Mexican health officials issue cholera alert for Hidalgo

"Given the natural disasters we've undergone recently, a cholera outbreak is a considerable risk"

*Updated Oct. 20*
Guadalajara -
Mexico's Secretary of Health has issued a cholera warning for the east central state of Hidalgo. The alert was published Thursday, Sept. 26.

Cholera is a serious intestinal infection characterized by intense diarrhea and vomiting. It can quickly lead to severe dehydration, and if not treated aggressively, to death. Fecal contamination of food or water is the usual transmission route. Transmitters themselves may present no sign of illness. Lack of hand-washing, personal hygiene and the failure to observe high standards of sanitation in places where food products are cooked and sold are typically implicated in outbreaks, which are far more common in emerging nations than in those which are industrialized.

Mexican press sources reported Friday that seven cholera cases have been diagnosed in Hidalgo this month. One victim, a woman, died. Two cases were also diagnosed in Mexico City.

A health department official said the alert was limited to that state, although Mexico's other 31 entities are being notified through customary channels. "For the moment, with the measures we have undertaken in ports of entry, and after checking with local health service providers, we can say the situation appears to be isolated," he said.

Another official suggested that the illness may be of Caribbean origin, noting cholera outbreaks in recent months in Cuba, Haiti and the Dominican Republic. "Many cases have been reported in that area, and given the global movement of tourists and business visitors, it's very difficult to prevent the illness from entering our country," he said.

According to Mexico's Secretary of Health, Haitian officials diagnosed more than 671,000 cases of cholera between October 2010 and August 2013, and the Dominican Republic almost 31,000 cases in approximately the same period.

Mexico has epidemiological systems in place to check new passenger arrivals for signs of cholera infection, especially those traveling from the Caribbean. But there is also fear the illness could be jump started by the disaster left on both coasts by hurricanes Ingrid and Manuel earlier this month. Cholera outbreaks often follow natural disasters due to the destruction of public infrastructures and homes, with consequent disruption of normal hygiene routines. The ongoing Haitian cholera outbreak has killed over 8,000 people, and is directly linked to that country's Jan. 12, 2010 earthquake, which left more than 100,000 dead.

"Given the natural disasters which we've undergone in recent days, a cholera outbreak is one of our greatest risks," said a Mexican health official this week.

Health officials in Hidalgo, where the first patient presented with symptoms Sept. 5, have launched an intense campaign focused on educating the public about how to avoid cholera transmission, coupled with the distribution of free antibacterial gels. Early containment of the illness is essential to prevent a widespread epidemic, which could have devastating regional or even national consequences.

Sept. 30 - The outbreak has moved westward. The Secretary of Health's alert now includes Aguascalientes, which shares a border with Jalisco.

Oct. 11 - 77 cases have now been diagnosed in Hidalgo state.

Oct. 14 - Nine cholera cases have been reported by public health authorities in the State of Mexico (EDOMEX), which borders the Federal District. Mexico has 159 known cases of cholera overall, 145 of them in Hidalgo.

Oct. 20 - Diagnosed cholera cases continue to rise according to the federal secretary of health, with 171 nationwide. The majority are in Hidalgo (157), indicating the illness is being somewhat contained.

July 18, 2012 - Mexican state of Tabasco on cholera alert
July 14, 2012 - Cuban cholera outbreak has Yucatán health authorities on alert