As evidenced in multiple reports by the HEAS, a clear route of cholera transmission from Artibonite existed along the coastal highway from Arachaie to Lafito to, potentially, "Camp Obama" and (of greater concern) Cite Soleil. As feared, cholera has now been reported in Cite Soleil in a case without a travel history from Artibonite Valley:
The clinic in Cite Soleil treated a patient this morning that presented at the clinic with rice water diarrhea and vomiting. It is the considered diagnosis of the tropical medicine experienced physician at the clinic that this is cholera.
It was further determined that this individual had not traveled outside of Cite Soleil. It is of very great concern that the case history proved that this patient has not been away nor does she ever travel from her home in Cite Soleil. This transmission occurred in Cite Soleil.
Also of great concern, because of efforts to clear rubbish and garbage from the water courses the contaminated soil that lines these channels is being spilled onto the banks which serve as the paths leading into the heart of this overcrowded area of the city. The Cite Soleil is seeing a sharp rise in diarrheal illness most probably associated with the spillage of what constitutes raw sewage along the afore described paths.
While these later described patients that are presenting to the clinic with diarrhea do not have symptoms consistent with a diagnosis of cholera this trend, a rapid increase in cases of diarrheal illness, portends a disaster if cholera now in the area crosses the epidemic threshold!!! Two days of rain will make this almost inescapable.
Please remember that the first case reported above is separate. The symptoms of that patient matched word for word the WHO accepted case description for cholera.
The team considers this a priority alert for Port-au-Prince worthy of immediate investigation.