Malaria enters the US

"Nearly a dozen cases of Malaria has been confirmed here in the United States. All of the cases were acquired in Haiti after the January 12th, 2010 earthquake" (Gibbons). "Seven emergency responders, three Haitian residents now in the United States and one American traveler are known to have caught malaria in Haiti after the Jan. 12 earthquake, United States health officials said Thursday. Malaria is endemic throughout Haiti, so Haitians now living outdoors and relief workers are 'at substantial risk for the disease,' the Centers for Disease Control and Prevention said" (McNeil).

"Haiti already had a problem with malaria, which is spread by mosquitoes that will have more places to breed in the cities and towns wrecked by the giant quake" (Reuters). Displaced people living in temporary shelters our outdoors are at substantial risk of contracting malaria. Health workers who flooded to Haiti after the earthquake to offer aid are also at risk. "U.S. health officials advise people travelling to Haiti should take medications to prevent malaria" (UPI).

"Six out of eight patients, including seven emergency responders, had been advised to take drugs to prevent malaria but had not done so, the PAHO experts said." Three of the cases that the CDC cited "occurred among Haitian residents traveling to the United States and one case involved a U.S. resident who was visiting Haiti. All are expected to recover fully" (Reuters).

Individuals in Haiti are still at risk. "Each year, Haiti reports about 30,000 confirmed cases of malaria to the Pan American Health Organization, but the CDC estimates as many as 200,000 may occur each year. According to the CDC, malaria transmission peaks after the two rainy seasons -- November to January and again during May to June" (Reuters). The peak season is still months away, but anti-malarial medications are already needed to treat those who are infected and reduce the number of possible cases.

"There is no vaccine against the parasite that causes the illness[,] and it quickly evolves resistance against drugs"; however some drugs are known to treat and reduce malaria illness (Reuters).

The CDC indicates that "anyone traveling to Haiti should take drugs to help prevent infection" (Reuters).


Sources:
Gibbons, Sabrina. WSB News. "Malaria from Haiti Now in US." 4 March 2010.

McNeil, Donald G Jr. The New York Times. "U.S. Warns of Malaria Risk in Haiti". 4 March 2010.

Reuters. "Travelers from Haiti bringing Malaria to the US." 4 March 2010.

UPI. "Malaria Drugs for those going to Haiti." 4 March 2010.

Haiti in the wake of disaster

"Tuesday's earthquake could decimate what fragile medical care exists" in Haiti "and spawn a 'perfect storm' in a country already struggling to fight rare tropical and infectious diseases, health experts" warn. The Red Cross has estimated that "3 million people -- one-third of Haiti's population -- were affected by the quake", which was measured at a magnitude of 7.0 and "ripped apart buildings, shearing huge slabs of concrete off structures in the poorest country in the Western Hemisphere" (Park). The homeless are "clustering in public places without food, clean water or sanitation. It's the perfect environment for the spread of communicable disease." Photo by Pinheiro.

The earthquake has thwarted medical efforts in a place that already struggles to stave off infectious diseases. "Even before the earthquake, the country has been the subject of intense public health efforts, as nearly half the causes of deaths have been attributed to HIV/AIDS, respiratory infections, meningitis and diarrheal diseases, according to the World Health Organization." "Hundreds of thousands of people are sleeping in tents, or filling public squares waiting for some kind of help. There is no water, food or sanitation. Many of the survivors have broken arms and legs" (Kenny). "The earthquake decimated Haiti's capital just days ago[, but] it's an eternity in terms of getting medical care to the injured" (Pearson). Now, "if left untreated, minor injuries or fractures can become life-threatening because they're left open to bacterial infections such as tetanus".

Even the uninjured face severe medical risks.

"The disaster cut power, electricity and other utilities." Without clean drinking water, endemic diseases are hard to resist. "What you have is the perfect storm of infection. What you have is a breakdown. It is already a fragile infrastructure with high rates of infectious and neglected tropical disease. Now there are potential breakdowns in sanitation, clean water, housing and subsequent crowding. That's a terrible mix," says Dr Peter Hotez, head of the department of microbiology at George Washington University. "The potential new mass of displaced persons could create crowded, unsanitary conditions that facilitate the spread of contagious respiratory infections."

Cholera, typhoid fever, and other diarrheal diseases threaten the people. "Bacterial and mosquito-borne diseases such as dengue and malaria" are also major risk factors to the injured and uninjured alike.

Dirty water, broken drainage, and a tattered terrain create natural reservoirs where disease can breed. Malaria, an infectious disease that kills approximate one million people each year and is carried by mosquitoes, is expected to intensify in the aftermath of the quake. Malaria is already endemic in this region, and in the midst of this chaos, it will be difficult to avoid.

Doctors "worry that the major, long-term health initiatives to treat preventable diseases" like malaria and dengue "could be upended" by this disaster. "Any interruptions in fighting these preventable diseases has disastrous consequences", claims Hotez. "This is going to a big setback for public health control measures, and you will see the impact of this earthquake at least for months and possibly for years." Kaplan, who formed the Cap Haitien Health Network to tackle preventable diseases such as diarrhea, malaria and malnutrition agrees, "That's another tragedy of the earthquake."

"When the rubble is cleared and the bodies are buried," Haiti will still face the threat of devastating disease as it always has. But by that time, medical supplies and money will be expended on the newly injured, clinics and hospitals will need to rebuild, and the landscape will need to be reshaped in order to prevent water buildup, which fuels the spread of infectious diseases.

Despite it all, Kaplan has hope. He hopes that "this situation may lead to improvements, because it's bringing lots of attention and help to the area." "There's that silver lining," he said.

Want to help the relief & malaria prevention effort in Haiti? Support the Red Cross.
Send a $10 Donation by Texting 'Haiti' to 90999
You may also call 1-800-REDCROSS to make a donation over the phone.
Please DO NOT send donations for Haiti relief efforts to Infectious Bite. Donations to support the Infectious Bite malaria awareness campaign are always welcome.

Sources:
Kenny, Sean. Common Dreams. "Haiti's earthquake survivors face massive risk."
Park, Madison. CNN.com. "Haiti's earthquake could trigger 'Perfect Storm'." 13 January 2010.
Pearson, Carol. VOA News. "In Haiti, Wounds, Infectious Diseases are top concern." 15 January 2010.
Pinheiro, Roosewelt. Agência Brasil. [PHOTO]