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Haiti: Cholera Outbreak - 2010-2017

Statut
Passé
Pays
Haïti
+ 1
Types de catastrophes
Épidémie

Since the emergence of cholera in Haiti in October 2010, the Ministry of Public Health and Population recorded 719,377 suspected cases and 8,767 cholera-related deaths as of 30 Nov 2014. Despite severe infrastructure and financial constraints, concerted Haitian and international efforts have succeeded in drastically reducing the number of reported cholera cases in Haiti – down from a peak of over 350,000 reported cases for 2011, to 21,916 reported cases for 2014, from 1 January to 30 November. The persistence of cholera in Haiti is mainly due to the lack of access to clean water and appropriate sanitation facilities, and although considerable improvements have been made in this regard, Haiti continues to host the largest cholera epidemic in the Western Hemisphere. Structural issues such as weak water, sanitation and health systems enable cholera, acute diarrhoea and other waterborne diseases to persist. (UNCT, 31 Dec 2014)

At the beginning of 2015, the number of suspected cases was 75 per cent higher than originally expected in the mid-term review of the 2014 Humanitarian Action Plan (i.e. 15,000). From 8 Nov to 31 Dec 2014, the total number of reported suspected cholera cases was 11 324, with 133 fatalities. This is an increase of 20 per cent compared to the same period in 2013. (ECHO, 16 Jan 2015)

Suspected cholera cases reported for January to March 2015 were above those observed in early 2012 (but lower than those reported in the first quarter of 2013). This was predominately due to large outbreaks in the metropolitan region of Port-au-Prince which then spread to other high-risk regions. According to the national authorities, 4,321 suspected cholera cases and 36 deaths were reported in January, 4,055 suspected cases and 46 deaths in February ,and 3,014 cases and 22 deaths in March. (UNCT, 31 Mar 2015)

For the period between Jan-Jun 2015, OCHA reported 17,949 new cases - a 273% increase compared with the same period last year. As of June 2015, cholera has caused 8,992 deaths since the outbreak in Oct 2010. (OCHA, 27 Jul 2015)

According to the cholera figures released by the Minister of Public Health and Population (MSPP), 36,045 cholera cases and 322 deaths were recorded from January to December 2015. This represents, in comparison to 2014, an increase of 24% in the number of cases. In the last three months (October, November, December 2015), the upward trend of cholera persisted in the North and West departments. (OCHA, 31 Dec 2015)

During the first two months of 2016, the cholera epidemic has had a stable development in relation to the outbreak recorded at the end of 2015. The number of cases increased slightly compared to the same period in 2015, but the trend is downward since mid February. Nevertheless the return of the rain could be an important risk factor. In addition, the number of deaths has increased alarmingly: 15% more compared to 2015. (OCHA, 18 Apr 2016)

As of July 2016, health officials have observed a resurgence of cholera cases in several towns, including in the departments of Artibonite, Center, Nippes, North and West. According to a report of MSPP, more than 823 alerts were recorded during the week of 17-23 July 2016, and about twenty towns are on red alert. The situation is reported to be more critical in the towns of Carrefour (109 cases), Port-au-Prince (83 cases), Tabarre (75 cases), Mirebalais (45 cases) and Verrettes (39 cases). (OCHA, 31 Jul 2016)

In October 2016, Hurricane Matthew devastated Haiti which saw an increase of cases in Grand’Anse (148 cases) , Sud (53), and North-Ouest (6 cases) , and Artibonite (28) in the aftermath. (WHO/PAHO, 11 Oct 2016)

On 14 October, the UN Secretary-General established the Haiti Cholera Response Multi-Partner Trust Fund to finance critical priorities of the new UN system approach to cholera in Haiti designed to support the country in overcoming the epidemic and building sound water, sanitation and health systems. (UN, 14 Oct 2016)

A new approach to cholera in Haiti was laid out in the report by the UN Secretary-General (A/71/620) published on 12 December 2016. The UN General Assembly welcomed and committed to this new approach on 16 Dec 2016.

On 6 February, the Government of Haiti and the Humanitarian Country Team...launched an appeal for...US$ 291.5 million to cover the critical humanitarian needs of 2.4 million people, US$ 34.7 million of which would only be for cholera. (OCHA, 6 Feb 2017)

As of 31 December 2016, Haitian and international efforts have succeeded in reducing the cholera cases and fatalities in Haiti by almost 88% since the peak in 2011 (350,000 cases). From 1st January to 15 April, the MSPP registered 5,095 suspected cholera cases and 69 related deaths, in comparison to the 12,536 suspected cases and 134 deaths for the same period in 2016. This downward trend, if maintained, is an opportunity to take this year a big step towards the elimination of the transmission, in case funding is available and rapid response is accordingly intensified. (UNCT, 27 Apr 2017)

According to PAH/WHO, Haiti recorded 814,551 suspected cases of cholera with 9,693 deaths between October 2010 and 31 July 2017. However, since 2016, the epidemiological situation indicates a marked decrease in the transmission of the disease. According to the MSPP / DELR figures, EPI week 23 (2017) to date is officially the period with the lowest number of suspected cases ever since the outbreak of the epidemic in 2010. This situation is more remarkable given that the rainfall accumulated in April and May 2017 was equal to or even higher than the rainfall measured during the passage of Hurricane Matthew in October 2016. (OCHA, 17 Aug 2017)

The efforts of humanitarian partners to achieve the objective of zero cases of cholera continues with encouraging results. Thus, between January and September 2017, the country recorded a total of 10,814 suspected cases of cholera and 107 deaths against 30,211 cases and 289 deaths for the same period of 2016, a decrease of 64.2%. The highest peak in the number of cholera cases occurred in the department of Artibonite with 64.9% of the suspected cases in the month of September followed by Centre ant Ouest departments. To contain this situation, UNICEF’s partners (ACF, ACTED, Solidarités International, and French Red Cross) mobilized teams from other departments to constitute 19 teams mixed with the Rapid Response Teams (EMIRA) of the MSPP1 in the Artibonite alone. PAHO/WHO also deployed teams to outbreak areas to strengthen response either through institutional care or community activities. However, the lack of required funding for all the components of the National Elimination Plan is a handicap and a major risk for future control of the epidemic. (OCHA, 25 Oct 2017)

In Haiti, the cases reported between EW 1 and EW 50 of 2017 (13,468) represent a decrease of 68% with respect to the cases notified since EW 1 and EW 52 of 2016 (41,421) and is the lowest reported cases since the outbreak started in Haiti in October 2010 (Figure 1). Nevertheless, there are still 200–300 suspected cases reported each week. Between EW 47 and EW 50 of 2017, suspected cases were reported in 9 of the 10 Departments, although four Departments (Artibonite, Centre, Nord-Ouest and Ouest) account for 90% of the cases. In the same period, the average number of cases reported exceeded what was reported in the preceding weeks, mainly with the increases observed in the Nord (36% increase) and Nord-Ouest (19% increase) departments. Similarly and comparatively between 2016 and 2017 the number of deaths reported decreased by 65% (from 447 to 157 deaths) and represents the lowest number of deaths reported since 2010. (WHO/PAHO, 28 Dec 2017)