Cólera

InternacionalSalud Pública,

Desde que el COVID-19 envolviera al mundo hace dos años, la expresión “sin precedentes” se ha vuelto en una especie de muletilla. Pero, si bien el coronavirus ha planteado retos únicos en tiempos de profunda interconectividad global, las pandemias no son nada nuevo. Ni siquiera la pandemia de COVID-19 es la única que estamos padeciendo hoy. En gran parte del mundo en desarrollo están proliferando los brotes de cólera.

Mientras que el virus SARS-CoV-2 es “nuevo”, el cólera –una enfermedad diarreica transmitida por el agua y causada por la bacteria Vibrio cholerae- es antigua, como es su historial de devastación generalizada.…  Seguir leyendo »

Ganar la lucha contra el cólera

InternacionalSalud Pública,

A partir del año 2017, Yemen ha sufrido el brote de cólera más grande y de más rápida propagación en la historia moderna. Se emitían reportes diarios que informaban sobre el surgimiento de miles de nuevos casos, más de la mitad de los cuales afectaban a niños. Además, Yemen no estuvo solo: ese año, más de 1,2 millones de personas contrajeron cólera en 34 países, y 5.654 personas murieron. Debido a que el cólera es prevenible y tratable, esto nunca debería haber ocurrido. Afortunadamente, hay razones para esperar que no vuelva a ocurrir.

El cólera es una enfermedad diarreica causada por el consumo de agua o alimentos contaminados por la bacteria Vibrio cholerae.…  Seguir leyendo »

MundoÁfrica, , ,

As the world reckons with the covid-19 pandemic, we are learning firsthand how health epidemics often reveal underlying social, political and economic tensions in a society. In his latest book, “The Political Life of an Epidemic,” offers a vivid and rigorous account of the causes and consequences of Zimbabwe’s 2008-2009 cholera outbreak. Chigudu, associate professor of African politics and Fellow of St. Antony’s College, Oxford University, argues the cholera outbreak served as a “perfect storm,” opening a window to understanding the multiple ways disease affects the relationship of citizens with their government.

Scholars of diseases may look at the weakness and dysfunction of the Zimbabwean health system, and predict that a cholera outbreak was inevitable.…  Seguir leyendo »

InternacionalSalud Pública,

Cuando el ciclón Idai azotó a Mozambique, Malawi y Zimbabue en la noche del 14 de marzo, causó una devastación inimaginable y se cobró más de 1.000 vidas. Tras su paso, y el del ciclón Kenneth al mes siguiente, la inundación y la pérdida de infraestructura crearon las condiciones para un brote explosivo de cólera, una enfermedad diarreica mortal que puede matar a una persona en cuestión horas si no recibe tratamiento.

Pero lo que sucedió a continuación es clave: después del paso devastador de Idai, las autoridades lanzaron una iniciativa de respuesta rápida y, en el lapso de 24 horas, dispusieron el suministro de vacunas orales contra el cólera en Mozambique.…  Seguir leyendo »

Una receta bangladesí contra el cólera

MundoAsia, , ,

A estas alturas, el cólera debería ser historia. Hace mucho que las autoridades sanitarias saben cómo prevenir la enfermedad, los médicos saben cómo tratarla y los expertos en desarrollo comprenden que allí donde hay saneamiento y agua potable, los brotes rara vez se convierten en epidemias. Por desgracia, el mundo no es tan simple y ordenado, y la pesadilla del cólera persiste.

En muchas partes del mundo, el cólera ya fue domado. Las enfermedades transmitidas por el agua casi no existen en las economías avanzadas. E incluso en países y regiones con escasez de recursos, donde el cólera sigue siendo un problema, la terapia de rehidratación oral (TRO) ayudó a prevenir incontables muertes.…  Seguir leyendo »

A boy rinses a bucket for collecting well water that is believed to be contaminated with the bacteria that causes cholera, on the outskirts of Sana, Yemen, in July. Credit Hani Mohammed/Associated Press

MundoOriente Próximo, , , ,

The quality of mercy is strained in the Middle East. Last week, Saudi Arabia closed off the highways, sea routes and airports in war-torn Yemen, forbidding humanitarian groups from even shipping chlorine tablets for the Yemenis suffering from a cholera epidemic. More than 500,000 Yemenis have been infected with cholera this year and nearly 2,000, mostly children, have died, according to the World Health Organization. The International Red Cross expects about a million people to be infected by cholera in Yemen by December.

The spread of cholera in Yemen glaringly illustrates how disease follows in the wake of bombs.

The seeds of the epidemic were planted in 2015, when a military coalition led by Saudi Arabia and the United Arab Emirates and backed by the United States joined the fighting in Yemen on behalf of the ousted president, Abdu Rabbu Mansour Hadi, who had been forced out by Houthi rebels.…  Seguir leyendo »

Yemeni children suspected of being infected with cholera receive treatment at a hospital in Sanaa. Photo: Getty Images.

MundoOriente Próximo, , ,

Four months ago, the situation in Yemen was dire: there had been 124,000 suspected cases of cholera, and experts were predicting that it could rise to 300,000. Urgent action was called for – from health and humanitarian actors as well as from warring parties – to allow the population better access to health care and to allow supplies to reach those in need.

These pleas have had little effect. As of 2 November, with an estimated 900,000 suspected cases, Yemen’s cholera outbreak has now surpassed that of Haiti (which has seen 815,000 cases since 2010) to become the largest recorded in recent history.…  Seguir leyendo »

A girl seriously affected with cholera.

InternacionalSalud Pública,

“¿Dónde está el baño?”. Es lo primero que pregunto cada vez que visito un lugar donde estalló un brote de cólera. Las más de las veces, la respuesta es: “No tenemos. Vamos donde podemos”.

El cólera es una enfermedad antigua, y se ha convertido en una enfermedad de la pobreza. No discrimina geográficamente: se ensaña con comunidades vulnerables en áreas con deficiencias de saneamiento.

Arrastrada hasta fuentes de agua potable por una correntada contaminada, transportada sin saberlo por viajeros, ingresada a las casas en productos irrigados con aguas cloacales no tratadas, la bacteria Vibrio cholerae se aloja una vez ingerida en el intestino delgado y causa diarrea aguda y deshidratación.…  Seguir leyendo »

A child suspected of being infected with cholera sits outside a makeshift hospital in Sana'a, Yemen.

MundoOriente Próximo, , ,

From a lack of basic public services, to violations of internal humanitarian law by warring parties, Yemen’s humanitarian crisis is daunting. But infectious disease outbreaks, like the cholera currently sweeping Yemen, should not be considered inevitable. By pressuring donors to urgently deliver on pledged resources, and by supporting humanitarian advocacy efforts to protect and promote access to health and other essential commodities and services, cholera can be stopped.

The outbreak

In terms of health security risks, cholera in Yemen is a ‘known known’. We know that infectious diseases such as cholera spread in conflict zones, where there is lack of water, poor sanitation and a weak or absent health system.…  Seguir leyendo »

People bathe and clean clothes in a river cutting through Roche a Bateau, Haiti, after the devastation caused by Hurricane Matthew. PATRICK FARRELL pfarrell@miamiherald.com

MundoAmérica, , ,

With the number of suspected cases of cholera in Haiti now in the hundreds, the race is on to try to prevent further death and devastation following Hurricane Matthew.

With one million doses of cholera vaccine due to arrive this week, the hope is that we can prevent a repeat of the horrific outbreak in 2010 that infected nearly 800,000 Haitians, killing more than 9,000 people. But, even if we are successful in Haiti, the fact is for a highly preventable disease like cholera, vaccine stockpiles while certainly helpful cannot be a long-term solution.

Ten million people live in Haiti alone, and yet fewer than 6 million doses of cholera vaccine are currently produced each year, to maintain a global emergency stockpile of 2.2 million, with two doses recommended per person.…  Seguir leyendo »

Cholera patients received treatment at the St. Nicholas Hospital in St.-Marc, in 2010. Dieu Nalio Chery/Associated Press

MundoAméricaInternacionalONU, , , ,

Marseille, France In late 2010, the Haitian government asked me to investigate a cholera outbreak that struck that autumn following the arrival of a United Nations peacekeeping unit. It quickly became evident that some of the peacekeepers, who had been rotating through Haiti as part of a mission started in 2004 to provide security and stability, had introduced cholera from Nepal, where the disease had been flourishing.

By scrutinizing the most affected areas and using maps to trace the disease, I demonstrated how the epidemic originated with the peacekeepers. I published my findings in a July 2011 article, and an independent scientific team confirmed my conclusions within a few months.…  Seguir leyendo »

MundoAméricaInternacionalONU, , , ,

Depuis quelques mois, le virus Ebola a retenu l’attention des médias du monde entier. Il est tout à fait compréhensible qu’un nombre important d’articles de presse et de reportages qualifient l’épidémie en Afrique de l’Ouest de l’une des urgences les plus graves des temps modernes.

Mais nous ne devons pas oublier qu’une autre épidémie se poursuit de l’autre côté de l’Atlantique. Le choléra continue de créer une situation de crise en Haïti et la récente attention portée à l’épidémie d’Ebola devrait nous rappeler qu’il ne faut pas baisser la garde. Contrairement à Ebola, le choléra n’est pas un tueur systématique et peut être traité efficacement grâce à l’accès aux soins, mais il se déplace rapidement, transmis par les aliments ou l’eau contaminés.…  Seguir leyendo »

MundoAméricaInternacionalONU, , , ,

The mandate of the U.N. mission in Haiti includes ensuring “individual accountability for human rights abuses and redress for victims.” Yet instead of fulfilling its obligations to the roughly 600,000 Haitians affected by a cholera outbreak it caused, the United Nations is hiding, shamefully, behind a claim of immunity. By refusing to right its own wrong, the international body is violating the principles of international accountability and human rights that it purports to promote.

For all its challenges, Haiti was free of cholera for about a century before a U.N. peacekeeping force arrived from Nepal in October 2010. Although there had been an outbreak of cholera in Nepal shortly before the troops left for Haiti, the U.N.…  Seguir leyendo »

MundoAméricaInternacionalONU, , , ,

Imagine if a multinational company went to one of the world's most impoverished countries and, while saying it was there to help, contaminated the water supplies, unleashing a new disease that killed thousands of people. Hundreds of thousands more develop a hideous sickness, suffering such debilitating loss of liquid their eyes sink into their face, their skin wrinkles, their body shivers uncontrollably. Then there is a cover-up as the firm evades responsibility and, when finally taken to court, it simply refuses to play ball with the legal process.

Such a story sounds like something created in the febrile mind of a Hollywood scriptwriter, which in real life would lead to a huge and justified outcry.…  Seguir leyendo »

MundoAméricaInternacionalONU, , , ,

When U.N. Secretary General Ban Ki-moon invoked diplomatic immunity last week for peacekeepers who unwittingly caused the cholera outbreak that killed nearly 8,000 Haitians, his decision looked cold-hearted. Many in Haiti and in the humanitarian community are indignant that the United Nations will face no consequences for failing to properly test soldiers from Nepal who assisted in earthquake relief efforts in 2010. The incident seems like a sign of arrogance and ineptitude on the U.N.’s part.

But sympathy for Haitians should not mask the necessity of the secretary-general’s decision. It was right as a legal matter — and as a moral one, too.…  Seguir leyendo »

MundoAméricaInternacionalONU, , , ,

Last week’s decision by the United Nations to reject a claim to compensate Haiti’s half-million-plus cholera victims and their families is unconscionable and immoral. Numerous studies find that contaminated fecal matter from the U.N.’s Nepalese contingent was the source of the country’s cholera epidemic.

No one is suggesting that the asymptomatic Nepalese soldiers knew they were carrying the deadly bacteria — though if a recommendation to screen all peacekeepers before deployment was a requirement, as has been recommended, this whole tragedy could have been avoided. What the victims, legal teams and human rights activists believe is that rather than repair a broken sewage pipe, the U.N.…  Seguir leyendo »

MundoAmérica, , , ,

Haiti should be an unlikely backdrop for the latest failure of the humanitarian relief system. The country is small and accessible and, following last January's earthquake, it hosts one of the largest and best-funded international aid deployments in the world. An estimated 12,000 non-governmental organisations are there. Why then, have at least 2,500 people died of cholera, a disease that's easily treated and controlled?

I recently went to Haiti's capital, Port-au-Prince, and found my Médecins Sans Frontières (MSF) colleagues overwhelmed, having already treated more than 75,000 cholera cases. We and a brigade of Cuban doctors were doing our best to treat hundreds of patients every day, but few other agencies seemed to be implementing critical cholera control measures, such as chlorinated water distribution and waste management.…  Seguir leyendo »