Warnings issued over Cuban cholera outbreak

(CNS): Cayman Islands public health officials are warning people not to travel to Cuba unless their trip is essential following reports of a cholera outbreak in the country. This is the first incidence of the disease in Cuba for more than 130 years but officials say that at least 15 people are dead, and over one thousand people are affected by the disease. Cayman’s Medical Officer of Health Dr Kiran Kumar issued a travel advisory Monday. “We advise that residents travel to Cuba only when necessary,” he said, adding that the chances of the disease coming to Cayman were limited but if the worst happened the health service was prepared.

To ensure ultimate readiness, the Public Health Department said it is calling a multi-agency preparedness meeting this week. Dr. Kumar said the risk of importation of cholera is low but he backed the pro-active efforts by various local agencies in monitoring the cholera situation in Cuba and taking the necessary steps to prevent , detect and manage any imported cholera cases.  “The chances of importation of cholera into Cayman are limited and even if it occurs, our excellent sanitation and safe water will prevent its spread. In addition, we have adequate facilities and drugs to manage any cases should importation occur,” he added.

Dr.  Kumar urged travellers returning from Cuba who develop diarrhoea within five days to contact a doctor immediately, and state their travel history so that the right diagnosis can be made. He also told anyone who has to go to Cuba country to take the necessary precautions to protect themselves.

“If you have to go, take vital precautions such as ensuring hygienic food preparation, boiling or purifying all water, and washing hands often with soap and clean water,” the senior government doctor stated. He also advised that travellers should also carry an ample supply of oral rehydration salts.

Cholera is an acute intestinal infection caused by ingesting contaminated food or water with cholera bacterium. It can take anywhere from five hours to five days for symptoms to appear after infection, but usually symptoms appear within 24-48 hours.  Cholera infection is often mild or without symptoms but can sometimes be severe.  Approximately one in 20 (or 5% of) infected persons will have severe disease characterized by profuse watery diarrhoea, vomiting, and leg cramps. In these people, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.

According to WHO figures however, up to 80 percent of cases can be treated successfully with oral rehydration salts. Although there is an oral vaccine available for use in endemic countries, it is not available in the US or in Cayman.  

Officials said travellers to Cuba can greatly reduce the risk of contracting the disease by following these practices:

Drink only bottled, boiled or chemically-treated water and/or bottled or canned beverages.
Ensure that seals are unbroken when using bottled drinks.
Disinfect your own water: boil for one minute or filter the water and add two drops of household bleach or half an iodine tablet per litre of water.
Use bottled, boiled or chemically-treated water to wash dishes and brush teeth.
Use ice in your drink only if you know it was made from boiled or treated water.
Wash your hands often with soap and clean water.
Clean your hands before you eat or prepare foods, and after using the bathroom.
Eat foods that have been thoroughly cooked and are still hot, or fruitthat you have peeled yourself.
Cook all vegetables. Do not eat salads or other raw vegetables.
Do not buy food or beverages from street vendors.