An active outbreak of cholera is occurring in Haiti and there is risk that travelers between the United States (US) and Haiti could introduce cholera into US communities. Although sanitation systems in the US should prevent most waterborne transmission in the US , transmission could occur by other routes such as person-to-person spread in families. Prompt public health detection and response can help prevent transmission within US communities.
Please be aware that a laboratory-confirmed case of cholera imported from Haiti has been reported to the Florida Department of Health and additional imported cases are under investigation in several Florida counties. There have been no reported cases in New Jersey to date.
The New Jersey Department of Health and Senior Services (NJDHSS) is requesting that all public health and health care providers consider Vibrio cholerae in the differential diagnosis of individuals with clinically compatible illness and an epidemiologic link to Haiti. Providers should determine if the ill individual has had recent travel to Haiti (within last 7 days) or has an epidemiologic link to an ill individual diagnosed with cholera or an ill individual who has recently traveled to Haiti. Appropriate diagnostic testing should be performed and infection control measures instituted. Additional information regarding cholera can be accessed through the NJDHSS Communicable Disease Service (CDS) website at http://nj.gov/health/cd/cholera/index.shtml.
NJDHSS would like to emphasis the following:
- Individuals that are at high risk for spreading the disease (i.e. food handlers, daycare attendees/workers, healthcare workers that provide direct patient care) should be excluded from work or daycare until they are asymptomatic and have produced one negative stool sample taken at least 48 hours after the cessation of antibiotic treatment if given.
- Close contacts of cases that develop diarrhea and are at high risk for spreading the disease (i.e. food handlers, daycare attendees/workers, healthcare workers that provide direct patient care) should be managed in the same manner as a case.
- All household and other close contacts of cases should be reminded to be diligent about proper handwashing especially before eating or preparing food, after using the toilet, and after changing diapers or caring for sick individuals.
- Isolates of Vibrio cholerae should be sent to the Public Health and Environmental Laboratories of the New Jersey Department of Health and Senior Services for typing.
In accordance with N.J.A.C. 8:57, Vibrio cholerae is reportable within 24 hours of diagnosis to the local health department with jurisdiction over the municipality in which the patient resides. If unable to reach the local health department, contact the NJDHSS at 609-826-5964 during regular business hours or 609-392-2020 during holidays or off hours. For a full list of reportable diseases, please see the CDS website at http://nj.gov/health/cd/reporting.shtml.