The disease is most often spread through the ingestion of contaminated food or drinking water. Water may be contaminated by the feces of an infected person or by untreated sewage. Food is often contaminated by water containing cholera bacteria or because it was handled by a person ill with cholera.An epidemic cholera strain has been confirmed in Haiti, causing the first cholera outbreak in Haiti in many years. Cholera is a potentially fatal bacterial infection that causes severe diarrhea and dehydration.

The majority of cases have been reported in the Artibonite Departmente, approximately 50 miles north of Port-au-Prince. Affected hospitals are being strained by the large number of people who are ill.

This outbreak is of particular concern given the current conditions in Haiti, including poor water and sanitation, a strained public health infrastructure, and large numbers of people displaced by the January earthquake and more recent flooding.

The World Health Organization, along with a number of international agencies, is mobilizing to assist local and national response efforts.

Advice for Travelers

At this time, CDC and the U.S. Department of State maintain travel warnings for Haiti. These warnings recommend that U.S. citizens avoid all nonessential travel to Haiti. For more information, see Travel Health Warning: Major Earthquake in Port-au-Prince, Haiti on the CDC website.

Most travelers are not at high risk for getting cholera, but people who are traveling to Haiti should still take steps to prevent getting sick. Although no cholera vaccine is available in the United States, travelers can greatly reduce their risk for cholera by following CDC’s safe food and water advice:

• Before departing for Haiti, talk to your doctor about getting a prescription for an antibiotic to treat travelers’ diarrhea.
• Drink water that you have boiled for at least one minute or treated with chlorine or iodine (2 drops of household bleach or ½ an iodine tablet per liter of water). Other safe beverages include tea and coffee made with boiled or treated water, as well as drinks that have been bottled and sealed (such as bottled water, carbonated drinks, and sports drinks).
• Do not put ice in drinks, unless the ice is made from boiled or treated water.
• Eat only foods that have been thoroughly cooked and are still hot, or fruit that you have peeled yourself.
• Do not eat undercooked or raw fish or shellfish, including ceviche.
• Make sure all vegetables are cooked. Do not eat salads or other raw vegetables.
• Do not eat foods or drink beverages from street vendors.
• Do not bring perishable seafood back to the United States.

A simple rule of thumb for safe food and water is "Boil it, cook it, peel it, or forget it."

If you are traveling in Haiti and have severe watery diarrhea, seek medical care right away.  It is important to remember to drink fluids and use oral rehydration salts (ORS) to prevent dehydration.

Medical care facilities are strained with the high number of people who are ill. If you will be traveling to Haiti, CDC recommends that you purchase medical evacuation insurance in the event that you become ill while in Haiti. (See the U.S. Department of State list of U.S.-Based Air Ambulance or Medical Evacuation Companies.) If you are in Haiti and need medical care and you do not have access to medical evacuation, you can contact the Embassy of the United States in Port-au-Prince, Haiti, (American Citizens Services Unit office hours are 7:00 a.m. to 3:30 p.m., Monday through Friday. The Consular Section is closed on U.S. and local holidays.):

Boulevard du 15 October, Tabarre 41, Tabarre, Haiti
Telephone: (509) (2) 229-8000
Facsimile: (509) (2) 229-8027
Email: acspap@state.gov

By the Centers for Disease Control and Prevention