Haiti is cholera-free for two years

No new cholera cases have been reported in Haiti for just over two years. The last confirmed case was identified in Artibonite Department in late-January 2019 (1). With this news, the country is one year away from declaring cholera elimination. To officially proclaim elimination of the disease, a country must remain cholera-free for at least three consecutive years, while maintaining an effective surveillance system able to detect and confirm any cholera cases should they occur (2).

The cholera epidemic in Haiti was devastating, with 813,252 suspected cases and 9,611 deaths from 2010 to early-2019 (3). The epidemic was finally controlled thanks to the implementation of the Haitian National Cholera Elimination Plan 2013–2022. The plan included improvements in water and sanitation infrastructure, enhanced disease surveillance for early detection of cholera cases, and establishment of rapid response activities to quickly control localized outbreaks, including case-area targeted water, sanitation and hygiene interventions (1,4,5). A nationwide alert-response strategy was also established to monitor the epidemic and response efforts on a weekly basis. (5). As case numbers receded, it was critical to not let the guard down and effectively stop disease transmission during this “window of opportunity”. The same lesson could be applied to the ongoing COVID-19 pandemic.

The experience in Haiti clearly demonstrates that cholera elimination may be possible in other countries deemed cholera-endemic, if steps are taken to improve disease surveillance, outbreak response efforts and water and sanitation infrastructure.