UPDATE: Travelers' Health - Outbreak Notice, Cholera in Haiti

Warning - Level 3, Avoid Nonessential TravelAlert - Level 2, Practice Enhanced PrecautionsWatch - Level 1, Practice Usual Precautions

An outbreak of cholera has been ongoing in Haiti since October 2010. According to the Ministere de la Sante Publique et de la Population (MSPP), as of May 22, 2013, 657,117 cases and 8,096 deaths have been reported since the cholera epidemic began in Haiti. Among the cases reported, 363,740 (55.4%) were hospitalized. Cases have been officially reported in all 10 departments of Haiti. In Port-au-Prince, the country’s capital, 176,935 cases have been reported since the beginning of the outbreak. Cases in Port-au-Prince have been reported from the following neighborhoods: Carrefour, Cite Soleil, Delmas, Kenscoff, Petion Ville, Port-au-Prince and Tabarre.

For more information on cholera cases, see the Health Summary Report from MSPP.

Cholera is a bacterial disease that can cause diarrhea and dehydration. Cholera is most often spread through the ingestion of contaminated food or drinking water. Water may be contaminated by the feces of an infected person or by untreated sewage. Food is often contaminated by water containing cholera bacteria or by being handled by a person ill with cholera.

Since the earthquake, the U.S. Department of State has maintained a travel warning for Haiti urging U.S. citizens to avoid all nonessential travel to Haiti. For more information, see http://travel.state.gov/travel/cis_pa_tw/tw/tw_5541.html.

Most travelers are not at high risk for getting cholera, but people who are traveling to Haiti should still take their own supplies to help prevent the disease and to treat it. Items to pack include

A prescription antibiotic to take in case of diarrheaWater purification tablets*Oral rehydration salts*

*In the United States, these products can be purchased at stores that sell equipment for camping or other outdoor activities.

Although no cholera vaccine is available in the United States, travelers can prevent cholera by following these 5 basic steps:

Bottled water with unbroken seals and canned/bottled carbonated beverages are safe to drink and use.Use safe water to brush your teeth, wash and prepare food, and make ice.Clean food preparation areas and kitchenware with soap and safe water and let dry completely before reuse.

*Piped water sources, drinks sold in cups or bags, or ice may not be safe. All drinking water and water used to make ice should be boiled or treated with chlorine.
To be sure water is safe to drink and use:

Boil it or treat it with water purification tablets, a chlorine product, or household bleach.Bring your water to a complete boil for at least 1 minute.To treat your water, use water purification tablets, if you brought some with you from the United States, or one of the locally available treatment products, and follow the instructions.If a chlorine treatment product is not available, you can treat your water with household bleach. Add 8 drops of household bleach for every 1 gallon of water (or 2 drops of household bleach for every 1 liter of water) and wait 30 minutes before drinkingAlways store your treated water in a clean, covered container.Before you eat or prepare foodBefore feeding your childrenAfter using the latrine or toiletAfter cleaning your child’s bottomAfter taking care of someone ill with diarrhea

*If no soap is available, scrub hands often with ash or sand and rinse with safe water.

Use latrines or other sanitation systems, like chemical toilets, to dispose of feces.Wash hands with soap and safe water after using toilets or latrines.Clean latrines and surfaces contaminated with feces using a solution of 1 part household bleach to 9 parts water.

What if I don’t have a latrine or chemical toilet?

Defecate at least 30 meters away from any body of water and then bury your feces.Dispose of plastic bags containing feces in latrines, at collection points if available, or bury it in the ground. Do not put plastic bags in chemical toilets.Dig new latrines or temporary pit toilets at least a half-meter deep and at least 30 meters away from any body of water.Boil it, cook it, peel it, or leave itBe sure to cook shellfish (like crabs and crayfish) until they are very hot all the way through.Do not bring perishable seafood back to the United States.

*Avoid raw foods other than fruits and vegetables you have peeled yourself.

Wash yourself, your children, diapers, and clothes at least 30 meters away from drinking water sources.

Before departing for Haiti, talk to your doctor about getting a prescription for an antibiotic. If you get sick with diarrhea while you are in Haiti, you can take the antibiotic, as prescribed. Also, remember to drink fluids and use oral rehydration salts (ORS) to prevent dehydration.

If you have severe watery diarrhea, seek medical care right away.

Medical care facilities are strained with the high number of people who are ill. If you will be traveling to Haiti, CDC recommends that you purchase medical evacuation insurance in the event that you become ill while in Haiti. (See the U.S. Department of State list of U.S.-Based Air Ambulance or Medical Evacuation Companies.) If you are in Haiti and need medical care and you do not have access to medical evacuation, you can contact the Embassy of the United States in Port-au-Prince, Haiti, (American Citizens Services Unit office hours are 7:00 a.m. to 3:30 p.m., Monday through Friday. The Consular Section is closed on U.S. and local holidays.):

Boulevard du 15 October, Tabarre 41, Tabarre, Haiti
Telephone: (509) (2) 229-8000
Facsimile: (509) (2) 229-8027
Email: acspap@state.gov

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