Cholera's western front

Reinforcing cholera intervention through prediction-aided prevention

“…These measures are yet to be implemented on a global scale due to economic, logistic or other practical constraints. [2][3][4] However, the disease burden could be significantly reduced if these preventive measures could be deployed ahead of time with an early warning system before an outbreak hits a particular region.…”

“…Vaccination appears to be the predominant response, with a call for health authorities to incorporate it into existing intervention methods to reduce infection rates and minimize future epidemics. 1,4 With an increasing disease burden in endemic regions and high fatality rates in newly affected regions, there is a need to examine the efficacy of existing strategies and to explore the use of predictive technology to implement proactive intervention measures.…”

“…2 In addition, epidemiological surveillance and health facility and laboratory-based reporting have significantly contributed to global cholera prevention and control. 1,4 Yet, such treatment could not be translated to timely intervention in Haiti because of the inability to predict cholera outbreaks. With fatality rates less than 1% in south Asia, there is no reason for fatality rates to have exceeded 6% in Haiti.…”

“…With fatality rates less than 1% in south Asia, there is no reason for fatality rates to have exceeded 6% in Haiti. 2,4 A decrease in case-fatality rate and overall reduction in disease burden can be potentially achieved by timely prediction and identification of communities at imminent risk, followed by proactive intervention. While Bangladesh and Haiti provide extreme examples of contemporary cholera epidemiology, they help identify a major knowledge gap in our understanding of the global problem.…”

“…In Haiti, initial case-fatality rates were high, but were successfully brought down with increased access to safe water and sanitation. 4 Similarly, epidemic cholera outbreaks in sub-Saharan countries in recent years have had high initial case-fatality rates, showing an urgent need for an advanced warning system to limit disease burden. 4 What about primary prevention?…”