ECDC warns of risk of travel-associated cholera in the Dominican Republic
The European Centre for Disease Prevention and Control (ECDC) has warned of the risk of travel-associated cholera to tourists in the Dominican Republic. The cholera epidemic in the Dominican Republic has given rise to more than 5000 cases since it began in November 2010 and the disease has become extensively distributed endemic in the country.
As the Dominican Republic is a very popular destination for tourists, imported cases are expected in the European Union. However, with appropriate precautionary measures the risk of infection and further transmission upon return to Europe remains low. Travellers should seek information on how to prevent cholera contamination prior to visiting affected areas.
As of 20 November 2010, the Haitian Ministry of Public Health and Population (MSPP) reported 60,240 cumulative cholera cases including 1,415 deaths at the national level. The case fatality rate in hospitals at the national level is 2.3%, with 67% of the deaths occurring at health services level and 33% at community level.
Since August 2008, an extensive outbreak of cholera has been affecting much of Zimbabwe, adding to the already extensive burden of starvation being faced by much of the population. As of 8 December, more than 15,000 suspected cases including 774 deaths (giving an overall case fatality rate of 4.9%) have been reported from 9 of 10 provinces in Zimbabwe. Around 60% of cases reported are in Harare, the capital. The fatality rates appear to be much higher in the more rural areas (as high as 50% in some reports). In addition cases are being reported in neighbouring countries; in South Africa (468 cases, with 9 deaths) and Mozambique (310 cases with 9 deaths).
Travellers to Zimbabwe should boil all water for consumption (including water for brushing teeth) or use bottled water produced by reputable companies. Ice cubes should be avoided. It is important to bear in mind that vegetables and salads may have been washed in contaminated water and should be avoided unless you are sure the water used to rinse them has been boiled or bottled. It is important to observe good personal hygiene and wash hands following use of the toilet and before eating or feeding small children.
