outbreaks in the Region
In Haiti(1), since the beginning of the epidemic (October 2010) to 31 December 2012, the total number of cholera cases reached 635,980, of which 350,679 (55%) were hospitalized and 7,912 died. The global case-fatality rate is 1.2% since November 2011, however, with significant variations for example, in Grand Anse (4.0%) and Port-au-Prince (0.6%).
In general, the comparison of data by month and by epidemiological week (EW) between 2012 and 2011 reflect that a greater number of cases and deaths were recorded in 2011 than in 2012. However, the distribution of cases and deaths has followed similar trends in both years with peaks coinciding periods of heavy rain around the months of May-June-July and around September-October.
In the Dominican Republic(2), since the beginning of the epidemic through EW 51 of 2012 the total number of suspected cholera cases reported was 29,433 from which 422 died. The fatality rate recorded from EW 1 to EW 51 of 2012 is 0.8%. The number of cases recorded in 2012 show a decline in comparison with the cases recorded in 2011; however, increases in cases continued during the rainy season months, mainly affecting the Tamboril and Moca municipalities. During EW 44, there had been a cholera outbreak related to the contamination of drinking water in the Moca municipality, Espaillat province. In EW 51, cases were recorded in the provinces of: Duarte, Espaillat, La Romana, La Vega, Puerto Plata, San Pedro de Macoris, Monte Plata, Santa Domingo and the National District.
In Cuba, the cumulative number of confirmed cholera cases in 2012 reached around 500. No further deaths have been reported aside from the three previously reported in the 31 July 2012 Epidemiological Alert.
Following the passage of hurricane Sandy through the western provinces of the country, isolated cases were recorded in the provinces of Santiago de Cuba, Camagüey and Guantanamo. A total of 47 confirmed cholera cases were recorded in those three provinces. As of 15 December 2012, no further cases have been detected.
Control measures implemented by Cuba include the following: strengthen hygiene, improve environmental sanitation, ensure water treatment, food control, and provide health awareness education with an emphasis on hand hygiene, safe food consumption and water consumption.
Recommendations
The PAHO/WHO reiterates that recommendations made in the Epidemiological Alert of November 2, 2012 continue to be applicable.
References
Ministry of Public Health and Population, Haiti: Rapports journaliers du MSPP sur l'evolution du cholera en Haiti.Port-au-Prince, Haiti: Ministry of Public Health and Population, Haiti; 2012. Disponible en: http://www.mspp.gouv.ht/site/index.php
Boletín Epidemiológico de Republica Dominicana. Semana Epidemiológica 42, 2012. Disponible en: http://www.sespasdigepi.gob.do/