Letter to the Editor of the journal: Emerging Infectious Diseases
Letter to the Editor
Understanding the Cholera Epidemic, Haiti: Further Implications
From: Jerry M. Gilles MD,Yvrose S. Gilles MS
Piarroux et al provide additional new evidence for the UN camp in Meille, Haiti as the source of that country’s cholera epidemic1.They reasoned that the concentration and volume of cholera bacteria needed to transmit the disease to those who ingested water from the Artibonite River could only have been produced by one or more people sick with diarrhea from cholera in the UN Camp1.According to their data, illness in the camp preceded the manifestation of the disease outside the United Nation’s Nepalese Camp1. Certainly, the UN Nepalese troops, arriving from a region where cholera is endemic recognized the symptoms and treated their affected soldier or soldiers. Presumably the lives of those symptomatic from the disease were saved because the UN’s investigation of the disease does not mention the death of any of its soldiers2.Days later, as people living in close proximity to the camp developed the same symptoms as was seen on the UN Camp, the UN authorities, though in full knowledge of the causative agent, kept a deadly silence.The authors argue that it is important to understand the origin of the infection in Haiti, but fail to identify the UN’s silence on the first case that it treated as a critical event that contributed to the epidemic. That silence prevented prompt deployment of measures that could have helped to contain the disease and to treat victims.Early recognition of a communicable disease is crucial for potentially aborting an epidemic.The authors failed to make this point clear.
1.Piarroux R, Barrais R, Faucher B, Haus R, Piarroux M, Gaudart J, et al. Understanding the cholera epidemic, Haiti. Emerg Infect Dis. 2011;17:1161–8.
2.Cravioto A, Lanata CF, Lantagne DS, Nair GB. Final Report of the Independent Panel of Experts on the Cholera Outbreak in Haiti. www.un.org/News/dh/infocus/haiti/UN-cholera-report-final.pdf. May 6, 2011