Health Alert
CHOLERA: SURVEILLANCE AND REPORTING IN DELAWARE

Cholera Cases Confirmed Among Florida Residents Who Traveled to Haiti

Background

The Delaware Division of Public Health is alerting providers to the recent confirmation of cholera cases among U.S. residents living in Florida. All these cases were among travelers to Haiti. As Delawareans too may travel to Haiti – or other cholera-affected areas - the possibility of cholera should be considered when patients present with symptoms consistent with the disease.

Symptoms

Clinicians should inquire about travel when evaluating patients with diarrhea.

Cholera infection is often mild or without symptoms, but can sometimes be severe. Approximately one in 20 (5 percent) infected persons will have severe disease characterized by:

• profuse watery diarrhea,
• vomiting, and
• leg cramps.

In these people, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.

Treatment:

When there is reason to suspect cholera, rehydration should be initiated immediately, and a stool specimen collected for culture of Vibrio cholera.

Cholera can be simply and successfully treated by immediate replacement of the fluid and salts lost through diarrhea. Patients can be treated with oral rehydration solution, a prepackaged mixture of sugar and salts to be mixed with water and drunk in large amounts. This solution is used throughout the world to treat diarrhea.

• Severe cases also require intravenous fluid replacement. With prompt rehydration, fewer than 1% of cholera patients die.
• Antibiotics shorten the course and diminish the severity of the illness, but they are not as important as receiving rehydration.

To Report Cases

Medical practitioners are reminded that cholera is a notifiable disease in Delaware; cases should be reported to the DPH within 48 hours. Reporting specifics and forms are available at:  http://dhss.delaware.gov/dhss/dph/dpc/rptdisease.html . Reports can also be called into the DPH Bureau of Epidemiology by calling (302) 744-1033 or 1-888-295-5156.

More Information:

More information on cholera is available from the Centers for Disease Control and Prevention (CDC) at:  http://www.cdc.gov/cholera/general/

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