Cholera Outbreak in Haiti and Dominican Republic. Situation Report, n.10 (22 December 2022)
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2022Metadata
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In Haiti, as of 20 December 2022, the Department of Epidemiology, Laboratories, and Research (DELR) reports 18,469 suspected cholera cases in all 10 departments of the country since the first cases were reported on 2 October. Of these, 1,380 cases have been confirmed in nine departments, of which 1,024 (74.2%) of were reported in the Ouest Department, followed by 157 in Centre, 60 in Sud Est, and 54 in Artibonite. In Haiti, high levels of insecurity and limited access to populations continue to be major challenges in the response to the cholera outbreak. In Haiti, PAHO/WHO continues to support the Ministry of Health (Ministère de la Santé Publique et de la Population – MSPP) and partners, including: Strategic and technical support for the implementation of the first phase of the cholera vaccination campaign with more than 1,170,000 doses, which began on 18 December in Ouest and Centre Departments. Technical and logistical support to field investigations in all departments, strengthening completeness and quality of data and transportation of samples. Distribution of cholera kits and other essential supplies by air and land to ensure quality management of cases at Cholera Treatment Centers (CTCs) and Oral Rehydration Points (ORPs) in 9 departments. In the Dominican Republic, 6 new cholera cases (all male between 4-49 years old) have been confirmed in Santo Domingo in addition to the 2 imported cases from Haiti reported in October and November, bringing the total number of confirmed cases to 8. PAHO/WHO is providing technical and logistic support to the Ministry of Health in monitoring, investigating, and responding to cholera alerts, including prevention activities through risk communication and community engagement. In Haiti, as of 20 December, a total of 18,469 suspected cholera cases were reported in nine of the ten departments in Haiti, including cases reported in the Civil Prison in Port-au- Prince. Of these, 1,380 were confirmed by the national laboratory, including 324 deaths. To date, nine out of the ten departments that reported suspected cases have confirmed cases (54 in Artibonite, 157 in Centre, 60 in Sud-Est and 1,024 in Ouest). There has been an increase of 22.06% in overall suspected cases and a 6.98% increase in confirmed cases since 15 December (Figure 1). The case fatality rate among suspected cases is 2%. Regarding the 324 deaths reported as of 20 December, there is a 6.58% increase compared to 15 December 2022. The Ouest Department reported a 6.37% increase in suspected cases and a 6.44% increase in confirmed cases since 15 December 2022. However, the other 9 departments reported an average increase of 117.4% in suspected cases and 8.5% in confirmed cases in the same period (Figure 1). The most affected communes in the Ouest Department continue to be Port-au-Prince, Delmas, Cité Soleil, Carrefour, and Pétion-Ville, where the majority of suspected and confirmed cases are reported. Based on MSPP information from 20 December, 57.97% of reported suspected cases are male, 42.03% female and (Figure 2). Among the 1,380 confirmed cases, age groups 1-4 (19.4%) and 30-39 (14.42%) are the most affected. In Haiti, the complex humanitarian and socio-political crisis, with high levels of insecurity, fuel shortages and economic instability continue to impact response capacity. These are some of the main drivers of the cholera epidemic as they limit access to health and basic water and sanitation services, and food and water supplies as well: o Although fuel distribution has restarted in the Ouest Department, availability continues to be limited in other departments, hindering basic water and sanitation services (garbage collection), hindering the response and the distribution of life-saving medicines and supplies. o Lack of access to affected areas due to insecurity continue to hamper epidemiological surveillance, the installation of Oral Rehydration Points (ORP) and Cholera Treatment Centers (CTCs), the transport of patients to CTCs, and health promotion, as well as water, hygiene and sanitation activities at the community level. In the Dominican Republic, the 6 new confirmed cholera cases are all reported from the la Zurza neighborhood in Santo Domingo, which is an area with limited access to safe water in addition to poor hygiene and sanitation conditions. A large proportion of the population in that sector uses water from the river for cooking and bathing, which is one of the factors that increases the risk of cholera transmission among the most vulnerable populations living in these locations. Global cholera crisis generates a high demand for medical and non-medical supplies, including the oral vaccine, resulting in limited cholera commodities for immediate distribution in all affected countries.
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