Whodunnit? Officials have cholera problem in Haiti

WASHINGTON, (Reuters) – DNA fingerprinting has  confirmed what health experts have suspected — the cholera  epidemic that has killed more than 1,100 people in Haiti came  from one single source. But little immediate good can come from  tracking down that source.

Rumours had been circulating for weeks that Nepalese troops  with the United Nations mission brought the cholera to Haiti,  which, despite having many other health problems, did not have  cholera.

Health officials deny this and say checks show no evidence  that one of the Nepalese soldiers carried the infection.
But it has to have come from somewhere and at the height of  the humanitarian effort after January’s devastating earthquake,  an estimated 10,000 different non-governmental organizations  were sending people and supplies into the Caribbean island  nation.

Cholera broke out in Haiti’s breadbasket Artibonite  Department a month ago and despite efforts to control it, has  spread to infect more than 18,000 people.

It perfectly illustrates the classic public health warning  — any disease can be carried anywhere in the world in just  hours, and without good sanitation or a good public health  infrastructure, can spread like wildfire.

And in the case of cholera in Haiti, it is likely to become  a longtime, if not permanent, resident.
The U.S. Centers for Disease Control and Prevention and the  Pan-American Health Organization have analyzed samples of  Vibrio cholerae from several patients and they are all  identical.
SINGLE SOURCE SUSPECTED

This suggests it entered Haiti in a single “event” — not  necessarily an infected person, but possibly. People often can  carry cholera with no symptoms and in a country with  chlorinated water and good sewage, the bacteria in their waste  quickly get destroyed.

Other potential sources include imported food, especially  seafood, or a boat or ship’s bilge water. With tons of aid  pouring into Haiti for months, it may be impossible to track  down who or what carried it in.

Public health officials will try. They want to prevent such  outbreaks in the future and finding the culprit will help  experts come up with ways to prevent it from happening.

But what if it does turn out that a U.N. trooper carried it  in? Riots already going on in Cap-Haitien and protests in  Port-au-Prince could worsen and other countries may be  reluctant to accept U.N. aid when they need it the most.

And what if health experts are unable to find the source?  Will anyone believe them, or will suspicious residents call it  a cover-up — and resist public health advice that could help  stem the epidemic?

If some other aid organization turns out to be the source,  again, not only could Haitians resist more help, but other  countries may become warier of letting these non-governmental  organizations help in the case of disasters.

NGOs that poured into Haiti after January’s quake are  already widely accused of not cooperating with one another or  Haiti’s government .
Public health professionals often accept that they can  never win. It is difficult to prove that a disease outbreak was  prevented, since nothing happens, and if a disease does break  out, then the experts are blamed for a failure.

The cholera outbreak in Haiti could end up causing more  widespread damage than immediate death and illness.