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Cholera returns to Puerto Rico after a 126-year absence
El Nuevo Día (Spanish-language article) ^ | July 5, 2011 | Yanira Hernández Cabiya

Posted on 07/05/2011 6:57:27 AM PDT by Ebenezer

(English-language translation)

A septuagenarian missionary became the first person to import the dangerous cholera bacterium to Puerto Rico in over a century.

Confirmation was done by the Department of Health, following protocol which requires that confirmed cholera cases be reported within 24 hours.

The man, whom the Department of Health only identified as a missionary who lives in the northern part of the island, traveled to the Dominican Republic two weeks ago to do work in an area where hygienic conditions were not the best.

"He is a person who travels to the Dominican Republic frequently," State Epidemiologist Carmen Deseda explained.

Since 2009 and in the wake of the earthquake that struck Haiti, the island of Hispaniola is among those jurisdictions where cholera outbreaks have been reported.

In Puerto Rico, a single case of cholera has not been reported since the mid 1800s, when an epidemic claimed the lives of some 30,000 people.

In recent times, cholera outbreaks and epidemics have been reported worldwide, but no cases managed to enter the island.

This time around, infection occurred because the missionary did not take the necessary precautions.

According to Deseda, the man began to feel sick following his return on Tuesday of last week, for which he was taken to the emergency room of a hospital in the [San Juan] metropolitan area.

The official did not want to reveal the name of the hospital either, citing patient-privacy reasons.

"When the doctor sees him, [the cholera patient] explains to him that he is a missionary who just arrived from the Dominican Republic and drank water that was not bottled," Deseda explained.

According to the epidemiologist, the patient's wife traveled with him to the neighboring country, but she was not infected because she kept drinking bottled water. The man, who is presumed to be of Dominican origin, presented the typical symptoms of a cholera patient: constant diarrhea, white-colored stools resembling rice water.

"He was hospitalized to prevent getting dehydrated. Given the symptoms, his doctor ordered the necessary tests and began the recommended treatment for these cases," Deseda said. The official stressed that protocol ordinarily requires that, in all diarrhea and vomiting cases, patients be put in isolation and their secretions be disposed of separate from those of other patients.

Deseda said that samples from the missionary were sent on Friday to the Department of Health. The results arrived yesterday morning.

"When the samples are received, a culture is begun, but you have to wait 24 to 48 hours for colonies to grow and for the bacterium to be identified," the epidemiologist said.

Deseda maintained that, although the official results arrived on Monday, the patient received the indicated treatment for cholera immediately.

Water is to Blame

Health Secretary Lorenzo González explained in a press release that the bacterium may be transmitted by consuming contaminated water or food. Therefore, travelers are warned to avoid visiting countries where cases of the disease have been reported without taking the proper precautions.

González indicated, however, that those people who think they may have been exposed to the bacterium "should be on alert for 5 days after returning and immediately go to a doctor or emergency room if any of the symptoms surfaces."

The physician emphasized that "cholera is not transmitted person-to-person, so being in contact with an infected person is not a risk for contracting the disease, unless there is contact with his bodily fluids."

Constant Sampling

Irma López, Assistant Director of Environmental Compliance & Quality Control at the Aqueduct & Sewer Authority, maintained that there is constant water sampling in Puerto Rico to prevent disease problems.

"In a year, we collect close to 200,000 samples for different possible contaminants. We have 99% compliance for bacteriological our water is safe as far as pathogenic microorganisms are concerned," López said.

Does Not Like the Beach

Meanwhile, Deseda explained that the cholera bacterium can live in fresh-water bodies or in estuaries where fresh water and salt water mix.

However, she pointed out that, in order to become infected, a person would have to drink a considerable amount of that water and that there would have to be a considerable concentration: "There would have to be continuous exposure, so if some contaminated water sprays into the mouth, that does not mean that you are going to get the disease."

According to Deseda, contamination is not possibe in beaches because the salt should kill the bacterium.

Chlorine levels in swimming pools should kill the bacterium, but López emphasized that, during the hot months above all, they must be verified several times during the day.

TOPICS: Culture/Society; Front Page News
KEYWORDS: cholera; dominicanrepublic; epidemiology; health; publichealth; puertorico

1 posted on 07/05/2011 6:57:31 AM PDT by Ebenezer
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To: cll


2 posted on 07/05/2011 6:58:03 AM PDT by Ebenezer (Strength and Honor!)
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To: rrstar96

Michael Savage call your office.

3 posted on 07/05/2011 7:12:11 AM PDT by MSF BU (YR'S Please Support our troops: JOIN THEM!)
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To: rrstar96; AuH2ORepublican; livius; adorno; wtc911; Willie Green; CGVet58; Clemenza; Narcoleptic; ...
This is such a misleading article that's been kicking around the net all day.

Cholera HAS NOT returned to Puerto Rico. A missionary returned from the Dominican Republic, where there is a cholera outbreak, infected with the bacteria.

The bacteria is NOT communicable from person to person. So, there is NO outbreak of cholera in Puerto Rico.

It is a shame that it was local sources who started this fear campaign.

Puerto Rico Ping! Please Freepmail me if you want on or off the list.

4 posted on 07/05/2011 7:19:03 AM PDT by cll (I am the warrant and the sanction)
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To: cll; rrstar96

This is isolated and is not expected to have any effect because sanitary conditions are very different in the US (which PR is part of, lest people forget!). There are apparently something like 96 cases in the Dominican Republic, where this missionary visited - and 5,000 in Haiti, which shares the island and has horrible sanitary conditions. Haiti is the origin of the outbreak, and the DR has been fairly effective in preventing its spread, even though the countries are neighbors.

5 posted on 07/05/2011 7:25:05 AM PDT by livius
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To: livius

Puerto Rico has repeatedly rejected joining the union as a state. They may be part of the U.S., but barely.

6 posted on 07/05/2011 9:17:48 AM PDT by SatinDoll (NO FOREIGN NATIONALS AS OUR PRESIDENT!)
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To: livius

Exactly correct.

Cholera is the direct result of poor sanitation, and the real danger for third world inhabitants is not itinerant missionaries, but enviro-whackos like Greenpeace.

From the Washington Times in 2002:

“An example of the harm that well-meaning but misguided alarm can cause became succinctly evident during the cholera epidemic that hit Latin America in 1991. The health risk associated with disinfection byproducts (DBPs) had been overblown by the media. As a result, the general public perception was that everyone drinking water with DBPs exceeding the WHO Drinking Water Quality Guidelines would get cancer, even though the scientifically estimated risk was 1 additional case of cancer per 100,000 persons after a lifetime of exposure.

During the initial stages of the epidemic of this classical waterborne disease, I personally witnessed two national public health officials reject recommendations to chlorinate community water supplies, because of their concern for disinfection byproducts (DBPs). At the same time hundreds of new cases of cholera were occurring daily and approximately 1 percent of them were fatal. It took almost two additional months before orders to chlorinate were promulgated. The Latin America cholera epidemic resulted in more than 1 million illnesses and more than 10,000 deaths.”

7 posted on 07/05/2011 9:24:44 AM PDT by Stosh
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To: livius; cll

One can only be glad that Puerto Rico is under federal water-quality laws and regulations. A visitor from the mainland doesn’t have to worry about “don’t drink the water”.

It’s still a little scary that a disease that hasn’t been reported since the 1850s suddenly shows up. At least, the situation is under control and follow-up was quick.

8 posted on 07/05/2011 10:20:14 AM PDT by Ebenezer (Strength and Honor!)
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To: rrstar96
Cholera returns to Puerto Rico after a 126-year absence

The title could use some work.

When I saw the title, my fist thought was:


9 posted on 07/05/2011 4:00:44 PM PDT by SIDENET ("If that's your best, your best won't do." -Dee Snider)
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To: cll

In any case, from my understanding, cholera is not a big deal where medical help is effective and available. It is deadly in places where medical help is not available. Since these tend to be the kind of places that have untreated water too, its potentially a deadly combination particularly among the very poor.

But if you can afford a doctor and some antibiotics (and you don’t keep reinfecting yourself with more bad water) its a fever and a bad couple of nights staying close to the toilet.

10 posted on 07/05/2011 6:33:58 PM PDT by marron
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“Yeah! We missed ya!”

11 posted on 07/06/2011 1:16:55 PM PDT by Ebenezer (Strength and Honor!)
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