cholera

RECENT POSTS

NPR: Update on Haiti’s battle against cholera

Two reports by NPR’s Richard Knox provide a great overview of the cholera outbreak in Haiti, beginning with coverage of the launch of a (much delayed and fairly small) vaccination campaign aimed not so much at stopping the outbreak as demonstrating vaccines — if more widely used — can stem the epidemic.

Despite yet another tiresome headline riff off Gabriel Garcia Marquez’ book Love in the Time of Cholera, the accompanying report by Knox examines what really drives the cholera explosion — poverty and lack of access to clean water.

 

Two views on human impact of climate change

Researchers at McGill University have mapped out the longer-term impact of climate change on human health and well-being.

If populations continue to increase at the expected rates, the McGill researchers report, those who are likely to be the most vulnerable to climate change are the people living in low-latitude, hot regions of the world, places like central South America, the Arabian Peninsula and much of Africa.

In these areas, a relatively small increase in temperature will have serious consequences on a region’s ability to sustain a growing population. Here’s a direct link to the map (below is screen grab):

McGill University

Human vulnerability to climate change

On a related note, here’s a recent post from my NPR colleague Heather Goldstone at Climatide providing “Two reasons why climate change could be bad for your health.”

One of the reasons is that it could increase bacterial outbreaks, as Heather notes appears to be happening with cholera worldwide. As I’ve noted before, there are some (though a minority) of scientists who believe Haiti’s cholera outbreak was fueled by climate change. The medical community is not trained to think of environmental contributors to human disease, but climate change may require a more interdisciplinary approach.

Will climate change bring malaria here?

The common refrain that climate change will bring malaria to U.S. shores again turns out to be cause for heated debate in scientific circles, according to Arthur Allen in the Washington Post:

The room where 10,000 Anopheles stephensi mosquitoes hatch each week is hot and humid and smells like the tropics – an appropriate surrogate for a warming world. The Johns Hopkins Malaria Research Institute in Baltimore, where the insects are raised, was created with a billionaire’s anonymous donation a decade ago, after a map printed in Scientific American suggested that by 2020 malaria could be breaking out in Baltimore, and across the eastern United States and Europe.

The idea that climate change will bring malaria and other tropical killers to our door turns out to be an extremely controversial one among ecologists, climatologists and biologists such as Marcelo Jacobs-Lorena, who runs the “insectary” at Johns Hopkins. “It’s a very complicated story,” says Jacobs-Lorena.

Allen reviews the evidence, and broad consensus, supporting the claim that climate change is expected to expand the range of the mosquitoes that carry malaria. But he quotes some experts who cite other factors causing the spread of disease, such as increased urbanization and poor insect control.

None of this is to say climate change never plays a role in disease. To emphasize the difficulty in establishing cause and effect in disease outbreaks, Allen notes that some high-profile scientists contend Haiti’s cholera outbreak is likely environmental in origin rather than due to human-to-human transmission. I’ve written about this hypothesis a few times on Humanosphere.

The gist of Allen’s article is that whatever climate change may be doing to patterns of disease spread, we don’t have to be helpless victims:

“Whether or not human engineering got us into this mess,” Allen writes, “perhaps it can get us out.”

No new evidence, but UN again blamed for Haiti cholera

UN

UN Peacekeeper, Haiti

Haiti is in crisis, in the middle of a muddled election for the next president of this devastated nation, and the media are doing their own muddling regarding the source of its ongoing cholera outbreak.

The epidemic has so far killed more than 2,100, sickened maybe 100,000 and is expected to continue spreading for months.

A Nepalese UN peacekeeping team was accused of bringing cholera with them and spreading it due to improper sanitation. This caused attacks on the UN peacekeepers, rioting and some deaths. Testing of the bacteria by the CDC identified it as a South Asian strain and many concluded the UN team were indeed the culprits.

But some top cholera experts, in fact, believe the outbreak is too big and widespread to have come from a single point source. I posted on this alternative view earlier and talked with one of the scientists, Rita Colwell, former head of the National Science Foundation. Colwell says of the idea that UN troops caused this:

“It’s almost certainly incorrect…. The pattern of distribution and rapid spread across a large area indicates it was already present.”

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After the quake and cholera, Haiti at risk of resurgent HIV/AIDS

They say bad news comes in threes.

The quake that devastated Haiti led to the conditions that have now spawned a deadly cholera epidemic. In this report for the Pulitzer Center, Lisa Armstrong warns of the next looming opportunistic health threat:

Haiti used to be a model for combating AIDS. Experts at first thought the epidemic might wipe out a third of the population. But instead the country became a surprising success story: Thanks to significant financial support from the U.S. President’s Emergency Plan for AIDS Relief as well as the Global Fund to Fight AIDS, tuberculosis and malaria prevalence rates fell from 9.4 percent in 1993 to 2.2 percent in 2008.

January’s earthquake, however, destroyed many health facilities, and experts are afraid that with the high rates of rape, prostitution, and promiscuity in the camps, there will be an explosive increase in the number of new HIV infections.

Experts say UN did not bring cholera to Haiti: It was already there

United Nations

UN Peacekeepers Patrol Port-au-Prince Slum

Despite a growing body of evidence to the contrary, the United Nations is still getting blamed for bringing cholera to Haiti.

Three people have been killed, dozens injured, in rioting sparked by these accusations. And tensions remain high between many Haitians and UN peacekeeping troops, making the job of assisting with this island nation’s many humanitarian needs all the more difficult.

Meanwhile, the disease has now taken grip of Haiti, spreading rapidly and having so far killed perhaps 2,000 people. It is expected to sicken hundreds of thousands more before it burns itself out in perhaps a year or so. Many believe UN troops from Nepal, carrying the infection, brought the bacterial scourge to this already devastated nation.

“It’s tragic because it’s almost certainly incorrect,” said Rita Colwell, a world-renowned cholera expert and former director of the National Science Foundation.

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Haiti’s cholera outbreak caused by weather?

Hey, United Nations! You might want to give these scientists a call.

I noticed this report earlier, by María Elena Hurtado for SciDev.net, in which she quotes two highly respected scientists, Dr. David Sack of Johns Hopkins University and Dr. Rita Colwell at the University of Maryland, saying Haiti’s cholera epidemic is probably not due to bacteria-infested UN peacekeepers.

Sack and Colwell say Haiti’s cholera outbreak is likely due to current weather conditions and climate change.

The UN has been attacked (literally) because Haitians believe UN Nepalese peacekeepers were infected and, through improper sanitation, caused the contamination of local water supplies. Scientists with the CDC have identified the cholera bacteria in the outbreak as being a South Asian strain. As a result, riots have broken out, people have been killed and the UN is on the defensive.

But Sack and Colwell believe the UN’s Nepalese team probably had nothing do with Haiti’s cholera.

David Sack is one of the world’s leading experts on cholera. Rita Colwell, former director of National Science Foundation, is an expert on the interplay between waterborne infectious diseases and the environment. What they think about this matters a great deal and may help quell some of the Haitian anger directed at the UN.

This is based on SciDev’s news report by Hurtado, not a published paper. I’ll see if I can find out more from Sack and Colwell on this.

Haitians to vote in the time of cholera

Flickr, UNDP

Homeless camp in Port au Prince

The death toll from cholera in Haiti continues to climb, estimated today at more than 1300, as the nation heads into a national election for the next president.

Given the current national crises, some are calling for the election to be postponed. But as the New York Times noted, the crises could be the “most important in decades.”

Not only are competing crises demanding attention, but with the country poised to receive billions of dollars in international reconstruction money, the new president will have a historic ability to reshape the country, from its economy to its justice system to deciding where and how to house more than a million earthquake refugees.

Politics in Haiti can be a little chaotic anytime. But the combination of the devastation left by the earthquake and now the outbreak of cholera promises to up the ante.

As Time magazine notes, the anger and violence directed against the UN — which didn’t start with but was magnified by the cholera outbreak — could serve to distract Haitians from the shortcomings of current President René Préval:

With a presidential election set for Nov. 28, the U.N. sees more than just health concerns involved. UN spokesman Vincenzo Pugliese says the protests were not spontaneous because they all began at around 6 a.m. on Monday, suggesting to him a level of politically motivated coordination by Haitians who oppose the election.

As the death toll and numbers of those sickened continue, as expected to climb, we’ll see if Haitians have sufficient strength and confidence left to engage in the electoral process on Nov. 28.