Outbreak Notice
Cholera in the Dominican Republic

This information is current as of today, February 16, 2013 at 09:03 EST

Updated: January 16, 2013

What is the Current Situation?

An outbreak of cholera has been ongoing in the Dominican Republic since November 2010. According to the Dominican Ministry of Health (Ministerio de Salud Publica y Asistencia Social [MSP]), as of December 16, 2012, 7,766 suspected cholera cases and 62 suspected cholera-related deaths have been reported for 2012.

What is Cholera?

Cholera is a bacterial disease that can cause diarrhea and dehydration. Cholera is most often spread through the ingestion of contaminated food or drinking water. Water may be contaminated by the feces of an infected person or by untreated sewage. Food is often contaminated by water containing cholera bacteria or by being handled by a person ill with cholera.

How can Travelers Protect themselves?

Most travelers are not at high risk for getting cholera, but people who are traveling to the Dominican Republic should exercise caution to avoid getting sick.

CDC recommends that all travelers prepare a travel health kit when going abroad. If you are planning travel to the Dominican Republic, CDC advises packing the following supplies in your travel health kit to help prevent cholera and to treat it.

A prescription antibiotic to take in case of diarrhea
Water purification tablets*
Oral rehydration salts*

*In the United States, these products can be purchased at stores that sell equipment for camping or other outdoor activities.

Although no cholera vaccine is available in the United States, travelers can prevent cholera by following these 5 basic steps:

1) Drink and use safe water*

Bottled water with unbroken seals and canned/bottled carbonated beverages are safe to drink and use.
Use safe water to brush your teeth, wash and prepare food, and make ice.
Clean food preparation areas and kitchenware with soap and safe water and let dry completely before reuse.

*Piped water sources, drinks sold in cups or bags, or ice may not be safe. All drinking water and water used to make ice should be boiled or treated with chlorine.

To be sure water is safe to drink and use:

Boil it or treat it with water purification tablets, a chlorine product, or household bleach.
Bring your water to a complete boil for at least 1 minute.
To treat your water, use water purification tablets, if you brought some with you from the United States, or one of the locally available treatment products, and follow the instructions.
If a chlorine treatment product is not available, you can treat your water with household bleach. Add 8 drops of household bleach for every 1 gallon of water (or 2 drops of household bleach for every 1 liter of water) and wait 30 minutes before drinking.
Always store your treated water in a clean, covered container.

2) Wash your hands often with soap and safe water*

Before you eat or prepare food
Before feeding your children
After using the latrine or toilet
After cleaning your child’s bottom
After taking care of someone ill with diarrhea

* If no soap is available, use an alcohol-based hand cleaner (containing at least 60% alcohol).

3) Use toilets; do not defecate in any body of water

Use toilets, latrines, or other sanitation systems, like chemical toilets, to dispose of feces.
Wash hands with soap and safe water after using toilets or latrines.
Clean toilets and surfaces contaminated with feces using a solution of 1 part household bleach to 9 parts water.

4) Cook food well (especially seafood), keep it covered, eat it hot, and peel fruits and vegetables*

Boil it, cook it, peel it, or leave it.
Be sure to cook shellfish (like crabs and crayfish) until they are very hot all the way through.
Do not bring perishable seafood back to the United States.

*Avoid raw foods other than fruits and vegetables you have peeled yourself.

5) Clean up safely—in the kitchen and in places where the family bathes and washes clothes

Wash yourself, your children, diapers, and clothes at least 30 meters away from drinking water sources.

Before departing for the Dominican Republic, talk to your doctor about getting a prescription for an antibiotic. If you get sick with diarrhea while you are in the Dominican Republic, you can take the antibiotic, as prescribed. Also, remember to drink fluids and use oral rehydration salts (ORS) to prevent dehydration.

If you have severe watery diarrhea, seek medical care right away.