Haiti cholera outbreak reaches capital

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Port Au Prince, Haiti – The death toll from a cholera epidemic in Haiti topped 200 on Saturday and fears of it propagating in the crowded, earthquake-ravaged capital increased after five cases were detected in the city.

U.N. officials stressed that the five cases, the first confirmed in the capital since the epidemic started, were people who had become infected in the main outbreak zone of Artibonite north of Port-au-Prince and had subsequently traveled to the city where they fell sick.

"They were very quickly diagnosed and isolated," U.N. humanitarian spokeswoman Imogen Wall told Reuters, citing information from Haitian health authorities. "This is not a new location of infection."

But prevention measures and surveillance were being increased in Port-au-Prince, with its squalid sprawling slums and about 1.3 million survivors of the January 12 earthquake packed into tent and tarpaulin camps. All are highly vulnerable to a virulent diarrheal disease like cholera.

With more than 2,600 cholera cases reported and experts predicting the numbers will rise, Haitian and international medical teams are working desperately to isolate and contain the epidemic in the Artibonite and Central Plateau regions, north of the rubble-strewn capital.

It is the worst medical emergency to strike the poor, disaster-prone Caribbean nation since the earthquake killed up to 300,000 people and is also the first cholera epidemic in Haiti in a century.

Haitian health officials told a news conference on Saturday that 194 people had died from cholera in the Artibonite region, the main outbreak zone, with 14 other deaths in neighboring Central Plateau, where a prison was among places affected.

The total number of cases had reached 2,674.

Cholera, transmitted by contaminated water and food, can kill in hours if left untreated, through dehydration. But it can be treated easily with oral rehydration salts or just a simple mix of water, sugar and salt. TV and radio adds in Creole recommended that treatment to the population.

Besides rushing doctors, medicine and water supplies to the affected areas, Wall said the UN and aid agencies were identifying sites in Port-au-Prince where any cholera patients could be treated in tent clinics, separate from hospitals.

"If we have cases in Port-au-Prince, the only way to contain them is to isolate them," Wall said.

"Obviously, preventing the disease spreading to the city is an absolutely paramount concern right now," she said.

Daniel Rouzier, chairman of the Board of Trustees of U.S.-based charity Food for the Poor, earlier told Reuters he had learned of the five cholera cases at private clinics in the capital. "It was not originally in the geographical area of the camps. Now it is," he said.

Rouzier, whose charity has sent water purification units to the cholera-infected central zones, faulted the Haitian government and its aid partners for not moving quickly and effectively enough to contain and isolate the epidemic.

"Right now, it's been over 72 hours. There is no safety cordon," he said. "If the sick had the proper healthcare where they were, they wouldn't have come to this chaotic city."

Aid workers in the town of Saint-Marc, in the heart of the Artibonite outbreak zone, have reported the main local hospital overflowing with patients, many lying outside in the compound hooked up to intravenous drips.

Haiti is due to hold presidential and legislative elections on November 28 but it is not clear whether the epidemic could threaten the organization of the vote.

In the crowded camps that fill squares, streets, parks and even a golf course in Port-au-Prince, fears of contracting the disease are running high.

"All we can do is pray to God because if we catch this disease in these camps, it will be a real disaster," said Helen Numa, 35. "You can see for yourself how people are living here, packed in like sardines."

Haitian Health Minister Alex Larsen has urged people to wash their hands with soap, not eat raw vegetables, boil all food and drinking water and avoid bathing in and drinking from rivers. The Artibonite River, which irrigates all of central Haiti, is believed to be contaminated.

But many in the capital's camps said they did not have money to buy soap and chlorine to apply hygiene measures.

"We don't have anything, not even one dollar, because we don't have jobs," said Marjorie Lebrun, 45. "I'm afraid if I and my five children get sick, we could die."

Wall said the relief effort in Haiti had enough antibiotics to treat 100,000 cases of cholera and intravenous fluids to treat 30,000. But those would need replenishing.