An outbreak of cholera has been confirmed in Haiti. The majority of cases have been reported in departments of Artibonite, Centre, Nord-Ouest, Nord-Est, Nord, Sud and Ouest, with cases confirmed in Port-au-Prince.

The outbreak is expected to spread to other areas of the country and possibly beyond the island to other countries in the Americas. In response, there are international experts in both Haiti and the Dominican Republic to deal with the situation. To date, there has been one case confirmed in the Dominican Republic.

Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae. People usually become infected from drinking or eating contaminated water or food. It is associated with watery diarrhea and rapid dehydration, which may be life-threatening.

Earthquake in Haiti

Following the earthquake on January 12th, 2010, healthcare systems continue to be severely strained due to the large number of injuries and deaths, and widespread damage to health care infrastructure. Service delivery is hindered.

The Public Health Agency of Canada (PHAC) recommends that Canadians avoid all non-essential travel to Haiti following the major earthquake of January 12th, 2010.

Travellers should consult Foreign Affairs and International Trade Canada’s Travel report on Haiti (External link) for safety and security information regarding travel to affected areas.

The following recommendations are to advise all travellers going to Haiti.

Recommendations

Consult a doctor, nurse or health care provider, or visit a travel health clinic at least six weeks before you travel.

1. Be prepared before going to Haiti and while you are there

Get vaccinated
1. Make sure you are up-to-date with all of your routine vaccinations, especially a current tetanus vaccine.
2. Other vaccines to consider hepatitis A, hepatitis B, typhoid, rabies, and seasonal flu.
3. Those travellers who may be at high risk for cholera (humanitarian relief workers, travellers visiting areas of high risk with limited access to clean water and food) should consult with a health care provider to discuss the benefits of getting vaccinated.
Practise safe food and water precautions:

There is an increased risk of food and waterborne diseases such as travellers’ diarrhea, cholera, hepatitis A, typhoid fever, and leptospirosis.
Protect yourself from insects and animals

Travellers to Haiti are at risk for insect borne and animal diseases such as malaria, dengue fever, lymphatic filariasis as well as rabies.
Bring a travel first aid kit which could include:
1. Basic first aid supplies such as a thermometer, sun screen, gauze, bandages, ointments for cleaning wounds, hand sanitizer, etc.
2. Aspirin, ibuprofen and/or acetaminophen (Advil and/or Tylenol) for pains and fevers;
3. Anti-diarrheal medication, laxatives, antacids, and oral rehydration salts for upset stomachs; talk to a health care provider about self treatment for travellers’ diarrhea (TD).
4. Oral rehydration salts
5. Anti-histamines for allergies, cough suppressant and/or drops for throat and chest irritations;
6. Anti-malarial pills or other prescribed medications -- remember to bring copies of your prescriptions;
7. An adequate supply of personal prescribed medications to cover possible extension of stay in Haiti.
8. Personal protective equipment (PPE) such as safety glasses, work boots, leather gloves, rubber gloves for handling blood or body fluids.
Be aware
1. Access to adequate medical care in Haiti will be very limited.
2. Access to safe drinking water may be very limited.
  - Treat water that may not be safe for drinking
3. There will be limited or no commercial accommodation available.
4. The stressful situations that you may encounter while providing assistance to earthquake victims in Haiti may cause emotional and/or psychological difficulties. Make sure you have necessary mental health support while in Haiti and after you return.
5. There is a high incidence of HIV infection in Haiti. If you have a needle stick, puncture, cut or blood splash to your eyes, you should seek immediate medical attention.
6. Persons with chronic or unstable medical conditions should discuss whether to travel to Haiti with their health care provider.

2. For travellers going to Haiti and individuals working with or caring for those in transit from or arriving from Haiti

Protect yourself
1. Wash your hands with soap and water frequently
2. Keep your hands away from your face
3. Practise proper cough and sneeze etiquette
  - Cough and sneeze into your arm, not your hand
  - If you use a tissue, dispose of it as soon as possible and remember to wash your hands afterwards.
4. While providing care to someone with diarrhea and/or vomiting or when changing diapers:
  - If possible, wear a gown and gloves
  - Remove and dispose of them after in a plastic bag and close
  - Wash your hands
5. Wear gloves when touching blood, body fluids, mucous membranes and broken skin as well as when handling anything that may have been soiled with blood and body fluids.
6. If you are in close contact with a person who is ill with a fever and coughing, producing sputum or is a suspected or known tuberculosis (TB) patient:
  - Consider wearing Protective Personal Equipment (PPE) and follow proper guidelines for preventing transmission of respiratory diseases such as seasonal flu and TB.
  - If appropriate, place a surgical mask on the sick person.
If you develop severe diarrhea and/or vomiting
1. Infants, young children and the elderly and those with underlying health conditions are at greatest risk of dehydration
2. Seek medical attention immediately
3. Drink fluids and use oral rehydration salts to prevent dehydration

3. After your return home to Canada

If you get sick or develop severe diarrhea and/or vomiting when you return to Canada,
1. Seek medical attention immediately and inform them that you have travelled to Haiti and inform them what activities you participated in while in Haiti especially if you work in an occupation such as health care, food service and child care
2. Drink fluids and use oral rehydration salts to prevent dehydration
Remember that symptoms of malaria, which includes a fever, can occur up to one year after your return