Florida confirms first cholera case

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Nov 17, 2010 (CIDRAP News) – Health officials in Florida, home to the nation's largest Haitian population, today announced the state's first cholera case this year, in a woman from Collier County who had recently returned from Haiti, which is in the midst of a massive cholera outbreak.

Confirmation of the first US case related to the cholera outbreaks comes a day after the Dominican Republic, Haiti's neighbor, confirmed its first cholera case. Yesterday the Pan American Health Organization (PAHO) said it expected to see cholera cases turn up elsewhere in the Americas.

At a press briefing today, Dr Thomas Torok, an investigator with the Florida Department of Health (FDH), said the woman is from the Naples area and contracted the disease while visiting relatives in the Artibonite River region, where the cholera outbreak began, the Orlando Sentinel reported.

He said the woman was hospitalized upon her return from Haiti and is now home and recovering. She does not work in a job that requires contact with the public.

Officials declined to say how many other illnesses they were investigating, according to the Sentinel report. Torok said that, during Latin America cholera outbreaks from 1991 to 1993, Florida detected 20 travel-related cholera cases, none of which had local infection links.

Earlier this month the Florida Department of Health (FDH) said it anticipated finding cholera in some travelers returning from family visits or relief efforts, and it has asked doctors to increase their vigilance for possible cases. The FDH said in a press release that the woman's illness was detected through enhanced disease surveillance and that the US Centers for Disease Control and Prevention confirmed the case.

The FDH said the risk of cholera spread in the United States is extremely low, due to water, sanitation, and food systems that minimize fecal contamination. It said person-to-person transmission is rare, and that patients typically contract cholera from drinking water or eating food that has been contaminated with the Vibrio cholerae. However, the department said it does not want to miss any high-risk situations such as cholera in a food handler, clusters, or outbreaks.

In other developments, the World Health Organization (WHO) said the cholera patient in the Dominican Republic is a 32-year-old man who had recently returned from Haiti. The man is a Haitian citizen who had just returned from a 12-day trip to Haiti and was diagnosed in Higuey, near the popular tourist town of Punta Cana, the Associated Press (AP) reported yesterday.

PAHO officials have said they expected cholera cases to be detected in the Dominican Republic and have been working with the country's health officials to prepare for an outbreak that they expect would be less severe than Haiti's, due to better water and sanitary conditions.

Meanwhile, Haiti's health ministry in its latest update is reporting 17,418 hospitalized cholera cases and 1,065 deaths, according to the WHO statement. Seven of the country's 10 departments are reporting cholera cases.

The WHO said that in the capital of Port-au-Prince six of eight communes are reporting increasing numbers of cases.

PAHO said yesterday in a health-cluster bulletin that cholera cases have risen significantly over the past 3 days in the Northwest and North departments, where protests on Nov 15 and 16 have slowed the delivery of critical health supplies and the rollout of health promotion campaigns. Rumors that the United Nations (UN) peacekeeping mission might have been the source of the cholera and anger over how the UN has handled the outbreak sparked violent demonstrations aimed at the UN and police.

See also:

Nov 17 FDH press release

Nov 17 Orlando Sentinel story

Nov 17 WHO statement

Nov 16 PAHO health-cluster bulletin

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