ARTICLE - CHOLERA CASE IN MONTREAL

HOSPITAL CONFIRMS CHOLERA CASE IN MONTREAL
(Montreal Gazette) - By Rene Bruemmer

MONTREAL — The first case of cholera has been confirmed in Quebec since the outbreak in Haiti that has killed more than 4,000 people since October, but officials were quick to add there was no chance of "retransmission" of the disease.

A woman suffering from severe diarrhea was admitted to Montreal's Ste. Justine Hospital on Jan. 1, the Centre hospitalier de l'Universite de Montreal reported. Upon hearing that the woman had recently been in Haiti, the emergency room doctor suspected cholera and had her placed in isolation. She was given antibiotics and rehydrated, and released on Jan. 3. Samples were sent for testing, in keeping with regulations in cases where dangerous infectious diseases are suspected, and came back positive for cholera on Jan. 5.

"There is no danger of retransmission in Quebec," said Stephanie Menard, a spokeswoman for the province's public health agency. "Unlike gastroenteritis or the flu, which can be spread through particles in the air, cholera is transmitted though tainted water or food. In a hygienic place like Quebec or Canada, transmission is unlikely."

The last recorded case of cholera in Quebec came in 2007. Menard could not say where that case originated.

In Haiti, a cholera outbreak that began in late October has sickened more than 200,000 people and killed more than 4,000. Although mostly contained to Haiti, the disease has spread to neighbouring Dominican Republic, where 300 cases have been reported, resulting in one death of a Haitian migrant worker. The Dominican Republic has started deporting thousands of Haitian illegal immigrants in fear of an outbreak.

Cholera is an intestinal bacterial infection that causes severe diarrhea and can result in death through dehydration within 24 hours in serious cases if not treated quickly. Countries with poor sanitation infrastructure, especially those in the midst of upheavals requiring refugee camps, are most at risk, said Dr. Jean Vincelette, a microbiologist at Montreal's St. Luc Hospital.

Cholera is spread through the ingestion of infected fecal matter, be it through drinking water, often from contaminated rivers, or from food handled by people who have not cleaned their hands properly. Caregivers who don't wash their hands well are also at risk. Rapid rehydration, either orally or intravenously, can quickly cure the disease.

"The problem in Haiti is either people lived too far from medical help, or waited too long to get treatment," Vincelette said.

Anybody worried they might have cholera should seek treatment immediately, but it's only probable if the patient has travelled to a country with a known cholera outbreak. Vincelette said he had only seen one case in the last 15 years, in a patient recently arrived from abroad.

Montreal suffered a cholera epidemic in 1832, when Irish immigrants fleeing the famine in their homeland were infected and brought the disease to the urban poor living in squalid conditions.

More than 6,000 died.