Epidemiological Update Cholera 12 October 2013

Report
from Pan American Health Organization
Published on 12 Oct 2013 View Original

Current status of cholera in the Region

In Cuba, the situation continues as reported in the 26 September 2013 Epidemiological Alert, where 678 confirmed cholera cases, 1 including three deaths, have been reported since epidemiological week (EW) 27 of 2012 through EW 34 of 2013. The cases were registered in the provinces of Camaguey, Granma, Guantanamo, Havana and Santiago de Cuba, as well as in other municipalities associated with these provinces.

In the Dominican Republic, since the beginning of the epidemic (November 2010) through EW 39 of 2013, the total number of suspected cholera cases reported was 31,045 of which 457 died. During 2013, an increase of cases was recorded between EW 1 to EW 9 of 2013, and subsequently between EW 32 and EW 39; due to outbreaks in the provinces of La Altagracia, Maria Trinidad Sanchez, San Cristóbal, and Santiago. The case-fatality rate in 2011 reached 1.7% and 0.8% in 2012, however, thus far in 2013 it has reached 2.1%.

In Haiti, since the beginning of the epidemic (October 2010) to EW 39 of 2013, the total number of cholera cases reached 679,637, of which 377,951 were hospitalized (55.6%) and 8,297 died. The global case-fatality rate has been 1.2% since November 2011, however, with variations between 4.3%, in the department of Sud Est to 0.6%, in Port-au-Prince.

Since EW 1 to EW 11 of 2013, the number of cases and deaths registered at a national level was greater than the respective numbers registered for the same period of 2012 due to outbreaks recorded in the departments of Artibonite, Centre, Grand Anse and Ouest. From EW 12 to EW 39 of 2013, the number of cases and deaths registered has been lower than what was registered for the same period in 2012.

In Mexico, from 9 September to 10 October 2013, the Mexico International Health Regulations (IHR) National Focal Point (NFP) reported 159 confirmed cases, including one death, of infection with Vibrio cholerae O:1 Ogawa toxigenic.

Of the confirmed cases, 2 (1.3%) are residents of the Federal District, 145 (91.2%) are from the state of Hidalgo, 9 (5.7%) are from the state of Mexico, 1 (0.6%) is from the state of San Luis Potosi and 2 (1.3%) are from the state of Veracruz. In total, 84 (53%) are female and 75 (47%) are male with ages ranging from 3 months old to 88 years old. Forty-three (27%) of the cases were hospitalized.

Investigation results are indicating that the river water is the source of contamination in the state of Hidalgo.

The health authorities of Mexico continue to: strengthen epidemiological activities at the national level; ensure the availability of inputs and quality of care in medical units; implement actions to ensure access to drinking water and basic sanitation at the community level; and monitor and check the chlorine levels. Health professionals at different levels of the health care system are being trained in cholera prevention, treatment and control. Public awareness campaigns on water and food safety are being carried out in Spanish and indigenous languages (Nahuatl and Otomi).

This is the first local transmission of cholera recorded since the 1991-2001 cholera epidemic in Mexico. The genetic profile of the strain isolated from patients in Mexico presents high similarity (>95%) with the strain that is currently circulating in three Caribbean countries (Haiti, Dominican Republic and Cuba), and is different from the strain that had been circulating in Mexico during more than a decade ago.