American-Haitian's Cholera Spreads To Other Nations

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Cap Haitien, Haiti (CNN) -- Haiti reported more cholera deaths Wednesday as chaos reigned in the second largest city, and a woman who recently returned to Florida from Haiti was diagnosed with the potentially fatal disease.

The outbreak also has spread across the Haitian border to the Domincan Republic, and that nation has issued a maximum health alert, its health ministry said.

The case of cholera in Florida was identified through the state's enhanced disease surveillance system and sent to the Centers for Disease Control and Prevention in Atlanta, Georgia, where it was confirmed, the Florida Department of Health said. A department spokesman said while the case was confirmed, it was not a major health concern.

The state, which has a sizeable Haitian immigrant population and also serves as a gateway to the Caribbean nation, has asked local health care providers to watch for people who become sick or show symptoms of cholera after returning from travel to Haiti.

"We are working with our health care partners to ensure appropriate care of this individual and prevent the spread of this disease within the community," said State Surgeon General Ana Viamonte Ros. "We will continue to monitor the state for any future cases."

Gallery: Violence over cholera outbreak

Riots in Haiti over cholera source

Cholera killing hundreds in Haiti

Chart: Cholera in Haiti
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The first confirmed case in the Dominican Republic was a 32-year-old Haitian construction worker who returned to the Dominican Republic last Friday with symptoms of the intestinal illness, the health ministry said Tuesday night.

Wilmo Louwes came back from Haiti last Friday with symptoms of vomiting and diarrhea and was hospitalized in Higuey, near the eastern resort town of Punta Cana, said Health Minister Bautista Rojas Gomez.

He was in stable condition, according to the El Nacional newspaper.

In Haiti, the spreading outbreak has now claimed 1,110 lives, the health ministry reported Wednesday.

Another 18,383 people have been hospitalized with the disease.

Aid agencies appealed for calm in the northern port city of Cap Haitien, where angry demonstrators accused United Nations peacekeepers of starting the outbreak.

Residents erected burning barricades, then hid in alleyways and pelted convoys of armored personnel carriers driven by United Nations peacekeepers as they drove past.

Cap Haitien convulsed in a third straight day of violence, as medical workers struggled to cope with a dramatic increase of patients infected with cholera.

At a basketball stadium that has been turned into a make-shift cholera treatment center, Dr. Esther Sterk of the humanitarian Medecins Sans Frontieres (MSF, known in English as Doctors Without Borders) estimated close to 200 new patients had arrived overnight.

By mid-day, an elderly woman arrived, her head slumping as she was rolled into the gates of the compound in a wheelbarrow.

The stadium teemed with sick patients on cots, many of them being rehydrated with intravenous fluids.

A surplus of patients were being quartered in a hallway underneath the stadium risers.

MSF workers said a child died overnight at the stadium.

They also said that some patients were unable to reach the treatment center, because protesters continued to prevent most cars and trucks from traveling the streets of the port city.

At one of the burning barricades in the center of town, angry residents chanted in Creole for the United Nations to go away as white U.N. armored-personnel carriers rolled through piles of burning garbage.

The United Nations has a peacekeeping force of more than 10,000 foreign police and soldiers deployed in Haiti.

The global body has denied Haitian assertions that Nepalese peacekeepers had introduced the cholera bacteria to Haiti.

At Cap-Haitien's main hospital Wednessday afternoon, doctors were treating a patient with a gunshot wound.

Moments later, two wounded Haitian men were rushed into the hospital on wheelbarrows.

One man had an apparent bullet wound to the chest, the other a bullet wound through the leg.

"MINUSTAH shot them," said a man pushing one of the wheelbarrows and referring to the U.N. by its acronym in Haiti.

Aid workers said it was hard enough dealing with cholera, a bacterial infection spread through tainted water, in a poor country like Haiti.

The tense situation on the streets of Cap Haitien was hampering medical and logistical efforts, they said.

Aid agencies have suspended clean water projects to slum areas, and canceled flights to deliver soap and other supplies to affected areas, a statement from aid agencies said.

Supplies in Cap Haitien are running out and the medical staff is overwhelmed as cholera mortality numbers climb, said Nigel Fisher, coordinator for humanitarian action for the U.N.

"We call upon all involved in these clearly orchestrated demonstrations to stop immediately so national and international partners can continue to save lives with our response to the cholera," Fisher said.

"Every day we lose means -- hospitals go without supplies, patients go untreated and people remain ignorant of the danger they are facing.

It is vital that everything possible is done to contain this outbreak in Cap Haitien while we still can -- but this is very difficult in the current environment."

Stefano Zannini, head of the MSF mission in Haiti said the organization's medical staff members were able to continue treating patients in Cap Haitien as they have been for the last 10 days.

But, he said, "it is not an easy environment to work in."

In the capital of Port-au-Prince, Zannini said the number of cases MSF is treating has increased significantly.

In the northern slum of Cite Soleil, MSF doctors are seeing 10 times the patients they were last week.

MSF has been increasing bed capacity every day and hoped to raise it to 800 by the end of Wednesday, Zannini said.

"It's not enough," he said. As capacity rises, so do the number of patients.

Meanwhile, the Clinton Foundation announced Wednesday that it has committed $1.5 million for cholera response in Haiti.

The foundation said in a news release that it plans to partner with Haiti's health ministry to train 10,000 community public health workers across the country.

It will also purchase and distribute 10,000 portable treatment packs containing oral hydration salts, soap, aqua tabs, chlorine, hand sanitizer, garbage bags, educational material, and stationery.

The other $500,000 will be spent on a national awareness campaign.

"The recent outbreak of cholera is a devastating development for the people of Haiti, and serves as an important reminder of all that remains to be done in our work to help Haiti build back better after the earthquake," said former President Bill Clinton.

The last cholera epidemic in the Western hemisphere began in Peru in 1991 and spread to some 16 other countries, from Argentina to Canada, according to the Pan American Health Organization.

From 1991 to 1997, Peru alone saw more than 650,000 cases.

A similar pattern in Haiti could produce some 270,000 cases, which means public health officials likely face long-term challenges in Haiti.

Officials in the Dominican Republic, which shares the Caribbean island of Hispanola with Haiti, had feared all along the disease could spread into their borders.

The United Nations denied an assertion promoted by some Haitians that Nepalese peacekeepers were responsible for starting the cholera outbreak.

U.N. statements said the protests may be politically motivated to create insecurity ahead of November 28 elections.

Symptoms of cholera, an acute, bacterial illness caused by drinking tainted water, can be mild or even nonexistent.

But sometimes they can be severe: leg cramps, profuse watery diarrhea and vomiting, which can cause rapid loss of body fluids and lead to dehydration, shock and death.

Legrand Dessalines, November 17 2010, 3:23 PM

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