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Cholera Peaks ?????

AlMac99's picture

via leiderman@mindspring.com e-mail to HEAS

in Peacekeepers 'brought cholera to Haiti', Sunday, 21 November 2010
http://www.independent.co.uk/news/world/americas/peacekeepers-brought-cholera-to-haiti-2139739.html

"...The disease is expected to peak between 26 and 29 November in the northern slum areas of Cité Soleil, where the disease entered the capital three weeks ago, according to MSF epidemiologists...."

the subsequent text talks about seeing the "first peaks" of cholera within the next ten days, but the graphs in the last two PAHO/U.N. cluster bulletins seemed to show two mortality peaks already.

what is the customary curve over say a year's cholera?  waves?  plateau?  and how would it be affected by applying increments of medical response, both quantitatively (e.g. personnel on duty, supplies in storage, Haitian civil society engagement, etc.) and qualitatively (education, leadership, movement-making, etc.)?

we ought to be able derive curves for Haiti, given a range of Quant and Qual response variables.  then donors could know what they'll get for their money, and Haitians could know whether to be optimistic or pessimistic.

thank you,

Stuart Leiderman
leiderman@mindspring.com

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refs:

Codeco [codeco@malaria.procc.fiocruz.br]. A mathematical model for epidemic
and endemic cholera: the role of the aquatic reservoir.  13 July 2000
http://www.biomedcentral.com/content/backmatter/1471-2334-1-1-b1.pdf

Pascual et al. Cholera dynamics: disentangling the interplay of extrinsic and intrinsic factors
http://users.ictp.it/~eee/workshops/smr1651b/pascual.pdf

Pascual M et al. Hyperinfectivity in Cholera: A New Mechanism for an Old Epidemiological Model? PLoS Med 3(6): e280. doi:10.1371/journal.pmed.

0030280  June 27, 2006
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0030280

Nelson et al. Cholera transmission: the host, pathogen and bacteriophage dynamic. Nature Reviews: Microbiology, October 2009
http://gpilsinside.umaryland.edu/Courses/GPLS710/2010%20Course%20Materials/Lecture%20files/Lecture%2015%20Vibrios%20(Kaper)%20background%20paper1.pdf

Mathis. Epidemic Curve Classifications. November 21, 2008
http://www.mightystudents.com/essay/Epidemic.Curve.Classifications.8433

Kilian. Cholera in Haiti: A very steep learning curve. November 20, 2010
in H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health
http://crofsblogs.typepad.com/h5n1/2010/11/cholera-in-haiti-a-very-steep-learning-curve.html

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leiderman@mindspring.com