Final Report of the Independent Panel of Experts on the Cholera Outbreak in Haiti
Final Report of the Independent Panel of Experts on the Cholera Outbreak in Haiti
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发表时间：
2011
影响因子：
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通讯作者：
A. Cravioto;C. Lanata;D. Lantagne;G. Nair
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文献类型：
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作者：
A. Cravioto;C. Lanata;D. Lantagne;G. Nair
行政摘要2010年1月12日的毁灭性地震发生十个月后，海地出现了近一个世纪以来的第一次霍乱。疫情随后夺走了4500多人的生命，使近30万人患病，并继续在海地造成感染和死亡。霍乱的来源一直存在争议，假设导致霍乱的病原体(霍乱弧菌)由于地震造成的构造变化而从墨西哥湾进入海地，从海地自然存在的非致病菌株演变为致病菌株，或来自无意中将菌株引入海地环境的人类宿主。第三种假设的具体形式，即从霍乱流行国家部署到米雷巴莱联海稳定团营地的士兵是霍乱的源头，这是海地普遍持有的信念。为了最终确定疫情的源头，联合国秘书长成立了一个由四名国际专家组成的独立小组(“独立小组”)，其任务是“调查并设法确定2010年海地霍乱疫情的源头”。为了完成这项任务，同时进行了流行病学、水和卫生以及分子分析调查。2010年10月22日，海地近一个世纪以来的首例霍乱病例在海地国家公共卫生实验室得到确认。对阿蒂博尼特河沿岸从米雷巴莱山区到海岸圣马克的住院记录的审查清楚地表明，成人和儿童非致命性腹泻疾病的正常本底比率因霍乱爆发而突然中断。2010年10月17日晚，阿蒂博尼特河上游地区的米雷巴莱发生首例霍乱住院病例。2010年10月20日，在圣马克和德沙佩勒的阿蒂博尼特河三角洲，沿海地区第一批住院霍乱病例。到2010年10月22日，疫情在沿海地区广泛流行.时间表表明，疫情沿着阿蒂博尼特河蔓延。在确定病例开始于阿蒂博尼特河上游之后，对可能引发疫情的潜在污染源进行了调查。联海稳定团与一个外部承包商签订了处理人类排泄物的合同。米雷巴莱联海稳定团营地的卫生条件不足以防止粪便污染…
Executive Summary Ten months after the devastating earthquake of January 12, 2010, cholera appeared in Haiti for the first time in nearly a century. The outbreak subsequently claimed over 4,500 lives, sickened almost 300,000 people, and continues to cause infections and deaths in Haiti. The source of the cholera has been controversial, with hypotheses that the pathogen that causes cholera (Vibrio cholerae) arrived into Haiti from the Gulf of Mexico due to tectonic shifts resulting from the earthquake, evolved into disease-causing strains from non-pathogenic strains naturally present in Haiti, or originated from a human host who inadvertently introduced the strain into the Haitian environment. A specific form of the third hypothesis, that soldiers deployed from a cholera-endemic country to the Mirebalais MINUSTAH camp were the source of the cholera, is a commonly held belief in Haiti. In order to determine the source of the outbreak definitively, the Secretary-General of the United Nations formed an Independent Panel of four international experts (the " Independent Panel "), with a mandate to " investigate and seek to determine the source of the 2010 cholera outbreak in Haiti ". To fulfill this mandate, concurrent epidemiological, water and sanitation, and molecular analysis investigations were carried out. On October 22 nd , 2010, the first cholera case in Haiti in nearly a century was confirmed at the Haiti National Public Health Laboratory. A review of hospital admission records along the Artibonite River from the mountains of Mirebalais to St. Marc on the coast clearly showed that a normal background rate of non-fatal diarrheal disease in adults and children was abruptly interrupted by the onset of a cholera outbreak. The first hospitalized cholera case in Mirebalais, in the upstream region of the Artibonite River, was on the evening of October 17 th , 2010. The first hospitalized cholera cases on the coast, in the Artibonite River Delta in St. Marc and Deschapelle, were on October 20 th , 2010. The outbreak was widely established in the coastal areas by October 22 nd , 2010. The timeline suggests that the outbreak spread along the Artibonite River. After establishing that the cases began in the upper reaches of the Artibonite River, potential sources of contamination that could have initiated the outbreak were investigated. MINUSTAH contracts with an outside contractor to handle human fecal waste. The sanitation conditions at the Mirebalais MINUSTAH camp were not sufficient to prevent fecal contamination …