RENEE MONTAGNE, host:
Haiti is readying for more protests, and possibly the violence it saw earlier this week, as rival candidates have called on their supporters to take to the streets. Officials say they will recount the votes from the disputed presidential election. There have been widespread reports of ballot box stuffing and intimidation, and some of the candidates say the results should be tossed out entirely.
The recount faces a deadline. A runoff election between the two top vote-getters is planned for January.
STEVE INSKEEP, host:
And all of this takes place at a frustrating time. Many Haitians have complained about the dire living conditions and the slow pace of rebuilding after the earthquake. And cholera has now infected at least 100,000 people in Haiti; more than 2,000 people have died. Health officials are predicting even worse.
NPR has learned that health officials are considering a crash vaccination program. Here's NPR's Richard Knox on what would be a new approach to the crisis.
RICHARD KNOX: Public health leaders have argued that it's not feasible to use cholera vaccine in Haiti - that there isn't enough vaccine; that it would detract from treating those already sick. But that's changed in recent days.
Dr. Jon Andrus, of the Pan American Health Organization, says it's discovered there may be more than a million doses of cholera vaccine in manufacturers' storehouses - far more than previously thought.
Dr. JON ANDRUS (Pan American Health Organization): That's new information to us, and that basically changes our thinking.
KNOX: Andrus says it's time to consider vaccination now that cholera has a firm foothold in Haiti, and is beginning to spread to the Dominican Republic next door. Andrus says about two dozen cases of cholera have been confirmed there. More than 200 are under investigation - from rural areas on the border all the way to the capital, Santo Domingo. That could be just the beginning.
Dr. ANDRUS: I worry about some of the poor countries of the Caribbean. I worry about Central America.
KNOX: Andrus says the vaccine is needed not only in Haiti and the Dominican Republic, but also in other countries in the region.
Dr. ANDRUS: I see a real opportunity to vaccinate vulnerable groups in countries that have yet to see the outbreak, but we know would be very vulnerable if cholera was imported.
Dr. THOMAS FRIEDEN (Director, U.S. Centers for Disease Control and Prevention): Unfortunately, what's happening in Haiti is essentially a perfect storm for cholera.
KNOX: That's Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention.
A CDC report this week says the Haitian strain of cholera can kill with alarming speed.
Dr. FRIEDEN: Nearly half of the people who died, died outside of the hospital, before they got to the hospital. And they die in as little as two hours after first becoming ill with cholera.
KNOX: Scientists are beginning to understand why. A group at Harvard has spent the past month working feverishly to understand the Haitian cholera strain.
Dr. Matthew Waldor, of Brigham and Women's Hospital, led the team.
(Soundbite of door opening)
Dr. MATTHEW WALDOR (Brigham and Women's Hospital): This is like - what it looks like. This is a plate that has single colonies of Vibrio cholarae.
KNOX: Vibrio cholarae being the Latin name.
Waldor displays a hockey puck-sized lab dish dotted with yellow growths, each the size of a grape seed.
Mr. WALDOR: Each one of those grape seeds has at least a hundred-million cells, maybe getting onto a billion.
KNOX: There's no lid on the dish, which is inches away from my nose, but Waldor says don't worry.
Mr. WALDOR: There's no risk here - super promise.
KNOX: The only way to catch cholera, he says, is to swallow it in contaminated food or water.
Working night and day, Waldor and his colleagues have figured out the entire genetic code of the Haitian strain. The New England Journal of Medicine published their report last night. They found it produces a toxin that's genetically identical to one from an especially lethal strain that popped up in India four or five years ago.
That explains why the Haitian bug can kill so fast. It also has a missing string of genetic material in the same place as the Indian strain.
Mr. WALDOR: That's a fingerprint - very strong fingerprint.
KNOX: Waldor says it proves the new cholera bug was imported to Haiti from South Asia, probably inside the body of a traveler who was infected but not sick. The Harvard group can't say if this was a soldier from Nepal in a U.N. peacekeeping force, as many Haitians believe, but Waldor says there's no point in playing a blame game.
Mr. WALDOR: If it was a Nepalese peacekeeper or a Bangladeshi or Indian relief worker in Haiti - I think the evidence is strong that it was introduced by human activity into Haiti. That's a more important conclusion, because then we can take action in the future to prevent that.
KNOX: Such as vaccinating people from places with known cholera before they enter a vulnerable area like Haiti.
Waldor also agrees it's time to think about vaccinating people who live in Haiti and the Dominican Republic, to save lives and to prevent the spread of the potent new bug to other countries in the Americas.
Richard Knox, NPR News.
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