Lessons learned during public health response to cholera epidemic in Haiti and the Dominican Republic

Abstract

After epidemic cholera emerged in Haiti in October 2010, the disease spread rapidly in a country devastated by an earthquake earlier that year, in a population with a high proportion of infant deaths, poor nutrition, and frequent infectious diseases such as HIV infection, tuberculosis, and malaria. Many nations, multinational agencies, and nongovernmental organizations rapidly mobilized to assist Haiti. The US government provided emergency response through the Office of Foreign Disaster Assistance of the US Agency for International Development and the Centers for Disease Control and Prevention. This report summarizes the participation by the Centers and its partners. The efforts needed to reduce the spread of the epidemic and prevent deaths highlight the need for safe drinking water and basic medical care in such difficult circumstances and the need for rebuilding water, sanitation, and public health systems to prevent future epidemics.

Figure 1

Administrative departments of Haiti affected by the earthquake of January 12, 2010; the path of Hurricane Tomas, November 5–6, 2010; and cumulative cholera incidence by department as of December 28, 2010.

Figure 2

Reported cases of cholera by day, and 14-day smoothed case-fatality rate (CFR) among hospitalized cases, by day, Haiti, October 22, 2010–July 25, 2011. UN, United Nations; CDC, Centers for Disease Control and Prevention; PAHO, Pan American Health Organization; MSPP, Ministère de la Santé Publique et de la Population.

Figure 3

Educational poster (in Haitian Creole) used by the Haitian Ministère de la Santé Publique et de la Population (MSPP) to graphically present the ways of preventing cholera. DINEPA, Direction Nationale de l’Eau Potable et d’ Assainessement; UNICEF, United Nations Children’s Fund; ACF, Action Contre la Faim.