Cholera vaccine, antibiotics urged for Haiti

The cholera epidemic in Haiti continues to spread, particularly in the rural areas in the north, which has public health advocates calling for more to to be done to try to stem the spread of disease.

In a commentary published Friday in the journal The Lancet, Dr. Paul Farmer, a co-founder of Partners In Health and chair of the Department of Global Health and Social Medicine at Harvard Medical School, calls for more antibiotics and vaccines to be shipped to the small Caribbean nation.

He and his co-authors told reporters Friday that there are still areas and even some camps where only few people have been infected with the waterborne disease, which causes severe diarrhea and dehydration and in extreme cases can lead to death in just a few hours.

So far almost 100,000 people have been sickened in Haiti according to Pan American Health Organization and 2120 people have died as of December 4. Dr. Louise Ivers, an assistant professor at Harvard Medical School and the Chief of Mission in Haiti for PIH, told reporters Friday she believes these numbers are probably underreported because it’s still very difficult to get to some parts of Haiti.

David Schrumpf from Doctors Without Borders echoes Ivers' concerns. “We often see only the tip of the iceberg as we know there are people who are dying from cholera in the rural communities," he said in a statement. "We are trying to reach them, by car, motorbike or sometimes by foot, to install oral rehydration points and treatment units”

Farmer acknowledges that not everyone agrees with his recommendations. “The resistance tends to come from peers in public health communities,” he says.

Group fighting cholera in Haiti

“Cholera vaccine is not going to be the magic bullet for stopping the cholera outbreak at this stage,” says Dan Epstein, a spokesman for the PAHO tells CNN. For vaccination to work, he says, one has to take two oral doses one to two weeks apart and one isn’t fully protected until about a week after getting the second vaccine dose.

However, Epstein and Farmer both say vaccines are part of the equation to slow the progression of the epidemic. Preventing the spread by using clean water and proper sanitation control measures are essential too. Poor or non-existent sanitation is the main culprit in an epidemic because “the source of the contamination is usually the feces of an infected person that contaminates the food and/or water” according to the Centers for Disease Control and Prevention

Ivers gave one example of just how poor the sanitation in one Haiti camp for those left homeless after the devastating earthquake in January. “In Parc Jean-Marie Vincent there are 200 latrines for 51,000 people, which means the vast majority of people are using buckets or just an open area in the corner of the camp and there remains a very high risk of the further spread of the disease in the camps and elsewhere.”