Geographic Effects on Cholera in Haiti
What is it?
Cholera is an infectious disease caused by the bacterium Vibrio Cholerae (WHO, 2014). Transmitted through contaminated food or water, V. Cholerae infects one’s intestines, resulting in acute diarrhea (CDC, 2013). Approximately 75% of people infected with cholera show no signs of having the disease, although the bacteria can remain in one’s intestines and feces for 7-14 days (WHO, 2014). For those who do develop symptoms, most cases are mild with only 5-10% of the incidents being severe (CDC, 2013). Early signs of a severe cholera infection include: extreme watery diarrhea, vomiting, accelerated heart rate, dry mucous membranes, reduced skin elasticity, low blood pressure, thirst, irritability, and restlessness (CDC, 2013). In its advanced stages, a severe cholera infection can result in acute renal failure, electrolyte deficiencies, and coma (CDC, 2013). If left untreated, cholera infections in any form (mild or severe) can lead to dehydration and death (WHO, 2014).
Cholera: An Overview
John Snow
No one knew about the epidemiology of the disease until John Snow’s research in 1854. John Snow was an English physician born in 1813 who is regarded as the father of modern epidemiology (Snow, 1936). When a cholera epidemic struck Snow’s neighborhood of Broad Street in London, England, it killed over 500 people in 10 days (Snow, 1936). Determined to find the cause of the disease, Snow set out to map the incidence of the disease (Snow, 1936). What he found was that around each of the pumping stations were high concentrations of morbidity related to cholera (Snow, 1936, Figure 2). The correlation he found between concentrations of cholera and water pumps led him to believe that cholera was a waterborne disease (Snow, 1936). To test his theory, Snow removed the Broad Street pump handle and observed a decline in cholera cases in the area (Snow, 1936). Therefore, he concluded that cholera is a waterborne disease and demonstrated the effects of mapping illness.
Preventing Cholera
Being able to identify the infected source quickly allows responders and healthcare professionals to mitigate the problem before an entire population becomes sick (WHO, 2014). Furthermore, cholera is a disease that is relatively easy to identify and treat. Crystal VC Quick Test Dipsticks are one of the fastest ways to identify cholera by allowing healthcare providers to test for the disease in the field (CDC, 2013). Further lab results may be needed to confirm the initial test, but the Crystal VC dipsticks are much faster and less expensive (CDC, 2013). Once a healthcare professional identifies the disease, the greatest concern with cholera is the possibility of severe dehydration that can lead to death. In order to combat dehydration, healthcare providers administer oral rehydration salts, zinc, or antibiotics to patients depending on the relative severity of the cholera infection (CDC, 2013). Lastly, preparedness is crucial to limiting Cholera outbreaks since it facilitates initial prevention strategies through sanitation and a fast response by being able to identify the disease and treat patients accordingly (WHO, 2014).
Facts of Cholera
Each year, the World Health Organization (WHO) reports around 3-5 million new cases of cholera and about 100,000-200,000 consequent deaths. People most at risk of death resulting from infection are those with compromised immune systems, such as HIV/AIDS patients, children, the elderly, the malnourished, and chronically ill (WHO, 2014). Only two toxigenic strains of cholera are known to cause the wide-scale epidemics seen today (CDC, 2013). V. Cholerae is split into two biotypes known as Vibrio Cholerae O-group 1 (El Tor) and Vibrio Cholerae O-group 139 (Classical) (CDC, 2013). Although both biotypes display similar symptoms, people infected with O-139 or the Classical strain are only found Bangladesh and India (CDC, 2013).