In March, the U.S. Centers for Disease Control and Prevention said cholera was “extremely unlikely to occur” in Haiti. There were no cholera bacteria there. Most foreigners were relief workers with good sanitation who come from countries where cholera is not an issue.
Then it did happen. There are now more than 1,700 dead; experts say hundreds of thousands will fall ill as the disease ravages Haiti for years.
Even more surprisingly, it did not first appear in a major port, an earthquake tent camp or an area where foreigners are concentrated, but instead along the rural Artibonite River.
Speculation keeps returning to that river and a base home to 454 U.N. peacekeepers from Nepal. They are on the edge on a babbling waterway called the Boukan Kanni, part of the Meille River that feeds into the Artibonite.
Residence living nearby has long complained about the stink in the back of the base and sewage in the river. Before the outbreak began they had stopped drinking from that section of the river, depending instead on a source farther up the mountain.
The latest Nepalese deployment came in October, after a summer of cholera outbreaks in Nepal. The changeover at the base, which guards the area south of the central plateau town of Mirebalais, was done in three shifts on Oct. 9, 12 and 16.
The U.N. says none of the peacekeepers showed symptoms of the disease. But 75 percent of people infected with cholera never show symptoms but can still pass on the disease for two weeks – especially in countries like Nepal where people have developed immunity.
The CDC has said the strain of cholera in Haiti matches one found most prevalently in South Asia.
“It very much likely did come either with peacekeepers or other relief personnel,” said John Mekalanos, Harvard University microbiology chair. “I don’t see there is any way to avoid the conclusion that an unfortunate and presumably accidental introduction of the organism occurred.”