A mentally ill man who bathed in and drank from a contaminated river most likely was the first person to be infected in the Caribbean country's deadly cholera outbreak, a Boston humanitarian group said Monday.
Partners in Health, which works in Haiti, reported the case Monday in a study it did on the outbreak and published in the American Journal of Tropical Medicine and Hygiene.
Officials say the cholera outbreak that began in 2010 has killed 7,000 people and sickened nearly 500,000. The disease surfaced in Haiti months after a powerful earthquake struck the country two years ago this week.
The humanitarian group's Dr. David Walton, who co-authored the study with Dr. Louise Ivers, said information points to a 28-year-old mentally ill man from the central town of Mirebalais as the first person infected with the waterborne disease.
He said the man's family had access to clean drinking water but his auditory hallucinations and paranoia went without treatment and he bathed in and drank frequently from a river into which the Meye River fed. The Meye has been identified as the likely source of the epidemic.
"It's a striking example of how mental health, infectious disease and community health affects overall well-being," Walton, an internist, said by telephone.
The case serves as a reminder of how mental health services are often an afterthought in health services planning, he added.
The mentally ill man developed acute diarrhea on Oct. 12, 2010, and died at his home without seeking medical attention less than 24 hours later.
He was buried the next day and two people who prepared the body for the wake developed severe diarrhea in less than 48 hours.
The study also points out how globalization can help spread a disease like cholera to other parts of the world. Cholera cases were also found in the neighboring Dominican Republic, Miami and Boston.
Studies suggest the cholera was likely brought to Haiti by a United Nations peacekeeping battalion from Nepal, where the disease is endemic. Haiti now has the highest cholera infection rate in the world, according to Partners in Health.
On Tuesday, Partners in Health's co-founder, Dr. Paul Farmer, and the Haitian government will "inaugurate" the near completion of a 320-bed, national referral and teaching hospital in Mirebalais, 30 miles (48 kilometers) north of Port-au-Prince. It is described as one of the largest projects completed since the earthquake.
The new hospital will offer clinical facilities not previously available at any public hospital in Haiti, which include intensive care units and six operating rooms, Partners in Health said.
The center will also help train future generations of Haitian doctors, nurses and lab technicians. Located in the countryside, the hospital will bring to rural areas the medical services that have long been limited to Port-au-Prince.