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Forecasting Global Cholera Outbreaks

Global cholera outbreaks, due to water or food contaminated with Vibrio cholerae, affect 3-5 million people each year with an estimated  100,000-130,000 deaths.  Cholera outbreaks are increasing, particularly in Haiti where more than 320,000 cases have been reported, resulting in 5,000 deaths since October 2010.

Prior to the devastating earthquake, Haiti had been free of this debilitating disease for more than 100 years. Civil unrest in the country has resulted in the delayed chlorination of water and development of cholera treatment training programs.  With the rainy season approaching, Haiti is preparing for new outbreaks. CTK has sent their Cholera rapid test to Haiti which can detect and differentiate 09 serotype in addition to 0139.

Incubation period for the disease is 1-5 days followed by severe watery diarrhea which has a “rice water” appearance and fishy odor.  In patients with severe disease, the stool volume can exceed 250 mL/kg during the first 24 hours. Cholera is sometimes accompanied by vomiting, resulting in dehydration and eventual death if proper treatment is not provided.

After a 10 year study of Sub-Saharan Africa, researches have noted that there is a correlation between a two fold increase in cholera cases when temperatures are higher by 1°C and rainfall greater by 200 mm.  Cholera cases have also been reported at alarming levels in Cameroon, Chad, Niger and Nigeria.  The Florida Health department isolated and identified 13 cases of cholera in December 2010 noting them to be the same strain as that in Haiti.

The rainy season is approaching and infections are expected to increase.  Clean water and hydration salts are urgently needed to prevent further deaths.