Florida hospitals told to look out for cholera

ftasker@miamiherald.comNovember 11, 2010 

Reacting to the cholera epidemic that has killed nearly 600 and hospitalized 9,000 more in Haiti, health officials in Miami-Dade, Broward, Manatee and elsewhere in Florida have issued advisories requiring local doctors and hospitals to be on the lookout for it, and to treat and report it immediately.

They asked recent travelers from Haiti who experience severe symptoms to get medical help immediately.

South Florida’s large Haitian population and the increased number of travelers to and from Haiti since the Jan. 12 earthquake could spread the disease, health officials warn. Florida has about 241,000 Haiti-born residents, with 73,000 in Miami-Dade and 63,000 in Broward, the Florida Department of Health says.

“As a result, we can expect that some travelers returning from Haiti may become symptomatic with cholera en route to or shortly after arrival in Florida,” the advisory says.

Travelers who develop severe symptoms such as profuse diarrhea and vomiting should seek medical help immediately, said Dr. Fermin Leguen, chief epidemiologist for the Miami-Dade Health Department.

Cholera’s incubation period ranges from a few hours to five days. Most cases cause few or no symptoms. But with severe illness, rapid loss of fluids from diarrhea can lead to shock, and without treatment, death can occur within hours, the state advisory says.

In most cases, rapid rehydration and treatment with antibiotics can stop the disease.

So far, no cases — imported or locally transmitted — have been reported in Florida, the officials said. And Leguen said there is little or no threat of widespread cholera here.

“With our resources and hygienic conditions, the threat of cholera in South Florida is very, very limited,” he said.

The state advisory agrees: “The potential for spread in the United States is low because U.S. water, sanitation and food systems minimize the risk for fecal contamination of food and water, the primary route of transmission in epidemics.”

In the 1991-93 cholera epidemic in Latin America, Florida had 22 imported cases of cholera, but none passed on by local transmission, the advisory says.

“A person can get cholera by drinking water or eating food contaminated with the cholera bacterium,” the state health department says. “In an outbreak, the source of the contamination is usually the feces of an infected person that contaminates water and/or food. It is not likely to spread directly from one person to another.”

By Florida law, doctors, hospitals and emergency rooms are required to report suspected cholera cases 24 hours a day, without waiting for laboratory confirmation.

In Miami-Dade, they report it to the county health department’s Epidemiology, Disease Control and Immunization Services office at 305-460-5660. In Broward, cases are reported to the health department’s Epidemiology Department 24 hours a day at (954) 467-4700.

Daycare centers, nursing homes and other such facilities are asked to call in cases with suspicious symptoms to see if they should be officially reported, said Jack Perkins, the Broward health department’s epidemiology program manager.

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