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Analysis: Whodunnit? Officials have sticky problem in Haiti

WASHINGTON (Reuters) - DNA fingerprinting has confirmed what health experts have suspected -- the cholera epidemic that has killed more than 1,100 people in Haiti came from one single source. But little immediate good can come from tracking down that source.

Rumors had been circulating for weeks that Nepalese troops with the United Nations mission brought the cholera to Haiti, which, despite having many other health problems, did not have cholera.

Health officials deny this and say checks show no evidence that one of the Nepalese soldiers carried the infection.

But it has to have come from somewhere and at the height of the humanitarian effort after January’s devastating earthquake, an estimated 10,000 different non-governmental organizations were sending people and supplies into the Caribbean island nation.

Cholera broke out in Haiti’s breadbasket Artibonite Department a month ago and despite efforts to control it, has spread to infect more than 18,000 people.

It perfectly illustrates the classic public health warning -- any disease can be carried anywhere in the world in just hours, and without good sanitation or a good public health infrastructure, can spread like wildfire.

And in the case of cholera in Haiti, it is likely to become a longtime, if not permanent, resident.

The U.S. Centers for Disease Control and Prevention and the Pan-American Health Organization have analyzed samples of Vibrio cholerae from several patients and they are all identical.


This suggests it entered Haiti in a single “event” -- not necessarily an infected person, but possibly. People often can carry cholera with no symptoms and in a country with chlorinated water and good sewage, the bacteria in their waste quickly get destroyed.

Other potential sources include imported food, especially seafood, or a boat or ship’s bilge water. With tons of aid pouring into Haiti for months, it may be impossible to track down who or what carried it in.

Public health officials will try. They want to prevent such outbreaks in the future and finding the culprit will help experts come up with ways to prevent it from happening.

But what if it does turn out that a U.N. trooper carried it in? Riots already going on in Cap-Haitien and protests in Port-au-Prince [ID:nN18144494] could worsen and other countries may be reluctant to accept U.N. aid when they need it the most.

And what if health experts are unable to find the source? Will anyone believe them, or will suspicious residents call it a cover-up -- and resist public health advice that could help stem the epidemic?

If some other aid organization turns out to be the source, again, not only could Haitians resist more help, but other countries may become warier of letting these non-governmental organizations help in the case of disasters.

NGOs that poured into Haiti after January’s quake are already widely accused of not cooperating with one another or Haiti’s government [ID:nN22112893].

Public health professionals often accept that they can never win. It is difficult to prove that a disease outbreak was prevented, since nothing happens, and if a disease does break out, then the experts are blamed for a failure.

The cholera outbreak in Haiti could end up causing more widespread damage than immediate death and illness.

Editing by Cynthia Osterman