Cholera Outbreak in Haiti: Update

Updated: June 20, 2011

Travel Health Notice

In October 2010, an outbreak of cholera was confirmed in all departments of Haiti. Cases of cholera continue to be reported.

Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae. People usually become infected from drinking or eating contaminated water or food. It is associated with watery diarrhea and rapid dehydration, which may be life-threatening.

Following the earthquake on January 12th, 2010, healthcare systems continue to be severely strained due to the large number of injuries and deaths, and widespread damage to health care infrastructure. Service delivery is hindered.

Foreign Affairs and International Trade Canada continues to advise against non-essential travel to Haiti due to the hazardous and unpredictable security situation that remains volatile since the earthquake.

Recommendations

Consult a doctor, nurse or health care provider, or visit a travel health clinic at least six weeks before you travel.

1. Be prepared before going to Haiti and while you are there

1. Get vaccinated
   1. Make sure you are up-to-date with all of your routine vaccinations, especially a current tetanus vaccine.
   2. Other vaccines to consider hepatitis A, hepatitis B, typhoid, rabies, and seasonal flu.
   3. Travellers at high risk for cholera (humanitarian relief workers, travellers visiting areas of high risk with limited access to clean water and food) may benefit from vaccination and should consult with a health care provider to discuss this option.
2. Practise safe food and water precautions:
    
   

   There is an increased risk of food and waterborne diseases such as travellers’ diarrhea, cholera, hepatitis A, typhoid fever, and leptospirosis.

3. Protect yourself from insects and animals
    
   

   Travellers to Haiti are at risk for insect borne and animal diseases such as malaria, dengue fever, lymphatic filariasis as well as rabies.

4. Bring a travel first aid kit which could include:
   1. Basic first aid supplies such as a thermometer, sun screen, gauze, bandages, ointments for cleaning wounds, hand sanitizer, etc.
   2. Aspirin, ibuprofen and/or acetaminophen (Advil and/or Tylenol) for pains and fevers;
   3. Anti-diarrheal medication, laxatives, antacids, and oral rehydration salts for upset stomachs; talk to a health care provider about self treatment for travellers’ diarrhea (TD).
   4. Oral rehydration salts
   5. Anti-histamines for allergies, cough suppressant and/or drops for throat and chest irritations;
   6. Anti-malarial pills or other prescribed medications -- remember to bring copies of your prescriptions;
   7. An adequate supply of personal prescribed medications to cover possible extension of stay in Haiti.
   8. Personal protective equipment (PPE) such as safety glasses, work boots, leather gloves, rubber gloves for handling blood or body fluids.
5. Be aware
   1. Access to adequate medical care in Haiti will be very limited.
   2. Access to safe drinking water may be very limited.
      • Treat water that may not be safe for drinking
   3. There will be limited or no commercial accommodation available.
   4. The stressful situations that you may encounter while providing assistance to earthquake victims in Haiti may cause emotional and/or psychological difficulties. Make sure you have necessary mental health support while in Haiti and after you return.
   5. There is a high incidence of HIV infection in Haiti. If you have a needle stick, puncture, cut or blood splash to your eyes, you should seek immediate medical attention.
   6. Persons with chronic or unstable medical conditions should discuss whether to travel to Haiti with their health care provider.

2. For travellers going to Haiti and individuals working with or caring for those in transit from or arriving from Haiti

1. Protect yourself
   1. Wash your hands with soap and water frequently
   2. Keep your hands away from your face
   3. Practise proper cough and sneeze etiquette
      • Cough and sneeze into your arm, not your hand
      • If you use a tissue, dispose of it as soon as possible and remember to wash your hands afterwards.
   4. While providing care to someone with diarrhea and/or vomiting or when changing diapers:
      • If possible, wear a gown and gloves
      • Remove and dispose of them after in a plastic bag and close
      • Wash your hands
   5. Wear gloves when touching blood, body fluids, mucous membranes and broken skin as well as when handling anything that may have been soiled with blood and body fluids.
   6. If you are in close contact with a person who is ill with a fever and coughing, producing sputum or is a suspected or known tuberculosis (TB) patient:
      • Consider wearing Protective Personal Equipment (PPE) and follow proper guidelines for preventing transmission of respiratory diseases such as seasonal flu and TB.
      • If appropriate, place a surgical mask on the sick person.
2. If you develop severe diarrhea and/or vomiting
   1. Infants, young children and the elderly and those with underlying health conditions are at greatest risk of dehydration
   2. Seek medical attention immediately
   3. Drink fluids and use oral rehydration salts to prevent dehydration

3. After your return home to Canada

1. If you get sick or develop severe diarrhea and/or vomiting when you return to Canada,
   1. Seek medical attention immediately and inform them that you have travelled to Haiti and inform them what activities you participated in while in Haiti especially if you work in an occupation such as health care, food service and child care
   2. Drink fluids and use oral rehydration salts to prevent dehydration
2. Remember that symptoms of malaria, which includes a fever, can occur up to one year after your return