Titling Maggie Fox’s article on the source of the Haitian cholera outbreak “Whodunnit?,” Reuters makes distraction the main attraction.
Finger pointing about the “cause” of the outbreak — finger pointing at Nepalese peace keepers, the UN mission, relief workers, or Haitian health workers — is a way of avoiding the fundamental problem: insufficient political will to create working infrastructure for poor countries. Haiti being the leading example, the cholera outbreak being the case study.
Given how shaky the living arrangements have been for many Haitians since the January earthquake, given the pre-existing destitution and the anemia of efforts to fix that, it’s a tribute to the Haitian health system that cholera didn’t break out until October. It might have been much sooner.
But now that cholera is spreading, it seems that more energy is going into using the outbreak to whip up political animus in, and about, Haiti than to figuring out how to make sure it doesn’t happen again.
This week, the politicization of the cholera outbreak seems to get worse by the day (Crawford Kilian’s cholera coverage at H5N1 continues to keep abreast of both the cholera outbreak and the political uses it’s being put to). I talked to John Hockenberry and Celeste Headlee about this on The Takeaway yesterday, pointing out that the problem is social crisis, not Nepalese troops. It’s poverty, lack of adequate sanitation, poor access to clean water — not foreigners.
Here’s the segment of The Takeaway:
In contrast to the misleading headline of Reuters’ piece, what Ms. Fox covers is not the (pseudo) mystery of “who brought cholera to Haiti?” It’s the effort by CDC, the Haitian health ministry, and PAHO to determine whether the outbreak likely started from a single source or multiple ones.
The findings are reported in the Morbidity and Mortality Weekly Report this week: Haitian cases all carried Vibrio cholerae of the O1 serogroup, serotype Ogawa (a very common strain), with DNA of a single pulse-field gel electrophoresis pattern. Because of the propensity for mutation or recombination events in the reproduction of bacteria, it would be extremely unlikely for different people to be carrying bacteria with the identical PFGE pattern unless they had all been exposed to an identical strain. [N.B. Strictly speaking, cholera is not an infection: the illness results from poisoning by V. cholera in the intestine, not from actual infection of tissue. Therefore I write “exposed to” rather than “infected by.”]
Based on the findings so far, CDC and its partners concludes that the outbreak probably began with a single strain.
Did this strain arrive in cholera recently, or has it been around for some time and only recently came to attention as a cause of mass morbidity and mortality? Did it arrive in a person and contaminate the environment via feces, or arrive in food or water? Was there a single initiating exposure, or did cholera arrive inside multiple people or food items? As Fox points out, the study can’t answer these questions.
It makes sense to seek information on how the outbreak got started in order to plan for better systems to prevent future outbreaks. CDC is on the right track here.
But by calling this a whodunit, Reuters is pandering to people who want to inflame tempers, not spreading information about what can be done to make Haiti healthier. Shame on you, Reuters.
This entry was posted on Friday, November 19th, 2010 at 10:45 am and is filed under epidemics, News, Outbreaks, public health. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.