notes: Voodoo killings reportedly rise in Haiti epidemic Posted: Dec 24, 2010 11:50 AM PST Updated: Dec 27, 2010 3:31 PM PST http://www.ktnv.com/story/13738389/voodoo-killings-reportedly-rise-in-haiti-epidemic ----- 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If ORT Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon / This homemade ORT recipe should NEVER REPLACE medical care for Cholera. If the patient is mildly symptomatic or sent home after observation and released and Rehydration Salts (ORS) is not available, this is an alternative. The patient should ALWAYS seek the treatment of a medical professional (if available). It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot Soup, Fruit Juice and Coconut Water can also be given in addition to the homemade hydration cocktail (never in place of!) if the patient is able to eat. This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donorm or responder, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Hygiene Kits *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Large Waste Containers (for toxic materials) *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment/Systems *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets for distribution ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------ -> Voodoo killings reportedly rise in Haiti epidemic Posted: Dec 24, 2010 11:50 AM PST Updated: Dec 27, 2010 3:31 PM PST http://www.ktnv.com/story/13738389/voodoo-killings-reportedly-rise-in-haiti-epidemic ----- 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If ORT Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon / This homemade ORT recipe should NEVER REPLACE medical care for Cholera. If the patient is mildly symptomatic or sent home after observation and released and Rehydration Salts (ORS) is not available, this is an alternative. The patient should ALWAYS seek the treatment of a medical professional (if available). It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot Soup, Fruit Juice and Coconut Water can also be given in addition to the homemade hydration cocktail (never in place of!) if the patient is able to eat. This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donorm or responder, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Hygiene Kits *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Large Waste Containers (for toxic materials) *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment/Systems *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets for distribution ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------ CHOLERA SUPPLIES FROM PROMESS Simplified procedure to get cholera medical supplies from PROMESS for organizations NOT registered with the Ministère de la santé publique et de la population (MSPP). 1) Go to the Cellule opérationnelle d`urgence nationale (COUN) of the MSPP Contact person Dr Claude Surena Health Coordinator, MSPP Rue Butte N# 7 Bourdon, Port au Prince, Haiti Tel : +509-3701-7077 Assistant : Ms Margaret Beaudin : +509-3491-8955 Documents to provide: · Photocopy of ID of the country director or person responsible for coordination of the organization. · Legal recognition document from the country of origin. · NGO Status. · Project work plan (a summary of one page: activities and operations) Upon approval, Dr Surena will issue the same day a temporary authorization to operate in the country. 2) Bring this authorization to PROMESS This procedure can also be found at www.paho.org/promess. Select “Simplified procedure for Cholera” on the left-hand side. For those who are registered with the MSPP country, go directly to PROMESS or write to promess@paho.org.

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If ORT Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon / This homemade ORT recipe should NEVER REPLACE medical care for Cholera. If the patient is mildly symptomatic or sent home after observation and released and Rehydration Salts (ORS) is not available, this is an alternative. The patient should ALWAYS seek the treatment of a medical professional (if available). It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot Soup, Fruit Juice and Coconut Water can also be given in addition to the homemade hydration cocktail (never in place of!) if the patient is able to eat. This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donorm or responder, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Hygiene Kits *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Large Waste Containers (for toxic materials) *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment/Systems *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets for distribution ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------ -> Voodoo killings reportedly rise in Haiti epidemic Posted: Dec 24, 2010 11:50 AM PST Updated: Dec 27, 2010 3:31 PM PST http://www.ktnv.com/story/13738389/voodoo-killings-reportedly-rise-in-haiti-epidemic ----- 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If ORT Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon / This homemade ORT recipe should NEVER REPLACE medical care for Cholera. If the patient is mildly symptomatic or sent home after observation and released and Rehydration Salts (ORS) is not available, this is an alternative. The patient should ALWAYS seek the treatment of a medical professional (if available). It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot Soup, Fruit Juice and Coconut Water can also be given in addition to the homemade hydration cocktail (never in place of!) if the patient is able to eat. This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donorm or responder, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Hygiene Kits *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Large Waste Containers (for toxic materials) *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment/Systems *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets for distribution ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If ORT Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon / This homemade ORT recipe should NEVER REPLACE medical care for Cholera. If the patientis mildly symptomatic or sent home after observation and released and Rehydration Salts (ORS) is not available, this is an alternative. The patient should ALWAYS seek the treatment of a medical professional (if available). It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot juice and coconut water can also be given in addition to the homemade hydration cocktail (never in place of!). This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donorm or responder, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Hygiene Kits *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Large Waste Containers (for toxic materials) *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment/Systems *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets for distribution ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------ -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If ORT Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon / This homemade ORT recipe should NEVER REPLACE medical care for Cholera. If the patient is mildly symptomatic or sent home after observation and released and Rehydration Salts (ORS) is not available, this is an alternative. The patient should ALWAYS seek the treatment of a medical professional (if available). It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot Soup, Fruit Juice and Coconut Water can also be given in addition to the homemade hydration cocktail (never in place of!) if the patient is able to eat. This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donorm or responder, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Hygiene Kits *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Large Waste Containers (for toxic materials) *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment/Systems *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets for distribution ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If ORT Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon / This homemade ORT recipe should NEVER REPLACE medical care for Cholera. If the patientis mildly symptomatic or sent home after observation and released and Rehydration Salts (ORS) is not available, this is an alternative. The patient should ALWAYS seek the treatment of a medical professional (if available). It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot juice and coconut water can also be given in addition to the homemade hydration cocktail (never in place of!). This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------ -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If ORT Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon / This homemade ORT recipe should NEVER REPLACE medical care for Cholera. If the patientis mildly symptomatic or sent home after observation and released and Rehydration Salts (ORS) is not available, this is an alternative. The patient should ALWAYS seek the treatment of a medical professional (if available). It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot juice and coconut water can also be given in addition to the homemade hydration cocktail (never in place of!). This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donorm or responder, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Hygiene Kits *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Large Waste Containers (for toxic materials) *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment/Systems *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets for distribution ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If ORT Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon / This homemade ORT recipe should NEVER REPLACE medical care for Cholera. If the patientis mildly symptomatic or sent home after observation and released and Rehydration Salts (ORS) is not available, this is an alternative. The patient should ALWAYS seek the treatment of a medical professional. It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot juice and coconut water can also be given in addition to the homemade hydration cocktail (never in place of!). This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------ -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If ORT Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon / This homemade ORT recipe should NEVER REPLACE medical care for Cholera. If the patientis mildly symptomatic or sent home after observation and released and Rehydration Salts (ORS) is not available, this is an alternative. The patient should ALWAYS seek the treatment of a medical professional (if available). It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot juice and coconut water can also be given in addition to the homemade hydration cocktail (never in place of!). This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot juice and coconut water can also be given in addition to the homemade hydration cocktail (never in place of!). This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------ -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If ORT Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon / This homemade ORT recipe should NEVER REPLACE medical care for Cholera. If the patientis mildly symptomatic or sent home after observation and released and Rehydration Salts (ORS) is not available, this is an alternative. The patient should ALWAYS seek the treatment of a medical professional. It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot juice and coconut water can also be given in addition to the homemade hydration cocktail (never in place of!). This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------ -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 teaspoon salt 8 teaspoon sugar NOTE: A Bottlecap can be used in place of a teaspoon It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. Carrot juice and coconut water can also be given in addition to the homemade hydration cocktail (never in place of!). This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------ -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CCCM Cluster Meeting Tuesday, 23 November, 2010 – 10:00 a.m. at OCHA tent Chaired By: Bradley Mellicker – CCCM Emergency Preparedness Officer Action items For urgent cases that do not have transport, partners should call 34827636 / 38515331. If deaths occur in camps, partners should call 38799177. 1. General update on cholera situation Patrick DUIGAN (Tel. (509) 38499115. pduigan@iom.int) – Health Program Manager, IOM ----------------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------ -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: ORT (Oral Rehydration Therapy)/REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. This is a YouTube Video that is perfect for training the Haitian Community on how to make ORT very easily: http://www.youtube.com/watch?v=yPrqgZL7G6E&feature=player_embedded#at=161 WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------ -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- Link to the CAT FACILITY RECORD for Cholera, Acronyms/Definitions of Cholera facilities from PAHO: http://www.citizencommandcenter.org/shelters/show/6790 -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------ -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- TREATING CHOLERA Treatment ( from CDC and WHO) Administer Oral Rehydration Salts (ORS) and, when necessary intravenous fluids and electrolytes, in a timely manner and in adequate volumes. This will reduce case–fatality rates to <1%. Antibiotic therapy will reduce fluid requirements and duration of illness and is indicated for severe cases. If possible, use antimicrobial susceptibility testing to inform treatment choices (special considerations for doxycycline and erythromycin testing, see http://www.who.int/drugresistance/publications/WHO_CDS_CSR_RMD_2003_6/en/). WHO Fluid Replacement or Treatment Recommendations No dehydration Oral rehydration salts Children<2 years: 50–100 ml, up to 500 mL / day Children 2–9 years: 100–200 ml, up to 1000 mL / day Patients >9 years: As much as wanted, to 2000 mL / day Some dehydration Oral rehydration salts (amount in first 4 hours) Infants<4 mos (<5 kg): 200–400 mL Infants 4–11 mos (5–7.9 kg): 400–600 mL Children 1–2 yrs (8–10.9 kg): 600–800 mL Children 2–4 yrs (11–15.9 kg): 800–1200 mL Children 5–14 yrs (16–29.9 kg): 1200–2200 mL Patients >14 yrs (30 kg or more): 2200–4000 mL Severe dehydration IV drips of Ringer Lactate or, if not available, normal saline and oral rehydration salts as outlined above Age < 12 months: 30 mL/kg within 1 hour*, then 70 ml/kg over 5 hours Age > 1 year: 30 mL/kg within 30 min*, then 70 ml/kg over two-and-a-half hours *Repeat once if radial pulse is still very weak or not detectable Reassess the patient every 1-2 hours and continue hydrating. If hydration is not improving, give the IV drip more rapidly. 200ml/kg or more may be needed during the first 24 hours of treatment After 6 hours (infants) or 3 hours (older patients), perform a full reassessment. Switch to ORS solution if hydration is improved and the patient can drink Antibiotics: CDC first choices for oral antibiotic treatment are: - adults (non-pregnant), doxycycline 300 mg by mouth in one dose; - pregnant women, azithromycin 1 gram in one dose - children (all ages): azithromycin 20 mg/kg in one dose (not to exceed 1 gram), erythromycin 12.5 mg/kg (not to exceed 500 mg) 4 times a day for 3 days, or doxycycline 2-4 mg/kg in one dose (not to exceed 300 mg). --------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 Chrintine Ellis shemichel@gmail.com writes: I have something as a guideline 1. Diareah needs to be under control 2. Able to drink and retain fluid (Access to clean water) 3. No longer hypovolemic 4. Normal lab: potassium, sodium, chloride, magnesium, bicarbonate, 5. Normal BP/BS ------------------------------------------------- -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 by phuocvanle@gmail.com Below discharge guideline is copied from the 2004 MSF cholera guidelines. we don't do any labs unless warranted for special cases like renal failure. it's a 3 meg file so if you'd like it please let me know. we've been following this protocol in St. Marc which seems to work. best of luck. 9. Discharging the patient – If hospitalised, first transfer to recovery area and keep under observation and ORS for 6 hours. – From recovery area, discharge when there are no more signs of dehydration and less than 3 liquid stools during the past 6 hours. – Advise the patient or caregiver to come back to the treatment centre immediately if: ∑ vomiting restarts, ∑ diarrhoea worsens, ∑ patient is drinking or eating poorly – Discharge with enough ORS bags for 2 days at home and instruct the patient to prepare the ORS solution with clean water. Table 11. Number of ORS bags to give at home (from the WHO) Age Amount of solution after each loose stool ORS sachets needed Less than 24 months 50 to 100 ml Enough for 500 ml/day 2–9 years 100-200 ml Enough for 1000 ml/day 10 years or more As much as wanted Enough for 2000 ml/day ORS bags are usually for 1 litre. In some countries ORS bags are conditioned for less than 1 litre. ------------------------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." ---------------------------------------------- WHEN TO RELEASE PATIENTS Posted on HEAS 11/12/10 Chrintine Ellis shemichel@gmail.com writes: I have something as a guideline 1. Diareah needs to be under control 2. Able to drink and retain fluid (Access to clean water) 3. No longer hypovolemic 4. Normal lab: potassium, sodium, chloride, magnesium, bicarbonate, 5. Normal BP/BS -------------------------------------------------
cat_notes: Removed this list of Cholera impacted communities....it's outdated...unless you can and plan to update it daily I think we should skip it - LTel 11/12/10: By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- -> Absolutely agree! Lpar 11/12/10 Removed this list of Cholera impacted communities....it's outdated...unless you can and plan to update it daily I think we should skip it - LTel 11/12/10: By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau --------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)."
cat_notes: -> Removed this list of Cholera impacted communities....it's outdated...unless you can and plan to update it daily I think we should skip it - LTel 11/12/10: By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau --------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)." -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes TIP FROM HEAS GROUP: Product: CREOLINA EPA Registration Number: 01496104419 This pesticide is used as a: DISINFECTANT As effective as Chlorine Bleach but smells better SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)."

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes * Cholera Beds OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer *Disinfectant Cleaner *Chlorine Bleach (liquid Clorox) *Buckets *Waste Bags *Tents (LARGE) *Plastic Sheeting *Ropes SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies *Water Tanks *Water Bladders *Cholera Prevention/Education Pamphlets ------------------------------------------ "The Master Cholera Response Packing List for CTC/CTU (has been developed by MSPP, PAHO/WHO, UNICEF and other health partners. The list of supplies includes items for infection control (chlorine, disinfectant, a...nd sprayers), treatment support (waste bags, and buckets), module installation (plastic sheeting, ropes, tents, and cholera beds), water distribution (water tanks/bladder) and treatment and consumables (oral rehydration salts, ringer's lactate, antibiotics, and soap)."

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): Search this site: http://haiti.mphise.net/ -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): http://haiti.mphise.net/ -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES/DEDICATED WEBSITES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx Haiti MPHISE (Active Forums addressing 'everything Cholera' in Haiti): Search this site: http://haiti.mphise.net/ -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- CHOLERA OUTBREAK MAP - PAHO: http://haiti.mphise.net/cholera-outbreak-haiti-pahoorg-map -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- Link to this Databases' list of Cholera Treatment Centers and Responding organizations can be found on the Quick Start page. http://www.citizencommandcenter.org/quick/start -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Bercy (near Cabaret) Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Posted 11/4/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report, Communes / Sites Affected: Bas Limbe Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Updated 11/5/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report Acahaie Bas Limbe Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Montrouis Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies

name: CHOLERA: Treatments/Signs & Symptoms/Educational Data/Supply List - INDEX - 10/10 Cholera Outbreak -> CHOLERA: Tracking/Treatments/Signs & Symptoms/Educational Data/Supply List - INDEX - 10/10 Cholera Outbreak

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- By Official Report, Commune (Section(s)) Affected By Cholera: (Posted 11/4/10) Anse a Foleur (Cote de fer, Mayance, Riviere des Negre) Anse Rouge (Plaine d’arbe, Source chaude) Bassin Bleu (Haut des moustiques, Carreau Datty, La Plate) Bombardopolis (Plaine d’Oranger, Plate Forme, des Forges) Chansolme (Section de Chansolme, Source Beauvoir) Desdunes Dessalines / Marchandes (Duvallon, Villars, Oge, Poste Pierrot, La Croix, Fiefie) Ennery (Chemin neuf, Passe Reine, Puilboreau, Savanne Carre) Gonaives (Bassin, La Branle, Poteau, Pont Tamarin, Riviere de Bayonnais) Grande Saline (Poteneau) Gros Morne (Pendu, L’Acul, Savane Caree, Moulin, Riviere blanche, Riviere Mancelle, Ravine Gros Morne, Boucan Richard) L’Estere (Petit Desdunes, Pont de l’Estere) La Chapelle (Bossous, Martineau) Lascahobas (La Hoye, Petit Fond, Juampas) Maissade (Hatty, Grande Savane) Marmelade (Crete a Pins, Platon) Mirebalais (Grand Boucan, Crete Brulee, Gascogne, Sarazin) Petite Riviere de l’Artibonite (Savane a Roche, Labady, Bas Coursin, Perodin, Medor) Port de Paix (Mahotiere, Base des Moustiques, Lacome, Aubert, Baudin, La Pointe, Riviere des Negres) Saint Marc (Bocozelle, Charette, Bois Neuf, Lalouere, Goyavier, Deluge) Saint-Michel (Camathe, Bas du Sault, Lalomas, Platana, L’Attalaye, Mamont, Lacedras, L’Ermite) Verrettes (Belanger, Guillaume Roge, Liancourt, Bastien, Terre Nette, Desarmes) By HEAS Report, Communes / Sites Affected: Bas Limbe Cap Hatien Carrefour Cite Soleil Croix des Bouquets Delmas Hinche Lafito Sault D'Eau -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- WATER PURIFICATION OPTIONS IN HAITI Gadyen Dlo/ Dlo Lavi/ Klorfasil/ Aquatabs/ Bleach Cost per unit (cash req.) $0.12 $0.63 $2.50 $0.03 Variable Cost per 1000 liter treated $0.13 $1.10 $0.24 $1.32 Variable Est. annual cost per family $0.96 $8.03 $1.78 $9.64 Variable Product shelf life (months) 12 18 60 36 6 The cash outlay for each purchase is critical in Haiti. Qualitative research indicates some people report Aquatabs are "more economical" than other chlorine options because one Aquatab (treating 20 liters) costs less than other options treating higher quantities of water, despite the fact Aquatabs has the highest cost per liter treated. Gadyen Dlo: Locally produced sodium hypochlorite, DSI Deep Springs International (DSI) produces 0.7% sodium hypochlorite locally and distributes in 8 oz. refillable bottles as ‘Gadyen Dlo’ (Water Guardian). Users add one cap of solution to a 5-gallon plastic storage container. One bottle treats 48 five gallon buckets and lasts a family 1-1.5 months. Benefits are ease-of-use, demonstrated acceptability to users, scalability, and greater control over costs and import challenges. Drawbacks include higher transportation costs and challenges compared to solid chlorine. Contact Michael Ritter at michael.ritter2@gmail.com or see www.jolivert.org. Klorfasil: Imported granulated NaDCC The Klorfasil (‘Easy Chlorine’) project manufactures plastic bottles holding 70 grams of granulated chlorine disinfectant (NaDCC). Users invert the bottle and use the cap to dispense 1 dose (129 mg) of chlorine to 5 gallons of water. One bottle treats 540 five gallon buckets and lasts a family about 1.5 years. Benefits are low transportation costs compared to liquid and low frequency of need for refills. Drawbacks include high cost of dispensing bottle and reliance on imported chlorine and bottle pieces. Contact Jon Steele at jon@madewell.com or see www.klorfasil.org. Dlo Lavi: Imported sodium hypochlorite, PSI Population Services International (PSI) imports and distributes 0.94% sodium hypochlorite in disposable 4 ounce Dlo Lavi (‘Water is Life’) bottles. Users add one cap of solution to 5 gallons of water. One bottle treats 30 five gallon buckets and lasts a family about 1 month. Benefits are ease-of-use and high quality marketing provided by PSI. Drawbacks include high cost, reliance on PSI’s supply chain, creation of plastic waste, and higher transportation costs and challenges compared to solid chlorine. Contact Natacha Riviere at nriviere@psihaiti.org or see www.psi.org/where_we_work/haiti.html. Aquatabs: Solid NaDCC tablets, Medentech. Medentech, a for-profit company based in Ireland, markets solid NaDCC Aquatabs in Haiti. Various sizes of Aquatabs are available, allowing users to add one tablet to quantities of water ranging from 1 liter to 5 gallons. Aquatabs are typically sold in sleeves of 10, but can also be purchased individually in Haiti or in bulk from Medentech. Benefits are ease-of-use, demonstrated acceptability to users, and low transportation costs compared to liquid chlorine. Drawbacks include high cost and reliance on imported product. Contact Paul at pedmondson@medentech.com or www.medentech.com/. Jif or Clorox: Commercial bleach, US or DR. Commercial bleach (5.25% sodium hypochlorite) enters markets in Haiti from the United States and the Dominican Republic for various household uses. Users add 3-5 drops to 5 gallons of water. Some bleach bottles come with a top that dispenses by drops. If not, users find other caps for measuring drops. Bleach is sold in bottles ranging from 4 oz. to 1 gallon. Benefits include local familiarity with product. Drawbacks include uncertain concentration and shelf life, susceptibility to gaps in supply chain, high transportation costs, and difficulty in dispensing precise quantities. -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. According to the CDC's website, Azithromycin and Erythromycin can be used for cholera in Haiti: http://www.cdc.gov/haiticholera/clinicalmanagement/ MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel *Hand Sanitizer SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets *Well Pumps *Well Water Testing Supplies

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orphanages are looking and asking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby/Toddler Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (Sensitive to Cholera per CDC) Ciprofloxacin (Sensitive to Cholera per CDC) Tetracycline (Sensitive to Cholera per CDC) Azithromycin Erythromycin Per CDC on 10-25-10: This 01 Cholera Strain is RESISTANT to Bactrum and Ampicillan. MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatablets -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (CHLORINE BASED ONLY - IODINE BASED IS NOT EFFECTIVE ON CHOLERA) *Aquatablets

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (Aquatabs, etc.) -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatablets

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (Aquatabs, etc.) -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 cup coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (Aquatabs, etc.)

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets (Aquatabs, etc.)

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ 10/23/10 CDC TRAVELERS ADVICE: http://wwwnc.cdc.gov/travel/content/outbreak-notice/haiti-cholera.aspx -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC/HEALTH CARE WORKERS EDUCATIONAL MATERIALS: WHO GUIDELINES HANDOUT - IF YOU SUSPECT CHOLERA: http://www.who.int/topics/cholera/publications/en/first_steps.pdf Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1 tsp salt 8 tsp sugar 1/2 coconut water It is important that the solution is tasted after it's prepared. It should taste no saltier than tears. It's unlikely that people in Haiti would have actual measuring spoons, so families will need help determining how much "1 tsp" actually is. Mashed banana can be given to patients as young as 4 mos. old if it is possible for the patient to eat. WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizers * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS (NOTE: The listed supplies below are the types of items clinics, hospitals, camps and orgphanages will be looking for. If you are a donor, these are the types of items you'd want to collect to make an impact): * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizer * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizers * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi CARE-CHOLERA & BREASTFEEDING: http://www.ibfanasia.org/ife/CARECholeraandBreastfeeding.pdf ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizers * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizers * Towelettes * Alcohol Swabs * Rectal Swabs * Tape, Tegaderm (Silk works best in humidity) * Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizers * Towelettes * Alcohol Swabs * Rectal Swabs (For surveillance, NOT acute care) * Tape, Tegaderm (Silk works best in humidity) * Non Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizers * Towelettes * Alcohol Swabs * Rectal Swabs * Tape, Tegaderm (Silk works best in humidity) * Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- HAITI CHOLERA UPDATES: HAITI - OPERATIONAL BIOSURVEILLANCE (Maps/Updates/Alerts): http://biosurveillance.typepad.com/haiti_operational_biosurv/ H5N1 - News and Resources about Influenza, Infectious Diseases and Public Health: http://crofsblogs.typepad.com/h5n1/ -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizers * Towelettes * Alcohol Swabs * Rectal Swabs * Tape, Tegaderm (Silk works best in humidity) * Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: *Zinc (Supplementation to decrease volume and duration of Diarrhea) *Sugar *Oral Rehydration Salts *Chlorine (Bleaching Powder) *Ringers Lactate (10-20 litres per patient) *IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles *Foley Catheters (to control Diuresis - urine flow) Lubricators for the Foley Catheters *Gauze *Iodine *Hand Sanitizers *Towelettes *Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: * Zinc (Supplementation to decrease volume and duration of Diarrhea) * Sugar * Oral Rehydration Salts * Chlorine (Bleaching Powder) * Ringers Lactate (10-20 litres per patient) * IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles * IV Start Kits * IV Lines * Foley Catheters (to control Diuresis - urine flow) * Lubricators for the Foley Catheters * Tournequets * Gauze * Iodine * Hand Sanitizers * Towelettes * Alcohol Swabs * Rectal Swabs * Tape, Tegaderm (Silk works best in humidity) * Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: *Zinc (Supplementation to decrease volume and duration of Diarrhea) *Sugar *Salt *Ringers Lactate (10-20 litres per patient) *IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles *Foley Catheters (to control Diuresis - urine flow) Lubricators for the Foley Catheters *Gauze *Iodine *Hand Sanitizers *Towelettes *Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Aquatabs -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS (If IV Fluids aren't available): 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: *Zinc (Supplementation to decrease volume and duration of Diarrhea) *Sugar *Oral Rehydration Salts *Chlorine (Bleaching Powder) *Ringers Lactate (10-20 litres per patient) *IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles *Foley Catheters (to control Diuresis - urine flow) Lubricators for the Foley Catheters *Gauze *Iodine *Hand Sanitizers *Towelettes *Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) *Soap *Antibacterial Gel SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Water Purification Tablets *Aquatabs

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: Zinc (Supplementation to decrease volume and duration of Diarrhea) Sugar Salt Ringers Lactate IV Fluids (Normal Saline - NO DEXTROSE) OTHER SUPPLIES: Adult Diapers Baby Diapers Purified Water Pedialyte Gatorade Sports Drinks -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: *Zinc (Supplementation to decrease volume and duration of Diarrhea) *Sugar *Salt *Ringers Lactate (10-20 litres per patient) *IV Fluids (Normal Saline - NO DEXTROSE) * Intracatheters for IV administration * IV poles *Foley Catheters (to control Diuresis - urine flow) Lubricators for the Foley Catheters *Gauze *Iodine *Hand Sanitizers *Towelettes *Sterile gloves in all sizes OTHER SUPPLIES: *Adult Diapers *Baby Diapers *Pedialyte *Gatorade *Sports Drinks (any fluids that replace Electrolytes) SANITATION SUPPLIES: *Purified Water *Water Purification Equipment *Aquatabs

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: Zinc (Supplementation to decrease volume and duration of Diarrhea) Sugar Salt Ringers Lactate IV Fluids (Normal Saline - NO DEXTROSE) OTHER SUPPLIES: Adult Diapers Baby Diapers Purified Water Pedialyte -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: Zinc (Supplementation to decrease volume and duration of Diarrhea) Sugar Salt Ringers Lactate IV Fluids (Normal Saline - NO DEXTROSE) OTHER SUPPLIES: Adult Diapers Baby Diapers Purified Water Pedialyte Gatorade Sports Drinks

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: Zinc (Supplementation to decrease volume and duration of Diarrhea) Sugar Salt Ringers Lactate IV Fluids -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: Zinc (Supplementation to decrease volume and duration of Diarrhea) Sugar Salt Ringers Lactate IV Fluids (Normal Saline - NO DEXTROSE) OTHER SUPPLIES: Adult Diapers Baby Diapers Purified Water Pedialyte

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: Zinc (Supplementation to decrease volume and duration of Diarrhea) Sugar Salt Ringers Lactate IV Fluids -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- HAITI PUBLIC EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ Cholera Treatment Protocol Developed by MSF and MSPP: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0133f54c266c970b-pi ------------------------------- WASH CLUSTER INTERVENTION IN ARTIBONITE - MAPPED UPDATES: http://biosurveillance.typepad.com/.a/6a01053695fa5c970b0134886c0887970c-pi -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: Zinc (Supplementation to decrease volume and duration of Diarrhea) Sugar Salt Ringers Lactate IV Fluids

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin SUPPLEMENTS: Zinc (Supplementation to decrease volume and duration of Diarrhea) Sugar Salt -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin MEDICAL SUPPLIES/SUPPLEMENTS: Zinc (Supplementation to decrease volume and duration of Diarrhea) Sugar Salt Ringers Lactate IV Fluids

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin SUPPLEMENTS: Zinc (Supplementation to decrease volume and duration of Diarhhea) Sugar Salt -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin SUPPLEMENTS: Zinc (Supplementation to decrease volume and duration of Diarrhea) Sugar Salt

name: CHOLERA: Treatments/Signs & Symptoms/Educational Data - INDEX - 10/10 Cholera Outbreak -> CHOLERA: Treatments/Signs & Symptoms/Educational Data/Supply List - INDEX - 10/10 Cholera Outbreak
notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- EDUCATIONAL MATERIALS: Kreyole Sanitation Handbook/Cholera Prevention Handout: https://www.yousendit.com/transfer.php?action=batch_download&batch_id=ZGJkOU1lZ2pGOFN4dnc9PQ -------------------------------- CHOLERA MEDICAL SUPPLY LIST: NOTE: See details of treatment with the above med's including complications and dosing at: http://sleepydoctor.blogspot.com/ RX: ANTIMETICS: Zofran (Ondansetron) Reglan (Metoclopramide) Compazine (Prochlorperazine) ANTIBIOTICS: Doxycycline (for children over 12 yrs. old) Ciprofloxacin (some evidence of resistance in Africa) Azithromycin Erythromycin SUPPLEMENTS: Zinc (Supplementation to decrease volume and duration of Diarhhea) Sugar Salt

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms SLEEPY DOC's BLOG (This isn't Grey's Anatomy): http://sleepydoctor.blogspot.com/?spref=fb

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS: -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS: MAYO CLINIC - CHOLERA SIGNS (INCLUDES UNIQUE CHILDRENS SIGNS/SYMPTOMS): http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms

name: Cholera Treatments/Signs & Symptoms/Educational Data - INDEX - 10/10 Cholera Outbreak -> CHOLERA: Treatments/Signs & Symptoms/Educational Data - INDEX - 10/10 Cholera Outbreak

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (World Health Organization/U.N.) position paper on Oral Rehydration Salts to reduce mortality from cholera: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS: -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (WORLD HEALTH ORGANIZTION/U.N.) POSITION PAPER ON ORAL REHYDRATION SALTS TO REDUCE MORTALITY FROM CHOLERA: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS:

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy Reduced osmolarity oral rehydration solution for treating cholera: http://www2.cochrane.org/reviews/en/ab003754.html WHO (World Health Organization/U.N.) position paper on Oral Rehydration Salts to reduce mortality from cholera: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS: -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy REDUCED OSMOLARITY ORAL REHYDRATION SOLUTION FOR TREATING CHOLERA: http://www2.cochrane.org/reviews/en/ab003754.html WHO (World Health Organization/U.N.) position paper on Oral Rehydration Salts to reduce mortality from cholera: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS:

name: Cholera Treatments/Signs & Symptoms - 10/10 Cholera Outbreak -> Cholera Treatments/Signs & Symptoms/Educational Data - INDEX - 10/10 Cholera Outbreak

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy Reduced osmolarity oral rehydration solution for treating cholera: http://www2.cochrane.org/reviews/en/ab003754.html WHO (World Health Organization/U.N.) position paper on Oral Rehydration Salts to reduce mortality from cholera: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS: -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- CHOLERA REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy Reduced osmolarity oral rehydration solution for treating cholera: http://www2.cochrane.org/reviews/en/ab003754.html WHO (World Health Organization/U.N.) position paper on Oral Rehydration Salts to reduce mortality from cholera: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS:
areas_served: -> Haiti

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for signs, symptoms and educational information to share with Haiti populations to prevent and treat Cholera. -------------------------------- REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy Reduced osmolarity oral rehydration solution for treating cholera: http://www2.cochrane.org/reviews/en/ab003754.html WHO (World Health Organization/U.N.) position paper on Oral Rehydration Salts to reduce mortality from cholera: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS: -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for Signs, Symptoms, Treatment, and Educational Information to share with Haiti Responders and Haiti populations. -------------------------------- REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy Reduced osmolarity oral rehydration solution for treating cholera: http://www2.cochrane.org/reviews/en/ab003754.html WHO (World Health Organization/U.N.) position paper on Oral Rehydration Salts to reduce mortality from cholera: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS:

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for signs, symptoms and educational information to share with Haiti populations to prevent and treat Cholera. -------------------------------- REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy Reduced osmolarity oral rehydration solution for treating cholera: http://www2.cochrane.org/reviews/en/ab003754.html -------------------------------- -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for signs, symptoms and educational information to share with Haiti populations to prevent and treat Cholera. -------------------------------- REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy Reduced osmolarity oral rehydration solution for treating cholera: http://www2.cochrane.org/reviews/en/ab003754.html WHO (World Health Organization/U.N.) position paper on Oral Rehydration Salts to reduce mortality from cholera: http://www.who.int/cholera/technical/en/index.html -------------------------------- CHOLERA - SIGNS & SYMPTOMS:

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for signs, symptoms and educational information to share with Haiti populations to prevent and treat Cholera. -------------------------------- REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy -------------------------------- -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for signs, symptoms and educational information to share with Haiti populations to prevent and treat Cholera. -------------------------------- REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy Reduced osmolarity oral rehydration solution for treating cholera: http://www2.cochrane.org/reviews/en/ab003754.html --------------------------------

notes: 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for signs, symptoms and educational information to share with Haiti populations to prevent and treat Cholera: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water -------------------------------- Wikipedia: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy -------------------------------- -> 10/10 HAITI CHOLERA OUTBREAK: The following is a list of resources for signs, symptoms and educational information to share with Haiti populations to prevent and treat Cholera. -------------------------------- REHYDRATION RESOURCES: REHYDRATION DRINK/COCKTAIL INGREDIENTS: 1 liter water (purified/boiled) 1/2 tsp salt 8 tsp sugar 1/2 cup mashed banana or coconut water WIKIPEDIA: ORT (Oral Rehydration Therapy: http://en.wikipedia.org/wiki/Oral_rehydration_therapy --------------------------------