Cholera outbreak prompts Cuba travel advisory

The Cayman Islands has issued an advisory recommending only essential travel to Cuba following a cholera outbreak.

Cayman’s Medical Officer of Health Dr. Kiran Kumar issued the travel advisory Monday in response to reports of 15 deaths due to the illness in Cuba.

According to media reports, more than 1,000 people have been affected by the cholera outbreak.

“We advise that residents travel to Cuba only when necessary. If you have to go, take vital precautions, such as ensuring hygienic food preparation, boiling or purifying all water, and washing hands often with soap and clean water. Travellers should also carry an ample supply of oral rehydration salts,” said Dr. Kumar.

“The chances of importation of cholera into Cayman are limited and even if it occurs, our excellent sanitation and safe water will prevent its spread. In addition, we have adequate facilities and drugs to manage any cases should importation occur,” he added.

He urged travellers coming from Cuba, who develop diarrhoea within five days of returning, to contact a doctor immediately and state their travel history so that the right diagnosis can be made.

The southeastern province of Granma, and specifically the city of Manzanillo, is most affected by the cholera outbreak. It saw “an outbreak of gastrointestinal infection due to bacteria in the water from several polluted wells used for the local supply of drinking water,” according to a Cuba Public Health Ministry statement published in the official daily newspaper Granma, the Associated Press reported.

Cholera is an acute intestinal infection caused by ingesting contaminated food or water with cholera bacterium. It can take between five hours and five days for symptoms to appear after infection, but usually symptoms appear within 24 to 48 hours.

Cholera infection is often mild or without symptoms but can sometimes be severe. Approximately one in 20 infected persons will have severe disease characterised by profuse watery diarrhoea, vomiting, and leg cramps. In these people, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.

According to World Health Organisation figures, up to 80 per cent of cases can be treated successfully with oral rehydration salts. Although there is an oral vaccine available for use in endemic countries, it is not available in the US or in Cayman.

Cayman’s Public Health Department is calling a multi-agency preparedness meeting this week to discuss the outbreak.

Minister of Health Mark Scotland said: “I am pleased that the Medical Officer of Health has alerted the health professionals and issued the travel warning.” 

Dr. Kumar noted that the risk of importation of cholera is low, but said he applauded the pro-active efforts by various agencies in monitoring the cholera situation in Cuba and taking the necessary steps to prevent, detect and manage any imported cholera cases.

Tips for prevention

Travellers to Cuba can reduce the risk of contracting the disease by following these practices:

Drink only bottled, boiled or chemically-treated water and/or bottled or canned beverages.

Ensure that seals are unbroken when using bottled drinks.

Disinfect your own water: boil for one minute or filter the water and add two drops of household bleach or half an iodine tablet per litre of water.

Use bottled, boiled or chemically-treated water to wash dishes and brush teeth.

Use ice in your drink only if you know it was made from boiled or treated water.

Wash your hands often with soap and clean water.

Clean your hands before you eat or prepare foods, and after using the bathroom.

Eat foods that have been thoroughly cooked and are still hot or fruit that you have peeled yourself.

Cook all vegetables. Do not eat salads or other raw vegetables.

Do not buy food or beverages from street vendors.