What can kill you in less than 3 hours, and be treated with salt and clean water?

No, it’s not a jellyfish sting, or lethal poison – the surprising answer is Cholera.

According to the CBC, over 7000 people have been infected in Haiti over the last week, resulting in the deaths of 500 individuals, many of whom could have easily been saved if Haiti had the proper infrastructure in place to treat them. There has been no cholera outbreak in Haiti for around 50 years, and the initial reaction was one of confusion as many Haitians just did not know how to avoid the disease (BBC News).

Directly from the World Health Organization website: “Cholera is an easily treatable disease. Up to 80% of people can be treated successfully through prompt administration of oral rehydration salts (WHO/UNICEF ORS standard sachet). Very severely dehydrated patients require administration of intravenous fluids. Such patients also require appropriate antibiotics to diminish the duration of diarrhoea, reduce the volume of rehydration fluids needed, and shorten the duration of V. cholerae excretion. Mass administration of antibiotics is not recommended, as it has no effect on the spread of cholera and contributes to increasing antimicrobial resistance. In order to ensure timely access to treatment, cholera treatment centres (CTCs) should be set up among the affected populations. With proper treatment, the case fatality rate should remain below 1%.”

Cholera is a disease which is believed to have originated in India, and which thrives in disaster-type situations like this one, such as floods, hurricanes or earthquakes which disrupt normal water treatment routines. The original outbreak is believed to have started approximately three weeks ago, but the number of cases have drastically increased since Hurricane Tomas struck last Friday, causing flooding across western Haiti. Unfortunately the bad news continues to grow, as one of the rivers which has been identified as a source of the epidemic is soon expected to overflow with excess water.

The best intervention strategy for reducing cholera deaths is through a combination of  controlling the disease spread through provisions of safe water, proper sanitation and immediate education about the disease to the affected population group. Infected individuals can be difficult to identify since most are asymptomatic, but insuring access to quick treatment to those persons who do show signs of the illness helps to prevent further spread and save many lives. Providing safe water and sanitation is a major challenge, particularly in emergency situations, however it has been shown to be the critical factor in reducing the number and spread of infections.

Perhaps this is another opportunity for the use of SODIS (solar disinfection of drinking water) to be taught and used as a weapon against the further spread of this deadly disease. This simple method of disinfecting drinking water can be readily achieved by filling a clear plastic bottle with collected water (which has low turbidity) and leaving it out in the sun for more than 6 hours. (Stay tuned for a more in-depth follow-up post about SODIS, how and when it works, and benefits of using it to disinfect water.)

Written by Sarah Topps – 2010

Read more: http://www.cbc.ca/world/story/2010/11/07/haiti-cholera-toll-rises.html?ref=rss#ixzz14l2qWRgI

Flu Pandemic

Since the H1N1 virus first emerged, panic about the possibility of a global flu pandemic has subsided substantially. It seems that while the virus may be moving fast enough to kill people, it is not moving fast enough to scare them. However, a press report released today said that this outbreak could infect up to 2 billion people – one third of humanity!

The World Health Organization raised their estimation of the threat of a widespread pandemic to phase 5 on April 29th, but more recently a spokesperson has mentioned the possibility that it will go to phase 6 – the highest level of threat, indicating a widespread outbreak in communities in at least two WHO regions globally.

Interestingly, while browsing the available information on what exactly we would do if a full-blown pandemic were to erupt, I found startlingly little concrete information and almost no one who said they would actually be in charge during such an event. Would it be the local governments? The state? The UN or the WHO? The Red Cross perhaps? No one really seems to know.

I also came across a talk given at TED by Laurie Garrett in 2007 in response to the outbreak of Avian Bird Flu, which is shown below. It is quite a riveting 20 minute video and she really covers, or at least asks, all of the questions and common answers that we would find ourselves giving if a flu pandemic were to occur.

– Sarah Topps