Deadly Cholera Outbreak Sickens Thousands In Haiti

A cholera outbreak in Haiti has left 250 people dead and more than 3,000 sickened. Health officials fear the spread of the outbreak to the squalid camps in Port-au-Prince where 1.3 million earthquake survivors live. Guest host Jacki Lyden speaks with David Olson, medical advisor of Doctors Without Borders .

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JACKI LYDEN, host:

This is TELL ME MORE from NPR News. I'm Jacki Lyden. Michel Martin is away.

We'll talk about the pink ribbons of October in a couple of minutes, the viewpoints of both the critic and the group associated with Breast Cancer Awareness Month.

But first, to Haiti, where cholera has made a worrisome mark more than nine months after the earthquake that killed hundreds of thousands of people. Cholera now has claimed over 250 lives in rural parts in that country and infected at least 3,000 more. To learn more, we've reached a doctor in Haiti, Dr. Michel Thieran is a staff member of the World Health Organization and the senior program management officer at the Pan American Health Organization office. He joins us from Haiti's capital in Port-au-Prince. Welcome to the show.

Dr. MICHEL THIERAN (Senior Program Management Officer, Pan American Health Organization): Thank you for inviting me. Good morning.

LYDEN: Remind us about cholera, what is it? What does it do? And how quickly does it work?

Dr. THIERAN: The cholera is a water-borne disease that is caused by a bacteria called Vibrio cholerae and that has a specific serotype that is labeled 01. Cholera is a disease that can immediately produce episodes of watery diarrhea, very intense, with or without vomiting.

LYDEN: So, just to summarize it, because we have you on a cell phone, you're saying that it's a water-borne disease, it strikes very quickly, produces a watery diarrhea, and can cause diarrhea and vomiting and lead to death within just hours.

Now, this outbreak started last Wednesday. Dr. Thieran, in what areas of Haiti are you seeing it?

Dr. THIERAN: The area where the epidemic appears at the moment is the Department of Artibonite with an extension in the southeast towards the Department of Centre. It is an area of about 100 kilometers long along the Artibonite River. And all this area is for the moment confined and located at about two, three hours driving north from the capital of Port-au-Prince, 100 kilometers.

LYDEN: So you talked about the area along the Artibonite River about 100 miles or so, I think you said, from Port-au-Prince, about 60 miles?

Dr. THIERAN: Yes. It's about 100...

LYDEN: Kilometers, I'm sorry.

Dr. THIERAN: I would say, yes, I would say about 70 miles north of Port-au-Prince.

LYDEN: So, not so very far away from the capital, the head of the Haitian House Ministry reportedly said that the outbreak might be getting a bit better. But what are the chances that it could spread into the capital, which of course is devastated and has over a million people still living in camps after the earthquake?

Dr. THIERAN: Yes, hard to predict the chance or it's really hard to quantify the chance, it's just all the more qualitative data that - and which factors are met for the cholera to spread and settle, I would say, in the country, as it has in the '90s appeared in Latin American country and gradually move from epidemic to a pandemic situation within a few weeks or months.

So we are expecting an extension of the epidemic and it is fair to say to what extent we can predict the path, the intensity and the severity of the transmission and the epidemic is very difficult to say. But we are preparing now a response that takes into account a national spread of the epidemic.

LYDEN: Okay. And, and because we have you on the cell phone, I'm just summing up. And you're saying that the conditions are there and that you fear that it will spread from an epidemic to a pandemic. Are you seeing some cases in Port-au-Prince?

Dr. THIERAN: We have confirmed five cases in Port-au-Prince. But all the cases are labeled in Port-au-Prince from the epidemic area. It means that those cases have contracted the disease in Artibonite, but were detected after they traveled to Port-au-Prince.

LYDEN: Okay.

Dr. THIERAN: So that doesn't allow us to conclude that Port-au-Prince is now a new focus of the epidemic. Port-au-Prince is still is epidemic free at the moment.

LYDEN: And if you're just joining us, this is TELL ME MORE from NPR News. And we're talking about cholera in Haiti with Dr. Michel Thieran who's working with the Pan American Health Organization. He's speaking to us on the cell phone. And you just said that there are five cases, but all those people have come into Port-au-Prince, the capital from this afflicted area around Artibonite. Who is most vulnerable to cholera?

Dr. THIERAN: Everyone is vulnerable at cholera. It would be misleading to say that in an epidemic situation it is a disease that is hitting a country and a population for the first time in maybe not in all history, but at least in several decades, would be a bigger risk for anyone in particular. Everyone is at risk. Everyone is at bigger risk.

(Unintelligible) the condition of the collective level of a community, more risky for transmission like in a neighborhood (unintelligible) population that (unintelligible) and people living in precarious conditions. But we labeled that it's an epidemic. Everyone has (unintelligible) resistance against cholera, so we consider that everyone is at risk.

LYDEN: We just have about 40 seconds left, Dr. Thieran. Would you say that the government is handling the situation well? Do you feel well enough prepared?

Dr. THIERAN: Yes. The government has both locally at the department level and national level (unintelligible) mobilization in response of it. Obviously, there is - we still have the benefit of the presence of the very major players and humanitarians, competence in agencies here - still there after the earthquake. And we are all organizing and coordinating an aggressive response together with the Ministry of Health and the government in general.

LYDEN: Thank you so much. Dr. Michel Thieran is with the World Health Organization and he joined us from Port-au-Prince. Thank you again.

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