April 2011 - Centre for Civil Society - University of KwaZulu-Natal

Experts such as Harvard’s Waldor agree. “This strain [in Haiti] came from
very, very far away,” Waldor says. He was part of a team that found
genetic similarities between the strain of cholera in Haiti and ones in
South Asia. “If you have the same genomic sequence in two different
places like continents, the most likely explanation is that human beings
brought one strain to the next,” Waldor says. “That goes back hundreds of
years in the history of cholera. Ships from one part of Asia brought it
elsewhere... It was spread by humans.”
Colwell doesn’t think so. “To ascribe outbreaks solely to introductions
externally is not what modern ecological data tell us,” she says. “The data
we’re gathering for the last 40 years show that these bacteria are part of a
natural aquatic environment, and the molecular genetic evidence now
accumulating is pretty convincing that the outbreaks are local. You can
have it introduced, but the big outbreaks are generally local.”
In Haiti, Colwell says, the earthquake washed silt and limestone into the
river system, creating the nutrient-rich, alkaline conditions that cholera
vibrios thrive in, just as an extremely warm summer set in. Rising
concentrations of cholera bacteria coincided with an explosion of
malnourished refugees with little access to treated water. It’s a series of
events that has triggered cholera outbreaks before, she says.
Colwell points out that the genetic analysis of the strain in Haiti is
complicated by the fact that cholera vibrio are genetic rogues, with many
mobile elements in their genomes, and the Haiti strain, while genetically
similar to a South Asian strain, is also similar to one found in East Africa.
According to Colwell, more research will be required to unravel the true
origins of Haiti’s cholera. The trouble is that the very idea of
environmentally driven outbreaks “is resisted by the medical community,”
she says. “But this is new data. And it is typical, when you produce a new
hypothesis, it takes years for acceptance.”
“Physicians are not trained in ecology,” says Colwell, who has taught in
medical schools. And yet, “in the twenty-first century of emerging disease,
the source is the environment, and animals in the environment...
Epidemiology really needs to take into account the ecology of microbial
systems.”
That’s not to say that the old truths don’t still hold true. “This is a disease
of poverty,” says Islam. The solution, he says, is simple: Clean drinking
water, good sanitation, and vaccines prevent the disease, and prompt
rehydration treatment and antibiotics cure it.
But with the environment changing, the disease on the move, and poverty
still entrenched in many parts of the world, “cholera cannot be defeated
by medicine alone,” he adds. “We need a new approach.”
www.zcommunications.org
Letter from Israel: Some comments on the situation in Egypt
Mordechai Peargut 24 February 2011
We received this letter which gives a taste of how the events in Egypt are
viewed in Israel. It also explains that faced with the threat of a general
strike called by the Histadrut, Netanyahu, once he had seen the events in
Egypt, very quickly stepped in and made some significant concessions to