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Jonathan Katz comments on UN cholera-denial stories
Submitted by CHAN on June 28, 2012 - 08:39
New (non-UN) cholera evidence?
By Jonathan Katz, former AP reporter in Haiti 2007-11, published on his blog, June 20, 2012 (see original story posting for full reference links)
NPR’s Richard Knox reports (June 18) on a new wrinkle in the story of how cholera got to Haiti. A team based in Maryland has published a study that found 21 percent of cholera patients in Haiti were infected with a non-Nepalese strain of the disease.
Dr. Rita Colwell says her team’s findings support a hypothesis that the epidemic was caused, at least in part, by environmental factors other than UN soldiers recently arrived from an outbreak in Nepal leaking excrement into a river. For corroboration, NPR’s Knox goes to Dr. David Sack at Johns Hopkins, who agrees the new study casts doubt on the “UN” hypothesis. Sack concludes we will probably never know where the epidemic, which has now killed some 7,500 people and infected more than half a million, came from.
A few thoughts:
1. Colwell and Sack have been arguing for an environmental cause of cholera since the first week of the epidemic in October 2010. After the UN evidence came to light, they have reliably pooh-poohed the UN-cholera connection. In fact, when the UN mission in Haiti started searching for answers in late 2010 and wanted someone to present a hypothesis that something other than the Nepalese soldiers were responsible for the outbreak, my sources inside the mission confirmed at the time, they called in David Sack.
You can make a similar argument against the big names backing the currently dominant hypothesis as well. Whenever you ask French epidemiologist Renaud Piarroux, he is likely to tell you that all the important evidence supports the UN being responsible for the outbreak. Piarroux being convinced by non-UN evidence, or Sack being persuaded that the UN was responsible, would be far more notable. (Disclosure: I try to keep an open mind, but you could probably say the same thing about me.)
2. According to Knox, the Colwell team’s findings don’t actually dispute that Nepalese cholera was a cause of the epidemic — just that it was the only cause. In fact, the study found the Nepalese strain in more than half of samples taken. Additionally, NPR says the non-Nepalese strain “has never been known to cause an epidemic.” To my untrained eye, that would seem to weaken the case for this other strain’s importance, but I don’t know. (Side note: According to the numbers in the NPR piece, only about 78 percent of the samples are accounted for: Half Nepalese, 21 percent non-Nepalese, 7 percent mixed. What happened to the other 22 percent? Maybe that’s in the full journal article, which I’ve reached out to Colwell to get.)
3. It’s not clear from the NPR piece when these samples were taken. That’s important, because we know that cholera can and does evolve once it has been introduced.
4. Some key parts of Colwell’s “perfect storm” hypothesis don’t make sense to me. She says, “You have this massive earthquake in January 2010 … Then Haiti had one of the hottest summers on record … That was followed by a hurricane that skirted Haiti, causing heavy rain and flooding … With all the river systems churned up with nutrients and warm water, and proper alkalinity, it would be ideal for the organism to become quite dominant.”
Hurricane Tomas hit on November 5, 2010, three and a half weeks after the epidemic began. At that point more than 500 people were known to have died and at least 7,000 had been infected — both likely undercounts. Tomas skirted the far edge of Haiti’s peninsulas, missing the region where the outbreak occurred. The storm made headlines in the states but didn’t actually cause all that much damage in Haiti. In fact, articles at the time noted that it was not clear if the storm was having an effect on cholera at all.
The earthquake, meanwhile, struck ten months before and was over 50 miles from the outbreak zone, which is probably why Colwell was quoted at the time in a Richard Knox article titled “Earthquake not to blame for cholera outbreak in Haiti.”
Neither the hurricane nor the earthquake explain how “01 serotype with close resemblance to the Nepalese strain” ended up in Haiti, whether as the whole of the early epidemic or “in about half the patients sampled.”
5. All that said, I agree with Colwell and Sack that the evidence to date against the UN peacekeepers has been largely circumstantial, if also overwhelming. I discuss this in my upcoming book, which you will please be sure to buy.
6. Watch this closely going forward. The UN peacekeepers have been referring to heretofore unspecified evidence for other hypotheses since they were first fingered as the cause of the outbreak. Considering the UN is now facing a lawsuit on behalf of cholera victims that has gotten recent support on the editorial pages of the New York Times and Washington Post, I’d expect to hear more about the Colwell article being cited as counter-evidence in the weeks and months to come.
Forthcoming: Jonathan Katz, The Big Truck That Went By: How the World Came to Save Haiti and Left Behind a Disaster, (to be published by Palgrave Macmillan)
An upcoming book about Haiti, the earthquake and what came after. Winner of the 2012 J. Anthony Lukas Work-in-Progress Award from Columbia and Harvard Universities. The J. Anthony Lukas Work-in-Progress Award is given to aid the completion of a significant work of nonfiction by helping to close the gap between the time and money the author has and what is required to finish the book. The judges said: “Katz is a great storyteller who enmeshes the reader in a lively web of history, incident, and examples of humanity pushing through disaster, hard luck, iniquity, and triumph to muck it up all over again.”
Katz was the Associated Press chief correspondent in Haiti from 2007 to 2011. The only full-time American reporter stationed there during the January 12, 2012, earthquake, he stayed on to cover the aftermath and stalled recovery that followed. Later that year, he broke the story that poor sanitation at a U.N. base was the likely source of a cholera epidemic that has since infected over 500,00 people.