Environmental Health Conditions and Cholera Vulnerability in Latin America and the Caribbean

Cholera in Haiti and Other Caribbean Regions, 19th Century

“…When cholera occurred in Peru in 1991 but did not spread from Latin America to Caribbean islands, researchers may have asked different questions than they would have otherwise ( 12 ), although their concluding assessment and prescriptions remained accurate: “The lack of reported cases in Uruguay and the Caribbean may reflect a low risk for ongoing transmission...” ( 13 ). From the time of the earliest medical commentaries on epidemics in the Caribbean, researchers had noted that proportions of infections and deaths were “much higher than in all European cholera epidemics” ( 14 ).…”

Assessing the Vulnerability of Eco-Environmental Health to Climate Change

“…In the context of environmental health research, “vulnerability” was first used by Witt and Reiff to isolate environmental health conditions and potential points of contamination responsible for a cholera outbreak in Latin America and the Caribbean [96]. …”

Major factors affecting the emergence and re-emergence of infectious diseases

“…Overcrowding in urban areas, especially with poor housing conditions, facilitates the spread of tuberculosis, other respiratory infections, and vaccine-preventable diseases [62]. Poor sanitation also results in the rapid spread of enteric diseases that are transmitted by contaminated food and water, as exemplified by the spread of cholera in the early 1990s throughout Latin America [38,66,67]. Large cholera epidemics typically occur when there is gross sewage contamination of municipal water sources due to the absence of sanitation systems including sewage or water treatment.…”

“…A number of previously known infectious diseases have also re-emerged either by occupying a new epidemiologic niche or reappearing in a more virulent form. In the last decade, cholera has re-emerged in the Western Hemisphere and rapidly spread to cause over a million cases of enteric infection with several thousand deaths [38,39]. Group A streptococci have become more virulent and are now a common cause of serious invasive disease with associated rapid necrosis of the soft tissue, fascia, and muscle-a condition that the lay press has designated as ''flesh-eating disease'' [8,40].…”