Poirier Mathieu Jp, Izurieta Ricardo, Malavade Sharad S, McDonald Michael D
Department of Global Health, University of South Florida, Florida, USA.
J Glob Infect Dis. 2012 Jul;4(3):162-71. doi: 10.4103/0974-777X.100576.
The re-emergence of cholera in Haiti has established a new reservoir for the seventh cholera pandemic which threatens to spread to other countries in the Americas.
Statistics from this new epidemic are compared to the 1991 Peru epidemic, which demonstrated the speed and complexity with which this disease can spread from country to country. Environmental factors implicated in the spread of Vibrio cholerae such as ocean currents and temperatures, as well as biotic factors from zooplankton to waterfowl pose a risk for many countries in the Americas.
The movement of people and goods from Hispaniola are mostly destined for North America, but occur to some degree throughout the Americas. These modes of transmission, and the probability of uncontrolled community spread beyond Hispaniola, however, are completely dependent upon risk factors within these countries such as water quality and availability of sanitation. Although North America has excellent coverage of these deterrents to the spread of infectious gastrointestinal diseases, many countries throughout Latin America and the Caribbean lack these basic services and infrastructures.
In order to curb the immediate spread of cholera in Hispaniola, treatment availability should be expanded to all parts of the island and phase II epidemic management initiatives must be developed.
霍乱在海地再度出现，为第七次霍乱大流行建立了一个新的疫源地，有可能蔓延至美洲其他国家。
将此次新疫情的统计数据与1991年秘鲁疫情进行比较，那次疫情显示了这种疾病在国家间传播的速度和复杂性。与霍乱弧菌传播相关的环境因素，如洋流和温度，以及从浮游动物到水禽的生物因素，对美洲许多国家构成风险。
从伊斯帕尼奥拉岛流出的人员和货物大多运往北美，但在某种程度上也流向整个美洲。然而，这些传播方式以及霍乱在伊斯帕尼奥拉岛以外不受控制地在社区传播的可能性，完全取决于这些国家内部的风险因素，如水质和卫生设施的可及性。虽然北美在预防传染性胃肠疾病传播方面有很好的覆盖，但拉丁美洲和加勒比地区的许多国家缺乏这些基本服务和基础设施。
为了遏制霍乱在伊斯帕尼奥拉岛的迅速传播，应将治疗服务扩大到该岛所有地区，并必须制定第二阶段的疫情管理举措。
