Epidemiological update – Cholera in the Region of the Americas – 26 April 2024 – Haiti

Situation summary

In October 2022, after three years with no confirmed cases of cholera, Haitian health authorities reported confirmed cases of Vibrio cholerae O1 in the Port-au-Prince metropolitan area. Since then, in the Region of the Americas, cases have been reported in both Haiti and the Dominican Republic (1-4).

Since the last Pan American Health Organization / World Health Organization (PAHO / WHO) cholera epidemiological update (5), Brazil has reported a confirmed case of cholera (6).

On 17 April 2024, the Brazil IHR National Focal Point (NFP) reported a case of autochthonous cholera in the municipality of Salvador, Bahia State. The case corresponds to a 60-year-old male, who developed abdominal discomfort and watery diarrhea on 19 March 2024. The case had no history of travel to countries with confirmed cases and no history of contact with suspected or confirmed cases of cholera. On 28 March 2024, the case sought medical attention and a stool specimen was collected and tested positive for Vibrio cholerae on 31 March. The sample was sent for analysis to the Oswaldo Cruz Foundation (Fiocruz), National Reference Laboratory. On 3 April, the case was discharged from the hospital following a favorable evolution. On 16 April, Fiocruz confirmed the identification of toxigenic V. cholerae O1 Ogawa. As of 3 April, the case remained hospitalized with favorable evolution (6, 7).

During contact follow-up, an asymptomatic close contact was identified, and a sample was collected on 17 April 2024. The sample was positive for V. cholerae and identification of the serotype and toxigenicity is pending. Other follow-up contacts have tested negative for V. cholerae. To date, the infection’s origin has not been identified, and the epidemiological investigation is being continued by the country’s health authorities. This is the first autochthonous case of cholera reported in Brazil since 2005 (6, 7).

In Haiti, between 2 October 2022 and 11 April 2024, the Haitian Ministry of Public Health and Population (MSPP per its acronym in French) reported a total of 82,885 suspected cases (Figure 1) in the country’s ten departments, including 4,836 confirmed cases, 80,436 hospitalized suspected cases, and 1,270 reported deaths.1 The case fatality rate among suspected cases is 1.5% (institutional case fatality rate of 1.2%) (3, 8).

Among a total of 14,980 samples tested by the National Public Health Laboratory of Haiti, 4,836 were confirmed (positivity rate of 32.3%) (3, 8).