|Event:|| EP Epidemic|
|Country:|| DOM Dominican Republic|
|Date (YMD):|| 2018-9-7|
|Comments:|| At the beginning of July 2018 (epidemiological week 27), the Ministry of Public Health and Epidemiology reported that the Los Pinos Health Centre (La Descubierta, Independencia) was seeing an increase in the number of patients presenting with vomiting and diarrhea from surrounding communities, which were suspected to be cases of cholera. Reports of suspected cases of cholera continued in neighboring communities, including Los Bolos, Guayabal and La Descubierta (chief of the municipality). As of 11 August 2018, 65 suspected cases of cholera have been reported (3 confirmed) in Angel Feliz (26), Los Pinos de Edén (34), La Descubierta urban area (6) and Los Bolos (2).
There are multiple factors that contribute to an increased risk of acute diarrheal diseases and the spread of cholera in the affected region, including poor hygiene practices, the use of unsafe water sources for drinking and food preparation, lack of access to health services due to the affected area's remote geographical location (it can take up to eight hours to reach the affected area), community resistance to treatment and lack of financial resources for families to access health care.
In addition, the communities in the upper area of the Sierra de Bahoruco's geographic location, which is adjacent to Haiti in the northern section of the Dominican Republic, has been affected by recurrent outbreaks of diarrheal diseases, thus putting the surrounding area at constant risk. The area's high vulnerability can be attributed to the regular passage of large numbers of people between Haiti and the Dominican Republic; this highly mobile population often does not seek care in the Dominican Republic before returning to Haiti (due to cultural and family ties), which could mean that the number of cases in the in the affected area exceeds current estimates.|