Volume 17, Number 11—November 2011 CHOLERA IN HAITI Epidemic
Cholera in a Crowded Urban Environment, Port-au-Prince, Haiti We
conducted a case–control study to investigate factors associated
with epidemic cholera. Water treatment and handwashing may have
been protective, highlighting the need for personal hygiene for
cholera prevention in contaminated urban environments. We also
found a diverse diet, a possible proxy for improved nutrition,
was protective against cholera. Epidemic cholera remains a
problem in poor countries that lack adequate water and
sanitation infrastructure, particularly among populations in
crowded, unsanitary conditions (1–4). On January 12, 2010, a
magnitude 7.0 earthquake struck metropolitan Port-au-Prince,
Haiti, killing >200,000 persons and destroying vital water and
sanitation infrastructure (5). Epidemic cholera had not been
reported in Haiti in the past century, but on October 21, 2010,
toxigenic Vibrio cholerae serogroup O1, serotype Ogawa, biotype
El Tor, was identified as the