Can the severe cholera outbreak in Haiti affect the United States?

In recent days, dozens of people in Haiti have died from an outbreak of cholera. It seems that the situation could perhaps be getting out of control as more cases are getting reported on a daily basis.

Very little information is known as to what plans are being put in place to contain this outbreak. The most immediate danger is that this will continue to spread through cities in Haiti, where currently thousands are still displaced and living in suboptimal conditions.

The condition in Haiti right now is a perfect feeding ground for this bacteria, which in the early 1900s was responsible for the death of thousands of people. Cholera is highly contagious, especially where there is poor hygiene, poor water conditions and where human waste can contaminate the food supply. All of these conditions have gotten worse in Haiti since the devastating earthquake in January of 2010.

Health and relief workers that are currently in Haiti probably received the cholera vaccine prior to going down there, but there is still a danger of this devastating health problem expanding past Haiti’s borders. A neighboring country like the Dominican Republic is at the present time in the most imminent danger, and a significant warning should be given to citizens of that country, especially to those living in towns that lie along the Haitian border.

My concern is also that, due to the daily influx of travelers from the island which includes Haiti and the Dominican Republic, a case of cholera could find its way into the United States.

The Haitian government is leading the fight to contain the outbreak, with aid from the World Health Organization and the Pan-American Health Organization. On a local level, efforts are ongoing to distribute soap, water purification tablets, and rehydration salts to prevent further spread of the disease. Tens of thousands of gallons of chlorinated, and therefore safe, water are being distributed in affected areas. Additionally, fliers and radio broadcasts are being used to warn people in settlement sites about proper hand hygiene.

The Center for Disease Control and the U.S. Department of State currently recommend that U.S. citizens avoid non-essential travel to Haiti. For those that do plan to visit the country, the CDC lists a number of measures on their website to help reduce the risk of getting sick, including getting a doctor’s prescription for an antibiotic for traveler’s diarrhea and, while in the country, only drinking water that has been boiled.

Cholera is defined as an acute intestinal infection caused by the toxigenic Vibrio cholerae, according to the CDC. Often, cholera is asymptomatic – meaning there are no symptoms – or manifests itself as mild gastoentiritis, also known as the “stomach flu”. Symptoms of severe cases of cholera consist of acute diarrhea, vomiting, increased heart rate, loss of skin elasticity, dry mucous membranes, low blood pressure and thirst.

The disease is most often spread through drinking water that has been contaminated by the feces of an infected person. It can also be spread through contaminated fish, shellfish or leftover cooked grains that have not been properly reheated. Person-to-person transmission is rare.

The best way to treat cholera is through rehydration. Oral rehydration salts, intravenous fluids and electrolytes can reduce the risk of fatality to less than 1 percent, if administered quickly enough and in a large enough volume. Antibiotics can also help by reducing fluid requirements and the duration of the illness. In severe cases, antimicrobial therapy is recommended.

Let us hope that this medical condition is brought under control. However, this problem in Haiti was predicted by many people, and it is very sad that so many months after this devastating earthquake, these challenges were not addressed in a timely fashion, and people have lost their lives because of it.

Dr. Manny Alvarez is a Cuban-American OB-GYN who serves as a senior medical contributor for the Fox News Channel and senior managing health editor of To read more from Dr. Manny, click here