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Flagler Health Department Downplays Worries As First Cholera Case Is Confirmed in Florida

| November 17, 2010

A young boy is treated for cholera by re-hydration in Haiti, where an epidemic has killed some 1,000 people. (Courtesy Water Missions International)

A young boy is treated for cholera by re-hydration in Haiti, where an epidemic has killed some 1,000 people. (Courtesy Water Missions International)

One confirmed case of cholera was reported in South Florida in connection with the epidemic in Haiti, which has killed some 1,000 people and sickened 9,000. The case was reported in Collier County, with a few other cases that are not confirmed as cholera but present similar symptoms.

But Flagler County Health Department Administrator Patrick Johnson said Flagler and Florida residents should not overreact even though the disease is contagious and can be deadly: It’s easily treatable, it won’t spread in the United States, and in most cases, especially when detected early, it doesn’t even require hospitalization. Something as simple as Gatorade—that is, quick re-hydration—does the trick.

“We’ve been watching it since the outbreak in Haiti,” Johnson said. “Cholera is highly contagious, however it is like a small fire that would burn out in our type of situation. Cholera spreads where there’s poor sanitation basically—unclean water sources and poor sanitation, which we don’t have. So wherever it pops up it’ll die quickly. It’s hard to transmit in our type of setting. It’s not like, say, other food-borne or other water-borne illnesses that we might have here.”

The Collier case affected a local woman who had traveled to Haiti to visit family. She has since recovered.

Cholera is a diarrheal disease caused by a bacterial infection of the intestine. The infection is often mild or without symptoms, yet illness sometimes can be severe, the state Department of Health said in an advisory today. In severe cases, the infected person may experience profuse, watery diarrhea and vomiting that can cause rapid loss of body fluids, leading to dehydration and shock. Without treatment, death can occur within hours.

“It is very important for travelers who develop severe, watery diarrhea, or diarrhea and vomiting within five days after return from Haiti to seek medical attention immediately,” State Surgeon General Ana M. Viamonte Ros said. “Rapid treatment is the key to recovery.”

As elsewhere in the state, Florida Hospital Flagler has been put on alert for symptoms of cholera.

Local health departments have not found it necessary to send out alerts beyond hospitals, since there hasn’t been such a thing as an outbreak: the cases in South Florida were carried by travelers coming back from Haiti. The patients were isolated and rehydrated. Recovery can be swift.

“Worst case would be to get it in the living conditions in Haiti,” Johnson said, “but it has zero chance of spreading in the United States, absolutely zero.”

In sum, Johnson said, “there’s no need to panic about it.”

Flagler County does have a Haitian community, and humanitarian and church groups from Flagler and Volusia have traveled back and forth to the island to care for people there in the aftermath of the Jan. 12 earthquake, which killed upward of 230,000 people and left 1 million people homeless, devastating the county’s public health systems.

Although the potential for the spread of cholera is low, the Florida Department of Health wants to ensure high-risk situations such as cholera in a food-handler or clusters of illness are identified, and those affected are provided medical treatment. Suspected cases of cholera should be immediately reported to County Health Departments by doctors, hospitals and laboratories without waiting for laboratory confirmation. (The Flagler Department of Health can be reached at 386-437-7350).
The department is also encouraging health care providers to administer specific cholera testing in suspected cases and notify the department of its laboratory results. Family members and caretakers of ill travelers returning from Haiti should wash their hands frequently as they may be at risk of contracting cholera if handling the vomit or feces of an infected person.

Here are the Centers for Disease Control’s tips for travelers:

  • Pack water purification tablets or other supplies to make your own safe water for drinking.

  • Eat food that is thoroughly cooked and hot.
  • Wash your hands often with soap and safe water.
  • Wash yourself, your children, diapers, and clothes away from drinking water sources.
  • Use latrines, or sanitation systems like chemical toilets, to dispose of feces. If you don’t have access to a latrine or chemical toilet, defecate away from any water source and then bury the feces.
  • Pack oral rehydration salts to use if you get sick with diarrhea, and use safe water to make your oral re-hydration solution.

On Tuesday, Health News Florida reports, “medical authorities in Haiti defended their decision not to focus on finding the origins of the cholera outbreak, which has stoked violent demonstrations against United Nations peacekeepers, whom many people blame for introducing the disease, the New York Times reported today. Protests that began Monday and carried into Tuesday in some places left two people dead as demonstrators directed their ire at the peacekeepers, a 12,000-strong, multinational force that arrived in Haiti in 2004 in response to political conflict.

“The health officials also mentioned what state public health veterinarian Carina Blackmore said was the first non-imported dengue fever case in Miami in 60 years. The report was confirmed last week. The DOH had previously noted an increase in the number of dengue cases in the Key West area.”

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