Cuba’s cholera outbreak said to be under control

The recent outbreak of cholera in Cuba [2] is under control and has not spread to the rest of the country from its epicenter of Manzanillo, a city of 130,000 in Granma province about 420 miles east of Havana, according to Cuban government statements.

Travelers to Cuba have little to fear adds a European Centre for Disease Prevention and Control risk assessment [3], which reports: “Should the outbreak not spread beyond the Granma province, the risk of infection for European tourists visiting Cuba is negligible.

In its most recent announcement, issued on Saturday, June 14, Cuba’s Ministry of Public Health [4] stated: "The outbreak of cases transmitted through water is diminishing, with no indication that the illness has spread through food or other means.”

The statement confirmed 158 cases, but no more deaths have been reported since the previous official statement on July 3. (As I reported in my blog post [5] of July 9, 2012, three people have died since the outbreak in June.) Meanwhile, yesterday Granma province epidemiologist Ana Maria Batista announced on the provincial television that 170 cases had now been confirmed, while the number of Granma municipalities where cholera has been confirmed rose from seven to nine.

Last Saturday’s official statement did confirm previous reports from independent journalists that cholera has been recorded beyond Manzanillo (see below). “Isolated cases have been diagnosed in other parts of the country in people who became infected while in Manzanillo. All were treated quickly,” says the statement, adding “There has been no spread of this epidemic.".

Last week, a CNN news crew reported direct from Manzanillo, where Dr. Manuel Santin Peña, Cuba’s national director of epidemiology, denied claims that the government has lied about the number of cases, and confirmed that the outbreak was under control. (To my knowledge, no other international news crews have been granted access.)

On the positive side, Cuba prides itself on having a much-admired public health system (not least a huge cadre of well-trained doctors and nurses that includes thousands who have experience combating cholera in neighboring Haiti) and has a very efficient civil defense system (its hurricane evacuation program is exemplary, for example), which no doubt was kicked into high gear to stem the outbreak and prevent it from becoming an epidemic.

Thus, apparently travelers leaving Manzanillo are being checked for symptoms before boarding buses and trains out of town. Work crews have been rushed in to pump out septic tanks and fix broken wells and water pipes, which officials blame for the outbreak (heavy rainfall in June apparently flooded many of the city’s septic tanks). CNN reports that anyone entering or leaving local hospitals must dip their hands and the soles of their shoes in buckets of bleach. And authorities have banned fishing and swimming in local waters, plus shut down local food kiosks selling ice creams, milk shakes, etc.

However, the Cuban government’s failure to keep the rest of Cuba apprised (it has issued only the two statements, and the state-run newspapers and radio and TV stations have otherwise remained mum) and to educate Cubans nationwide on the need for extra vigilance is a cause for concern. As I reported last week, the government’s relative silence on the outbreak has prompted unofficial reports of a much wider and deeper problem. My own contact with people in Cuba within the past few days confirms that they have been told little and are reliant on 'Radio Chisme,' as Cubans call street gossip, which says cases have been reported in Santa Clara and elsewhere.

Thus, since my last blog post last week, the Miami Herald [6]’s Juan Tamayo reports [7] on claims of eight unconfirmed deaths in Santiago de Cuba. And the H5N1 health information website [8] reports that a cholera alert has been issued for the Havana suburb of Mantilla, in Arroyo Naranjo, where it claims that public health officials halted the sale of liquid foods on July 11. H5N1’s source, independent journalist Calixto Martínez, of Hablemos Press [9], claims that about 30 suspected cholera cases have been reported in Havana: three in Yaguajay, eight in Cerro [10], and 19 in Centro Habana [11].

I’m unable to find any independent verification of such claims.

As I previously stated, travelers who follow basic hygiene precautions should have little fear of becoming infected. As the European Centre for Disease Prevention and Control states: “The risk to European travellers remains low.”

So... I’ll see you in Cuba!

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