Cholera Outbreak in Haiti and Dominican Republic. Situation Report, n.8 (8 December 2022)

Cholera Outbreak in Haiti and Dominican Republic. Situation Report, n.8 (8 December 2022)

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Cholera Outbreak in Haiti and Dominican Republic. Situation Report, n.8 (8 December 2022). (202 C.E.). [Newsletters]. PAHO. https://iris.paho.org/handle/10665.2/60408

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202

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Pan American Health Organization

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In Haiti, confirmed cholera cases are reported in new areas of the capital and in additional departments. As of 6 December 2022, the Department of Epidemiology, Laboratories, and Research (DELR) confirmed 1,193 cases of cholera in eight departments. 943 (79%) of confirmed cases were reported in the Ouest Department. 13,672 suspected cases have been reported in all 10 departments in the country since the first 2 cholera cases were reported on 2 October. In the Dominican Republic, two new cholera cases were confirmed on 7 December by the Ministry of Health in the city of Santo Domingo, bringing the total number of confirmed cases to 4 in the country since October 2022. In Haiti, high levels of insecurity and limited access to fuel continue to be the major challenges in the response to the cholera outbreak. In Haiti, PAHO/WHO continues to support the Ministry of Health (Ministère de la Santé Publique et de la Population – MSPP) and partners, including: Technical and logistical support to field investigations in all departments to identify suspected cases and collect samples for laboratory analysis. Distribution of 49 tons of essential medicines and medical supplies to Cholera Treatment Centers (CTCs) and Health Directorates in all departments. Training of additional Community Health Workers (ASCP) in the Ouest and Centre Departments, including in preparation for the upcoming vaccination campaign. Technical and financial support for the training and development of the communication strategy for the upcoming cholera vaccination campaign. In the Dominican Republic, PAHO/WHO continues to support the Ministry of Health in monitoring and investigating alerts, including through the donation of Rapid Diagnostic Tests, and in implementing prevention activities through risk communication and community engagement.

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Cholera Outbreak in Haiti and Dominican Republic. Situation Report, n.9 (16 December 2022)
(PAHO, 2022) Pan American Health Organization
In Haiti, confirmed cholera cases are reported in new areas of the capital and in additional departments. As of 14 December 2022, the Department of Epidemiology, Laboratories, and Research (DELR) confirmed 1,291 cases of cholera in nine departments. 962 (74.5%) of confirmed cases were reported in the Ouest Department, followed by 156 in Centre and 54 in Sud Est. 15,400 suspected cases have been reported in all 10 departments of the country since the first cases were reported on 2 October. In Haiti, high levels of insecurity and limited access to populations continue to be major challenges in the response to the cholera outbreak. In Haiti, PAHO/WHO continues to support the Ministry of Health (Ministère de la Santé Publique et de la Population – MSPP) and partners, including: Distribution of cholera kits and other essential supplies by air and land to ensure quality case management of cases at Cholera Treatment Centers (CTCs) and Oral Rehydration Points (ORPs) in 9 departments. Technical and logistical support to field investigations in all departments, including donation of Rapid Diagnostic Test to identify suspected cases and collect samples for laboratory analysis. Technical and financial support for the planning, training and implementation of the upcoming cholera vaccination campaign set to start on 18 December in the Ouest and Centre Departments. In the Dominican Republic, PAHO/WHO continues to support the Ministry of Health in monitoring, investigating and responding to cholera alerts, including in prevention activities through risk communication and community engagement. As of 14 December, a total of 15,400 suspected cholera cases were reported in nine of the ten departments in Haiti, including cases reported in the Civil Prison in Port-au- Prince. Out of these, 1,291 were confirmed by the national laboratory, including 305 deaths. To date, nine out of the ten departments that reported suspected cases have confirmed cases (47 in Artibonite, 156 in Centre, 54 in Sud-Est and 962 in Ouest). We note an increase of 12.64% in overall suspected cases and an 8.21% increase in confirmed cases since 6 December (Figure 1). The case fatality rate among suspected cases is 2%. Regarding the 305 deaths reported as of 14 December, there is a 7.77% increase compared to the update on 6 December 2022. The Ouest Department reported a 5.65% increase in suspected cases and a 2.01% increase in confirmed cases. Yet, the other 9 departments reported an average increase of 44% in suspected cases and 64% in confirmed cases, compared to 6 December 2022 (Figure 1). The most affected communes in the Ouest Department continue to be Port-au-Prince, Delmas, Cité Soleil, Carrefour, and Pétion-Ville, where the majority of suspected and confirmed cases are reported. Based on the MSPP information from 14 December, 58.77% of reported suspected cases are male, 41.23% female and (Figure 2). Among the 1,291 confirmed cases, age groups 1-4 (18.8%) and 30-39 (14.15%) are the most affected.
Cholera Outbreak in Haiti and Dominican Republic. Situation Report, n.10 (22 December 2022)
(PAHO, 2022) Pan American Health Organization
In Haiti, as of 20 December 2022, the Department of Epidemiology, Laboratories, and Research (DELR) reports 18,469 suspected cholera cases in all 10 departments of the country since the first cases were reported on 2 October. Of these, 1,380 cases have been confirmed in nine departments, of which 1,024 (74.2%) of were reported in the Ouest Department, followed by 157 in Centre, 60 in Sud Est, and 54 in Artibonite. In Haiti, high levels of insecurity and limited access to populations continue to be major challenges in the response to the cholera outbreak. In Haiti, PAHO/WHO continues to support the Ministry of Health (Ministère de la Santé Publique et de la Population – MSPP) and partners, including: Strategic and technical support for the implementation of the first phase of the cholera vaccination campaign with more than 1,170,000 doses, which began on 18 December in Ouest and Centre Departments. Technical and logistical support to field investigations in all departments, strengthening completeness and quality of data and transportation of samples. Distribution of cholera kits and other essential supplies by air and land to ensure quality management of cases at Cholera Treatment Centers (CTCs) and Oral Rehydration Points (ORPs) in 9 departments. In the Dominican Republic, 6 new cholera cases (all male between 4-49 years old) have been confirmed in Santo Domingo in addition to the 2 imported cases from Haiti reported in October and November, bringing the total number of confirmed cases to 8. PAHO/WHO is providing technical and logistic support to the Ministry of Health in monitoring, investigating, and responding to cholera alerts, including prevention activities through risk communication and community engagement. In Haiti, as of 20 December, a total of 18,469 suspected cholera cases were reported in nine of the ten departments in Haiti, including cases reported in the Civil Prison in Port-au- Prince. Of these, 1,380 were confirmed by the national laboratory, including 324 deaths. To date, nine out of the ten departments that reported suspected cases have confirmed cases (54 in Artibonite, 157 in Centre, 60 in Sud-Est and 1,024 in Ouest). There has been an increase of 22.06% in overall suspected cases and a 6.98% increase in confirmed cases since 15 December (Figure 1). The case fatality rate among suspected cases is 2%. Regarding the 324 deaths reported as of 20 December, there is a 6.58% increase compared to 15 December 2022. The Ouest Department reported a 6.37% increase in suspected cases and a 6.44% increase in confirmed cases since 15 December 2022. However, the other 9 departments reported an average increase of 117.4% in suspected cases and 8.5% in confirmed cases in the same period (Figure 1). The most affected communes in the Ouest Department continue to be Port-au-Prince, Delmas, Cité Soleil, Carrefour, and Pétion-Ville, where the majority of suspected and confirmed cases are reported. Based on MSPP information from 20 December, 57.97% of reported suspected cases are male, 42.03% female and (Figure 2). Among the 1,380 confirmed cases, age groups 1-4 (19.4%) and 30-39 (14.42%) are the most affected. In Haiti, the complex humanitarian and socio-political crisis, with high levels of insecurity, fuel shortages and economic instability continue to impact response capacity. These are some of the main drivers of the cholera epidemic as they limit access to health and basic water and sanitation services, and food and water supplies as well: o Although fuel distribution has restarted in the Ouest Department, availability continues to be limited in other departments, hindering basic water and sanitation services (garbage collection), hindering the response and the distribution of life-saving medicines and supplies. o Lack of access to affected areas due to insecurity continue to hamper epidemiological surveillance, the installation of Oral Rehydration Points (ORP) and Cholera Treatment Centers (CTCs), the transport of patients to CTCs, and health promotion, as well as water, hygiene and sanitation activities at the community level. In the Dominican Republic, the 6 new confirmed cholera cases are all reported from the la Zurza neighborhood in Santo Domingo, which is an area with limited access to safe water in addition to poor hygiene and sanitation conditions. A large proportion of the population in that sector uses water from the river for cooking and bathing, which is one of the factors that increases the risk of cholera transmission among the most vulnerable populations living in these locations. Global cholera crisis generates a high demand for medical and non-medical supplies, including the oral vaccine, resulting in limited cholera commodities for immediate distribution in all affected countries.
Cholera Outbreak in Haiti and Dominican Republic. Situation Report, n.12 (20 January 2023)
(PAHO, 2023) Pan American Health Organization
In Haiti, as of 16 of January 2023, the Department of Epidemiology, Laboratories, and Research (DELR) reports 24,451 suspected cholera cases in all 10 departments of the country. Of these, 1,870 cases have been confirmed in ten departments: 1,144 (61%) in Ouest, followed by 287 in Centre, 83 in Sud Est, and 85 in Artibonite. In Haiti, high levels of insecurity and limited access to fuel and populations continue to be major challenges in the response to the cholera outbreak. In Haiti, PAHO/WHO continues to support the Ministry of Health (Ministère de la Santé Publique et de la Population – MSPP) and partners, including: Technical and logistical support to epidemiological surveillance, field investigations and early multisectoral response in all departments, strengthening data completeness and quality and transportation of samples, in collaboration with the DELR and departmental health directorates. PAHO continues to strengthen the Cholera Response Structure agreed with departmental health directorates and UNICEF, through support for the recruitment of emergency response staff. Strategic and technical support for the development of the final cholera vaccination campaign report, which took place from 19 to 31 December in the Ouest and Centre Departments and targeted 1,170,800 people. In the Dominican Republic, on 18 January the Ministry of Public Health confirmed 6 new cholera cases, bringing the total number of confirmed cases to 25, five of which imported from Haiti and 17 in two sectors in Santo Domingo. PAHO/WHO is providing technical and logistical support to the Ministry of Health in investigating and responding to cholera alerts, prevention activities through risk communication and community engagement as well as in the upcoming vaccination campaign. In Haiti, as of 16 of January, a total of 24,451 suspected cholera cases were reported in all ten departments in the country, including cases reported in the Civil Prison in Port-au- Prince. Of these, 1,870 were confirmed by the national laboratory, including 496 deaths. To date, ten departments have reported confirmed cases, with the majority being reported in Ouest (1,144), followed by Centre (287), Sud-Est (83) and Artibonite (85). Since 12 January, there has been an increase of 6.21% in overall suspected cases and an 18.65% increase in confirmed cases across all the country (Figure 1). The case fatality rate among suspected cases is 2%. The 496 deaths reported as of 16 January represent a 7% increase compared to 10 January 2023. The Ouest Department reported a 1.45% increase in suspected cases and a 4.38% rise in confirmed cases since 10 January 2023. The other 9 departments reported an average increase of 17.2% in suspected cases and a 51.3% rise in confirmed cases during the same period (Figure 1). The most affected municipalities in the Ouest Department continue to be Port-au-Prince, Delmas, Cité Soleil, Carrefour, and Pétion-Ville, where the majority of suspected and confirmed cases are reported. Based on MSPP information from 16 January, 56.65% of reported suspected cases are male, and 43.35% female (Figure 2). Among the 1,870 confirmed cases, age groups 1-4 (19.4%) and 5-9 (15.56%) are the most affected.
Cholera Outbreak in Haiti and Dominican Republic. Situation Report, n.11 (5 January 2023)
(PAHO, 2023) Pan American Health Organization
In Haiti, as of 2 of January 2023, the Department of Epidemiology, Laboratories, and Research (DELR) reports 22,563 suspected cholera cases in all 10 departments of the country. Of these, 1,561 cases have been confirmed in nine departments: 1,097 (69%) in Ouest, followed by 242 in Centre, 63 in Sud Est, and 58 in Artibonite. In Haiti, high levels of insecurity and limited access to fuel and populations continue to be major challenges in the response to the cholera outbreak. In Haiti, PAHO/WHO continues to support the Ministry of Health (Ministère de la Santé Publique et de la Population – MSPP) and partners, including: Strategic and technical support for the implementation of the cholera vaccination campaign that took place from 19 to 31st December in the Ouest and Centre Departments. Technical and logistical support to field investigations in all departments, strengthening data completeness and quality and transportation of samples. Implementing a cholera community engagement strategy in the Sud-Est Department, which includes training and deployment of Community Health Workers (ASCP) to disseminate PAHO-developed risk communication materials for the prevention of cholera at individual and household level. In the Dominican Republic, on 28 December the Ministry of Public Health confirmed 2 new cholera cases (both female, 33 and 44 years old). These have no travel history, and both are residents in La Zurza sector in Santo Domingo, bringing the total number of confirmed cases to 10, two of them imported from Haiti. PAHO/WHO is providing technical and logistical support to the Ministry of Health in monitoring, investigating, and responding to cholera alerts, and in prevention activities through risk communication and community engagement. In Haiti, as of 2 of January, a total of 22,563 suspected cholera cases were reported in all ten departments in the country, including cases reported in the Civil Prison in Port-au- Prince. Of these, 1,561 were confirmed by the national laboratory, including 457 deaths. To date, nine out of the ten departments that reported suspected cases have confirmed cases, with the majority being reported in Ouest (1,097), followed by Centre (242), Sud-Est (63) and Artibonite (58). Since 29 December, there has been an increase of 12.09% in overall suspected cases and a 9.39% increase in confirmed cases (Figure 1). The case fatality rate among suspected cases is 2%. The 457 deaths reported as of 2 January represent a 22% increase compared to 29 December 2022. The Ouest Department reported a 9.73% increase in suspected cases and a 3.78% rise in confirmed cases since 29 December 2022. However, the other 9 departments reported an average increase of 18.1% in suspected cases and a 25.4% rise in confirmed cases during the same period (Figure 1). The most affected municipalities in the Ouest Department continue to be Port-au-Prince, Delmas, Cité Soleil, Carrefour, and Pétion-Ville, where the majority of suspected and confirmed cases are reported. Based on MSPP information from 2 January, 57.97% of reported suspected cases are male, 42.03% female and (Figure 2). Among the 1,380 confirmed cases, age groups 1-4 (19.4%) and 30-39 (14.42%) are the most affected.
Cholera Outbreak in Haiti and Dominican Republic. Situation Report, n.13 (6 February 2023)
(PAHO, 2023) Pan American Health Organization
In Haiti, as 5 February 2023, the Department of Epidemiology, Laboratories, and Research (DELR) have reported 28,901 suspected cholera cases in all 10 departments of the country. Of these, 2,107 cases have been confirmed in ten departments: 1,205 (57%) in Ouest, followed by 383 in Centre, 106 in Nord, and 104 in Artibonite. In Haiti, PAHO/WHO continues to support the Ministry of Health (Ministère de la Santé Publique et de la Population – MSPP) and partners, including in: - Coordination of the cholera response by strengthening the leadership of the National Unit for management of health emergencies (UNGUS) as the cholera coordination mechanism established by the MSPP. - Support to the Departmental Health Directorates through the deployment of 14 Assistant Epidemiologists in all 10 departments of the country, facilitating timely investigation of cholera alerts, data collection, analysis, and reporting. - Strategic and technical support for the implementation of the first cholera vaccination campaign, in the Ouest and Centre Departments, in which 850,067 people were vaccinated, including 3,797 inmates in the Mirebalais, Carrefour and Port au Prince civil prisons. - Distribution of medical and non-medical supplies for the cholera response in all departments across the country by air and land, including Cholera beds, Rapid Diagnostic Test, Ringer Lactate, laboratory reagents, aqua tabs, etc. In the Dominican Republic, on 1 February the Ministry of Public Health confirmed four new cholera cases, bringing the total number of confirmed cases to 47, eleven of which were imported from Haiti. PAHO/WHO is providing technical and logistical support to the Ministry of Health in investigating and responding to cholera alerts, the development of prevention activities through risk communication and community engagement, as well as in implementation of the ongoing vaccination campaign. On 26 January, the World Health Organization (WHO) Headquarters with all WHO Regional offices took the unanimous decision to label the current Global Cholera situation as a Grade 3 multi-region Public Health Emergency, which is the highest level of institutional priority assigned a public health event, ensuring a higher investment of resources and improved coordination at all levels of the organization to effectively respond to the scale of the emergency. The decision was reached considering the current scale of the ongoing cholera outbreaks, the potential for further international spread, the high urgency due to high levels of mortality and morbidity, complexity factors and the current limited capacity to respond. In Haiti, as 5 of February, a total of 28,901 suspected cholera cases were reported in all ten departments in the country, including cases reported in the Civil Prison in Port-au- Prince. Of these, 2,107 were confirmed by the national laboratory, including 560 deaths. To date, ten departments have reported confirmed cases, with the majority being reported in Ouest (1,205), followed by Centre 383), Nord (106) and Artibonite (104). Since 30 January, there has been an overall increase of 6.65% in suspected cases and a 2.48% increase in confirmed cases across the country (Figure 1). The case fatality rate among suspected cases is 2%. The Ouest Department reported a -1.89% decrease in suspected cases and a 0.84% rise in confirmed cases since 30 January 2023. The other nine departments reported an average increase of 21.04% in suspected cases and a 4.76% rise in confirmed cases during the same period (Figure 1). The most affected municipalities in the Ouest Department continue to be Port-au-Prince, Delmas, Cité Soleil, Carrefour, and Pétion-Ville, where the majority of suspected and confirmed cases are reported.