Homeland Security Watch

News and analysis of critical issues in homeland security

November 18, 2010

Cholera in Florida and DR

Filed under: Biosecurity,Catastrophes,Preparedness and Response — by Philip J. Palin on November 18, 2010

According to the Miami Herald:

A Southwest Florida woman who visited family in the disease-stricken Artibonite Valley of Haiti and a Haitian construction worker who lives in the eastern Dominican Republic but recently spent two weeks in Port-au-Prince became the first people to import deadly cholera.

The spread is worrying public health specialists in several countries who fear the illness could spread internationally.

The acute intestinal infection first surfaced in Haiti four weeks ago and has killed 1,110 people and hospitalized 18,382 since.

The Collier County woman does not work in a job that puts her in close contact with the public, so the chance that she might pass on the disease is small, Florida health officials said. Several more cases are under investigation in other counties, said Dr. Thomas Torok, a cholera expert in the Florida Department of Health’s Bureau of Epidemiology.

Read more: http://www.miamiherald.com/2010/11/18/1931309/cholera-fear-spread-beyond-the.html#ixzz15cpynwQD

Yesterday, November 17, the Pan American Health Organization released its most recent Situation Report.  Violence in Haiti — related to suspicions cholera was introduced by UN peacekeeping troops — is complicating efforts to contain the disease. According to PAHO:

Civil unrest since November 15 has slowed several activities of the response to the outbreak. In the northern city of Cap Haitian prevention and treatment supplies are were not delivered in last three days. WHO/PAHO cholera training was postponed, as well as an Oxfam initiative to chlorinate water for 300,000 people. A nearby World Food Programme (WFP) warehouse was looted and burned. In Hinche, six MINUSTAH personnel and a number of bystanders were injured, according to the MINUSTAH.

The full Situation Report and other updates are available via a new PAHO blog focusing on health conditions and operations in Haiti: http://new.paho.org/blogs/haiti/index.php?lang=en

As we have previously discussed at HLSWatch, catastrophes — especially in contrast to disasters — are almost always the result of a cascade of events over time.  It is the cumulative affect of the cascade, especially on human expectations, that permanently interrupts the status quo ante and results in a “new normal.”

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Comment by William R. Cumming

November 18, 2010 @ 10:58 am

And a new catastrophe may await Haiti on the 28th of November when it votes for its President.

Fortunately, Cholera in US is unlikely due to some basic public health standards including water supply and treatment. But who knows?

Comment by Dan O'Connor

November 18, 2010 @ 2:39 pm

I’d like to add a couple of additional thoughts to Bill’s point of view;

“And a new catastrophe may await Haiti on the 28th of November when it votes for its President.”

Although I think all governments have their respective issues, Haitians have a history of making less than desirable choices. I wonder if it’s simply the culture, the crime, or the reality of their economic situation. Who is to say? It is easy to speculate from afar.

“Fortunately, Cholera in US is unlikely due to some basic public health standards including water supply and treatment. But who knows?”

Although I do agree with your assessment that it is unlikely Cholera will become a United States issue, it does demonstrate again how fluid, rapid, and simple it is to move human borne illness and pathogens around the globe.

There is a small bit of irony in this for me in terms of the recent explosion of scrutiny placed on TSA and their outbound screening procedures. We have spent endless hours and millions of dollars both perfecting and justifying use of advanced technologies to prevent introduction of explosives and weapons into our air travel system. How much have we spent on a biological and pathogenic detection? How much have we invested in these screening methodologies for inbound air-traffic from outside of CONUS?

I would imagine that there is some crossover necessary between ICE, BCP, HHS, and TSA screening. Would that not constitute a broad homeland security requirement? It does again demonstrate that our systems are not as nimble or adaptive as their biological equivalent.

I think the bigger picture to at least discuss on some level is responsibility. Do we the United States have an inherent responsibility to simply protect our borders or inject ourselves completely into the Haitian situation? That question while perhaps rhetorical, demonstrates how potentially ineffective our foreign policy and homeland security interoperability is. Too strong a statement? Perhaps.

It is the larger, more altruistic question; are we doing enough of the right stuff as opposed to more of the other stuff? On some levels it creates huge contradictions. How much are we supposed to help and how much are we expected to help? And with that expectation, how long are we supposed to stay and how much are we supposed to spend?

So there is a question of altruism versus obligation, generosity versus responsibility. So is it in our best interests as a nation to repair and rebuild Haiti? Because if it is what does that say about our response to the 9th Ward in New Orleans? This gets very complex very fast.

I do not think we can dismiss the impact of lawlessness, human nature, and exploitive nature of both criminal elements and desperate people. We have seen time and time again a variety of foreign aid politicized by governments and criminal elements. Will we now see that in our own hemisphere or has it always been present and we are just now becoming acutely aware?

Concurrently, the debt reduction bipartisan commission is recommending some severe austerity medicine including but not limited to:
– Cuts in domestic/military spending
– 15 cent/gallon tax hike
– Increasing retirement to 69 from 67 and reducing cost of living increases
– Reduction of a variety of predetermined social programs and benefit programs
– Eliminating/reducing mortgage interest deduction, child credit, earned income tax credit and a host of other initiatives.

How will all of this economic contracting and spending reduction affect our ability to shape foreign-policy, maintain a sphere of influence, and deliver, what most of the world believes is our innate responsibility, humanitarian aid and assistance?

Again is that a presumptive United States-centric point of view or simply a reality? I’d be interested in what other readers and participants in the blog thing about this.

Comment by rageahol

November 21, 2010 @ 5:41 pm

cholera is caused by a bacteria, not a virus. it is spread by water or food contaminated with feces that contain the bacteria.

in countries with functioning sanitary sewer systems, there is so little risk of cholera spreading as to be laughable.

Comment by Philip J. Palin

November 22, 2010 @ 3:17 am


Thanks. I apologize for the error: caused by a combination of stupidity and rapidity… a dangerous duo. I have edited the original post.


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