BIOSURVEILLANCE UPDATE - 12

OPERATIONAL BIOSURVEILLANCE

Current official stats are 8,138 cases and 544 fatalities. In some areas of Haiti, we have confirmation that in-patient statistics are under-reported by as much as 400%.

There is no question of under-reporting. If we assume the case counts are 1/4 the true community load, then we now have nearly 30k cases shedding pathogen into the environment. We believe the true statistic to be closer to 50k based on the degree of under-reporting. Any claim of containment or control of this epidemic should be treated with skepticism.

2 CASES OF CHOLERA REPORTED IN LA VALLEE

From an HEAS partner in contact with Red Cross medical responders.

CHOLERA AT JEAN VARIE MINCENT, PORT AU PRINCE

An HEAS partner reports 7 confirmed cholera cases at Jean Marie Vincent, Port au Prince. This news, in addition to reports of more than 50 cases in Cite Soleil is deeply concerning.

CONFIRMATION OF CHOLERA IN CITE SOLEIL

We now have separate, independent confirmation of 5 cholera cases discovered at Wharf Jeremie, on the outskirts of Cite Soleil. Emergency assistance was request of the HEAS, and partners are responding now. Over the weekend, 47 cases of cholera were reported in Cite Soleil.

Port au Prince is directly at risk of epidemic cholera. All assertions that the situation is "under control" or epidemic surveillance and control activities "are adequate" should be viewed with skepticism. Time differentials between event warning and rapid swarm response should be minimized to the greatest extent possible in order to have the greatest possibility of saving lives.

PORT DE PAIX HIT HARD WITH CHOLERA

HEAS partner reporting indicating Port de Paix is getting hit hard with case loads...

MORE CASES AND A FATALITY IN BAS LIMBE

HEAS partners previously reported cholera activity in Bas Limbe, and recent reports indicate another surging of patients with a fatality. The case load was enough to cross check regional supply and grid level bed capacity. Situation stable but guarded / monitoring closely.

CHOLERA OUTBREAK IN ST LOUIS DU NORD: UPDATE

Four fatalities now. Personnel and materiel mobilized, and situation stabilized for the moment. Monitoring closely.

SUSPECT OUTBREAK IN MOLE ST NICOLAS

Previously reported a single suspect case of cholera. Information now strongly suggests they are dealing with multiple cases. Response activities are stable for the time being. Monitoring closely.

CHOLERA OUTBREAK: GRAND BOIS

From an HEAS Partner:

St. Vincent de Paul Health Center in Grand-Bois (the northeasternmost region in the Departement de L'Ouest) has had 5 cases of cholera (unconfirmed pending stool evaluation at the LNSP) and one death. All cases occurred in patients living just south of the Central Plateau.

SUSPECT CASE OF CHOLERA IN MOLE ST. NICHOLAS

Reported by a missionary in Mole St. Nicholas, they have received a suspect case of cholera, a young woman who had traveled from St. Louis du Nord. She emphasized the woman was very ill. More details to follow.

CHOLERA OUTBREAK IN ST LOUIS DU NORD

HEAS partners are responding now. Minutes passed between notification of the HEAS community and engagement of response partners.

FLASH REPORT/PRIORITY ALERT: 47 CASES OF CHOLERA REPORTED IN CITE SOLEIL

Because of ongoing evidence of cholera being spread by infected people along the coastal highway that connects the St Marc / Artibonite epicenter of the cholera epidemic with Arcahaie, Lafito, and Cite Soleil that repeated introduction of cholera to Cite Soleil would continue likely undetected until a cluster of cases emerged. Today, Samaritan's Purse announced discovery of 47 cases with critically ill children at an OB/gyn clinic in Cite Soleil. It has long been feared that transmission of cholera in Cite Soleil, given the degree of indigenous poverty, would represent a nearly uncontrollable situation. Needless to say, it demands the immediate attention of public health given the implied direct threat to Port au Prince.

This is a difficult task given the recent distraction of Tomas. The HEAS community is on maximum alert to support. The HEAS community is now comprised of 600+ complimentary ground networks in Haiti involved both in reporting and immediate coupling to swarm medical response. The community works outside of bureaucratic and political limitations and thus has evolved into an extremely agile system to support the people of Haiti.

600 CASES OF CHOLERA REPORTED IN GROS MORNE

MTI reports 600 cases of cholera in Gros Morne.

OVERWHELMED CLINIC NEAR CHATAR

From an HEAS partner:

Wow what a morning. 2 children just died in our cholera clinic. Staff is exhausted and supplies are low. Any contacts for reinforcements?

The HEAS community, within about an hour, indicated a UN helicoptor was mobilized to bring them supplies and EMT support. This is another example of the power of connecting instant warning, verification, and rapid response assets together in one network. In such situations, every moment counts to save lives and one must have all of the pieces for the system to work:

Early warning and forecasting assets unencumbered by political interference

Multi-discplinary community working together to instantly share information freely

Rapid response assets, either to verify rumor of outbreaks and / or to respond immediately at-hand within the network

Such response is referred to as "swarming", where the trigger to swarm is situational awareness information.