Florida health officials brace for more cholera from Haiti

Miami HeraldNovember 20, 2010 

MIAMI — A woman who returned to Florida's west coast from visiting family in Haiti's disease-stricken Artibonite Valley has become the state's first case of cholera transmitted from the beleaguered country, where the disease has killed more than 1,000 and hospitalized more than 9,000.

"She's doing quite well," said Dr. Thomas Torok, a cholera expert in the Florida Department of Health's Bureau of Epidemiology.

The woman was described as being from Collier County, near Naples on Florida's Gulf coast. "Additional cases are under investigation in several counties," Torok added, but declined to name the counties. Health officials in Broward and Miami-Dade counties on Florida's Atlantic coast, with large Haitian populations, said they have had no suspected cases

Torok declined further to identify the woman, except to say she does not work in a job that puts her in close contact with the public, so the chance that she might pass on the disease is very small.

Haiti had had no cases of cholera reported in decades until last month, when an outbreak quickly spread to more than 18,000 people. At least 1,000 people have died. Officials have not said precisely how the outbreak began, but the strain has been linked to one common in South Asia and suspicion has fallen on unsanitary conditions at a camp for U.N. peacekeepers from Nepal.

Torok said the woman returned from Haiti about a week ago showing cholera symptoms, and the Collier County Health Department confirmed the case and sent samples to the U.S. Centers for Disease Control and Prevention in Atlanta for further testing.

Last week, the state health department issued an advisory requiring Florida doctors and hospitals to quickly test patients showing cholera symptoms -- primarily profuse, watery diarrhea, dehydration and fever -- to county health departments.

New cases are expected in Florida because the state has about 241,000 Haitian-born residents, many of whom travel back and forth frequently, particularly since the Jan. 12 earthquake.

"With the setting of an ongoing epidemic in Haiti, we have increased our surveillance activities here anticipating that some travelers returning from Haiti will be ill," Torok said.

"We're asking travelers who develop severe watery diarrhea, the hallmark of cholera, within a week of returning from Haiti seek medical attention immediately."

He asked doctors and hospitals to report suspected cases to their county health departments immediately, without waiting for laboratory confirmation.

Chances for cholera to spread in the United States are low because of its modern water and sewer systems, Torok said

"Cholera in Haiti reflects the infrastructure's inability to provide clean water or safely dispose of sewage."

During a cholera epidemic in Latin America in the early 1990s, about 20 cases were found in Florida transmitted from those countries, Torok said. But none was spread from person to person in the state

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