A full year has passed since the first reports of the first reappearance of cholera in Cuba in decades, yet it appears that the island still hasn’t contained the outbreak, contrary to the Cuban government’s official claim.
Last week the Pan American Health Organization (the regional arm of the World Health Organization) reported five confirmed cholera cases among travelers to Cuba this summer: an Italian, two Chileans, and two Venezuelans. The five foreigners are the first tourists known to have contracted cholera on the island since the disease first broke out in eastern Cuba in July 2012, sickening almost 500 people and killing at least three people, according to official records.
Last Tuesday, the U.S. Interests Section—the diplomatic mission—in Havana issued a health advisory for U.S. citizens living in, or traveling to Cuba: “This message is to inform U.S. citizens residing in or visiting Cuba that media reports have indicated that cases of cholera have been identified in the city of Havana, possibly linked to a reported outbreak of cholera in eastern Cuba. The Panamerican Health Organization (PAHO) issued an epidemiological alert noting the presence of cholera in Cuba and confirming that foreign travelers have contracted cholera during recent trips to Cuba.”
So how bad is it?
During my most recent visit to Havana, in July, radio bemba (street talk) indicated widespread cases of cholera. Cuban authorities said nothing, although they did acknowledge an outbreak in Havana last January, with 51 confirmed cases. It closed restaurants in the Cerro district—the epicenter of the outbreak—and initiated a public health campaign to stamp it out quickly. (Reuters reporter Mark Frank reported that off-the-record discussions with a ministry official and doctor directly involved in fighting the outbreak indicated that hundreds of people had sickened.)
Despite the government’s best efforts, cholera keeps popping up.
Earlier this month, La Roca restaurant in the Vedado district of Havana (I eat there all the time!) was closed after an outbreak when locals and tourists became ill after eating there. In July, an outbreak was reported by residents in Matanzas province, while independent journalists reported cases in Jovellanos, Cárdenas, Cabaigüan, Jagüey Grande, Sierra de Cubitas, and elsewhere. Franks reports that last month public health workers in Camaguey province were mobilized to fight a local outbreak. “There were lots of cases,” one nurse told him. And on August 5, authorities in the province of Ciego de Ávila closed Playa Bolivia—a beach used solely by local Cubans—after 18 cholera cases were identified (they referred to it, however, as “a high-risk epidemiological situation,” avoiding reference to cholera).
According to Frank, a member of Cuba’s public health ministry admitted to outbreaks of “cholera in various places” and that “the government should stop keeping it a secret.”
Clearly, Cuban authorities appear to be sitting on the truth. Not least, they’re obviously frightened of killing off tourism (2.7 million visitors came in 2012).
Should you travel?
I’m leaving next week for more professional research in Cuba and I’ll be traveling the length and breadth of the isle. The cholera scare doesn’t phase me.
Not least, as awful as it is, cholera—which causes intense diarrhea—is usually not fatal and normally runs its course within a week. It can be treated easily with hydration and antibiotics. It can kill, however, if not treated promptly.
Following a good health regime goes a long way to ensuring you avoid contracting cholera. “We urge you to follow public health recommendations and guidelines, such as safe food and water precautions and frequent hand washing to help prevent cholera infection,” states the U.S. Interests Section advisory.
That means avoiding untreated water, street food, undercooked shellfish and uncooked foods. AND DRINK BOTTLED WATER ON ALL OCCASIONS!
Last February and March I led two group motorcycle tours of all Cuba, including Oriente—the eastern provinces that were the epicenter of last year’s outbreak.
Evidence of the government’s battle to contain the disease was everywhere. Every public building, from banks to hotels, had bottles of bleach and ostensibly required anyone entering to clean their hands. Arriving at Guantánamo city, the entire group had to stop at a police check-point, where our hands and shoes were “bleached,” along with those of bus passengers entering the city.
Cuban health workers have lots of experience working to battle the cholera epidemic in Haiti, and appear well drilled to respond to outbreaks in Cuba.
What’s more troublesome to me is the Cuban government’s silence aimed at protecting its $2.5 billion-a-year tourism industry.
“The lack of transparency coming from Cuba is truly bothersome,” says Sherri Porcelain, senior lecturer in global public health at the Institute of Cuban & Cuban-American Studies, at the University of Miami. “Sharing of information in a timely fashion is most essential for prevention … yet they post no information, no information at all.” (See her article, ‘Cuba in the Time of Cholera and Dengue’.)
As Dr. Luis Suárez Rosas, a professor at Cuba’s National School of Medicine, wrote in a recent edition of the Cuban Magazine for Public Health, secrecy tends to hide the risks and severity of the disease and does not help patients understand their condition.
Summing up… Only five tourists known to have been infected out of 2.7 million visitors! I’m safer in Cuba than walking the streets of Washington, D.C., or New York, reminding me of a story in The Guardian newspaper entitled “Why does America lose its head over ‘terror’ but ignore its daily gun deaths?”