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Origins of the Haiti Cholera Epidemic

Michael D. McDonald's picture

The mission of the "Origins of the Haiti Cholera Epidemic" collaboratory is focused on exploring the biological evidence, the memetics, and the social and political impacts of identifying the source of the cholera epidemic in Haiti.  

This collaboratory is open and the views stated in the collaboratory are solely the views of those making the statements as individuals.

Working Group email address:

UN Rolls Out Aid Package for Cholera-Hit Haiti

submitted by Mike Perrett           


Haiti's cholera epidemic started in 2010 and has and killed more than 10,000 people and affected 700,000.  AFP/File / by André VIOLLAZ - AFP - by André VIOLLAZ - September 29, 2016

UNITED NATIONS (UNITED STATES) (AFP) - The United Nations will mobilize $181 million to shore up the emergency response to the cholera epidemic in Haiti and at least an equal amount for the victims and their families, a senior UN official says.

The financial package follows the United Nations's admission that it had a moral responsibility to help Haiti deal with the epidemic that broke out near a UN peacekeepers' base. . . .

. . . The new measures are on top of a bigger 10-year plan valued at $2.2 billion to help Haiti improve its sanitation infrastructure, which the United Nations launched with the Haitian government.


U.N. Admits Role in Cholera Epidemic in Haiti


Julener Buisserette sanitizes a tent with cholera patients in Port-Au-Prince, Haiti, in November 2010. (Nikki Kahn/The Washington Post) - by Jonathan M. Katz - August 17, 2016

For the first time since a cholera epidemic believed to be imported by United Nations peacekeepers began killing thousands of Haitians nearly six years ago, the office of Secretary General Ban Ki-moon has acknowledged that the United Nations played a role in the initial outbreak and that a “significant new set of U.N. actions” will be needed to respond to the crisis.

The deputy spokesman for the secretary general, Farhan Haq, said in an email this week that “over the past year, the U.N. has become convinced that it needs to do much more regarding its own involvement in the initial outbreak and the suffering of those affected by cholera.” He added that a “new response will be presented publicly within the next two months, once it has been fully elaborated, agreed with the Haitian authorities and discussed with member states.”


Haiti in the Shadow of Cholera - April 23, 2014

The problem of ending Haiti’s cholera epidemic does not stem from an absence of planning. There is a 10-year plan to eradicate cholera from Hispaniola, the island Haiti shares with the Dominican Republic, by 2022. Within the 10-year plan is a two-year plan to get the 10-year plan up and running.


U.N. Struggles to Stem Haiti Cholera Epidemic


A young Haitian fishing in the Latem River, known to be contaminated. The country is still struggling to stem a cholera epidemic.  Ian Willms for The New York Times - By RANDAL C. ARCHIBOLD and SOMINI SENGUPTA - April 19, 2014

CHAPOTEAU, Haiti — For three years, the United Nations has refused to address whether its peacekeepers brought a deadly strain of cholera to Haiti, insisting instead that it was more important to help the country stanch the disease once and for all.

But on that score, it is still very far behind. In some ways, Haiti is even less equipped to tackle cholera than it was three years ago.


Rights Advocates Suing U.N. Over the Spread of Cholera in Haiti

Image: A cholera outbreak in Haiti that began in 2010 has killed 8,300 people and sickened 650,000. Damon Winter/The New York Times

Evolutionary Dynamics of Vibrio Cholerae O1 Following a Single-Source Introduction to Haiti - July 2, 2013


Prior to the epidemic that emerged in Haiti in October of 2010, cholera had not been documented in this country. After its introduction, a strain of Vibrio cholerae O1 spread rapidly throughout Haiti, where it caused over 600,000 cases of disease and >7,500 deaths in the first two years of the epidemic. We applied whole-genome sequencing to a temporal series of V. cholerae isolates from Haiti to gain insight into the mode and tempo of evolution in this isolated population of V. cholerae O1. Phylogenetic and Bayesian analyses supported the hypothesis that all isolates in the sample set diverged from a common ancestor within a time frame that is consistent with epidemiological observations. A pangenome analysis showed nearly homogeneous genomic content, with no evidence of gene acquisition among Haiti isolates.

Haiti Cholera Mutations Could Lead to More Severe Disease


submitted by Ted Kaplan - April 16, 2013
Analysis of Vibrio cholerae Genome Sequences Reveals Unique rtxA Variants in Environmental Strains and an rtxA-Null Mutation in Recent Altered El Tor Isolates - April 16, 2013

CHICAGO --- The cholera strain that transferred to Haiti in 2010 has multiple toxin gene mutations that may account for the severity of disease and is evolving to be more like an 1800s version of cholera, reports a new Northwestern Medicine study.

The strain, "altered El Tor," which emerged around 2000, is known to be more virulent and to cause more severe diarrhea and dehydration than earlier strains that had been circulating since the 1960s. This study reports the altered El Tor strain has acquired two additional signature mutations during the past decade that may further increase virulence.


Letter - Cholera in Haiti - March 22, 2013

Letter to the Editor - by Curt Welling, President and Chief Exec. - AmeriCares

A Worsening Haitian Tragedy” (editorial, March 18) points out the sad reality that cholera is now endemic in Haiti. But it gives the impression that most aid organizations are leaving the country at a time when thousands are dying from a preventable disease.

While some aid groups have indeed left the country or are scaling back programs, others have made fighting the epidemic their top priority.


A Worsening Haitian Tragedy - March 17, 2013

The aid group Doctors Without Borders said last Tuesday that the cholera crisis in Haiti was getting worse, for the most unnecessary and appalling of reasons: a lack of money and basic medical supplies.

. . . International efforts to defeat the epidemic include a 10-year, $2.2 billion plan for major investments in clean water, sanitation and medical infrastructure. But that is a project for the future, one that isn’t even funded yet. Doctors Without Borders says people are dying now, needlessly, because attention and money are running out.


Ex-Jamaican Leader Blasts UN For Denying Haiti Cholera Claims - March 14, 2013

BRIDGETOWN, Barbados — Former Jamaican Prime Minister P. J. Patterson blasted the decision by the United Nations to invoke “legal immunity” for rejecting compensation claims by some 5,000 Haitian victims of cholera.

“It is simply appalling, a most reprehensible behavior… for the U.N. to claim such immunity,” Patterson told the Jamaica Observer in a telephone interview.

“The more so when scientific evidence substantiates that the cholera epidemic was originally introduced in Haiti at the time by peace-keeping soldiers (from Nepal) under U.N. command,” Patterson said.


A Chance to Right a Wrong in Haiti - February 22nd, 2013 - Louise C. Ivers

On Thursday, the United Nations secretary general, Ban Ki-moon, rejected a legal claim for compensation filed in 2011 on behalf of cholera victims in Haiti. Through a spokesperson, Mr. Ban said the claims, brought by a nongovernmental organization, were “not receivable” because of the United Nations’ diplomatic immunity.

Regardless of the merits of this argument, the United Nations has a moral, if not legal, obligation to help solve a crisis it inadvertently helped start.


Op-Ed: What Role Did the Environment Play in Haiti’s Cholera Epidemic? - by Renaud Piarroux - October 17, 2012

". . . if the environment actually was an auxiliary at the onset of this epidemic, it would seem to be not permissive enough to sustainably host a large amount of the epidemic strain that was imported in 2010.

This enhances our hope of getting rid of cholera in Haiti, if increasing pressure is applied on current outbreaks, particularly on the often neglected outbreaks affecting inhabitants living in remote villages.

Haiti is not the first island territory to have been affected by cholera epidemic; others, like Madagascar, got rid of cholera after experiencing severe outbreaks in the early 21st century.

Hopefully everything will be done in order for this to happen in Haiti as well."


Tropical Storm Isaac Sparks Fears of More Cholera Deaths in Haiti - by Jacqueline Charles - September 5, 2012

Tropical Storm Isaac, which left 24 dead and 3 missing in Haiti, is reigniting fears of increased cholera deaths in Haiti.

The panic began to set in after Tropical Storm Isaac’s rains had subsided and the sun finally began to shine on this storm-damaged beachfront hamlet. Frantz Pierre-Louis, looking at the trail of fallen trees and flooded farms confronting him, had something much more pressing on his mind.

“We have to prevent a cholera outbreak,” Pierre-Louis, sitting in his pick-up truck, said, his voice filled with urgency.


Cuba - Cholera, Denque and Malaria - - August 11, 2012

The Community Journalists Network, an independent news service,
reported that Cuban health care authorities are not capable of
stopping the cholera epidemics in Granma, where according to the
official figures shown in local TV, 257 cases have already been

The Cuban government has not published information at the national
level about this disease since 14 Jul 2012, when they recognized 158
cases of cholera and stated that 3 persons had died. Reports about
cholera are restricted to Granma provincial bulletins.

Kenia Gonzalez Medina, provincial director of the Center for Hygiene
and Epidemiology, indicated that as of Wed 8 Aug 2012, 11 432 patients
in Granma have been treated for diarrhea and vomiting.

Significant outbreaks of diarrheal disease have occurred in other
provinces as well, such as Villa Clara, often accompanied by
respiratory diseases, reported Cubanet, an independent news service.

Cholera Superbug Found

CDC - Emerging Infectious Diseases -August 2012
Volume 18, Number 8

Abstract - Study - Conclusions

Third-Generation Cephalosporin–Resistant Vibrio cholerae, India

Cholera Superbug Found

In a major cause for concern, a new strain of cholera bacterium resistant to third generation antibiotics has been found to be circulating in India.

This cholera bacterial strain contains two super bug genes, including the notorious New Delhi Metallo beta-lactamase-1 (blaNDM-1). The other super bug gene is plasmid-mediated beta-lactamase-1 (blaDHA-1).

Thanks to these two super bug genes, the new cholera bacterial strain (O1 El Tor Ogawa) has developed resistance to a majority of known antibiotics.


Third-Generation Cephalosporin–Resistant Vibrio cholerae, India

[HEAS] leiderman: "perfect storm" is not scientific terminology

Subject: [HEAS] leiderman: "perfect storm" is not scientific terminology
Date: July 24, 2012 11:16:13 PM EDT

To everyone's credit, laboratories and journalists are keeping Haiti's cholera crisis in plain view, per example below.  However, to date, I have not read of any native Haitian involvement in the research effort, nor leadership by U.N., U.S. and other envoys to fulfill the funding appeal.  

Meanwhile, UNOCHA states, "outbreaks of cholera reach the Nord, Sud and Sud-Est departments," and predicts "high probability of a major emergency in the coming months, according to IFRC."

U.S. Lawmakers Press for Action on Cholera in Haiti

submitted by Ted Kaplan

The New York Times - by Deborah Sontag - July 21, 2012

In a letter sent this week, 104 members of the United States House of Representatives urged Susan E. Rice, American ambassador to the United Nations, to press the international organization to take the lead in responding to cholera in Haiti given the strong suspicions that its troops imported the disease. “As cholera was brought to Haiti due to the actions of the U.N., we believe that it is imperative for the U.N. to now act decisively to control the cholera epidemic,” said the letter from John Conyers Jr., Democrat of Michigan, and the other representatives. . . . The letter calls for the United Nations to push harder to find financing for water and sanitation systems to control the epidemic.


leiderman: cholera news and correspondence recap, mid-june'12, thank you

The following chronology plus the attached are concerns and responses across my desk in the past week to continuing efforts among many to understand and become a match for the cholera epidemic in Haiti. These were supplemented by telephone calls.

The signing of an international and interagency water/sanitation/anti-cholera declaration for Haiti and the Dominican Republic will be held June 29 at the Organization of American States, Washington, D.C. Attendance details below.

Thank you,

Stuart Leiderman

- - - - - - -

Date: Thu, 14 Jun 2012 14:10:07 GMT

Dear Community leaders,

I hope that this e-mail will find you in very good spirit.

Scientists Find New Wrinkle In How Cholera Got To Haiti


Most researchers currently believe that United Nations peacekeeping soldiers introduced cholera to Haiti in October of 2010.

After all, Haiti hadn't recorded cholera for as long as a century, Nepal had experienced a cholera epidemic in the months preceding the soldiers' arrival, and the Haitian and Nepalese cholera strains were found to be nearly identical.

But it's not that simple, says a research group based at the University of Maryland.


Proceedings of the National Academy of Sciences (PNAS) - June 18, 2012

Genomic diversity of 2010 Haitian cholera outbreak strains

50-Year Cholera Mystery Solved by Scientists at The University of Texas at Austin - May 29, 2012

AUSTIN, Texas — For 50 years scientists have been unsure how the bacteria that gives humans cholera manages to resist one of our basic innate immune responses. That mystery has now been solved, thanks to research from biologists at The University of Texas at Austin.

The answers may help clear the way for a new class of antibiotics that don’t directly shut down pathogenic bacteria such as V. cholerae, but instead disable their defenses so that our own immune systems can do the killing.

Every year cholera afflicts millions of people and kills hundreds of thousands, predominantly in the developing world. The infection causes profuse diarrhea and vomiting. Death comes from severe dehydration.

“If you understand the mechanism, the bacterial target, you’re more likely to be able to design an effective antibiotic,” says Stephen Trent, associate professor of molecular genetics and microbiology and lead researcher on the study.

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