Scientists: UN Soldiers Brought Deadly Superbug to Americas

Scientists: UN Soldiers Brought Deadly Superbug to Americas
http://abcnews.go.com/Blotter/scientists-soldiers-brought-deadly-superbug-am
ericas/story?id=15341129&singlePage=true#.Tw8aecmF-fY

By MATTHEW MOSK, BRIAN ROSS (@brianross) and RYM MOMTAZ
Jan. 12, 2012
Compelling new scientific evidence suggests United Nations peacekeepers have
carried a virulent strain of cholera -- a super bug -- into the Western
Hemisphere for the first time.

The vicious form of cholera has already killed 7,000 people in Haiti, where
it surfaced in a remote village in October 2010. Leading researchers from
Harvard Medical School and elsewhere told ABC News that, despite UN denials,
there is now a mountain of evidence suggesting the strain originated in
Nepal, and was carried to Haiti by Nepalese soldiers who came to Haiti to
serve as UN peacekeepers after the earthquake that ravaged the country on
Jan. 12, 2010 -- two years ago today. Haiti had never seen a case of cholera
until the arrival of the peacekeepers, who allegedly failed to maintain
sanitary conditions at their base.

"What scares me is that the strain from South Asia has been recognized as
more virulent, more capable of causing severe disease, and more
transmissible," said John Mekalanos, who chairs the Department of
Microbiology and Molecular Genetics at Harvard Medical School. "These
strains are nasty. So far there has been no secondary outbreak. But Haiti
now represents a foothold for a particularly dangerous variety of this
deadly disease."

More than 500,000 Haitians have been infected, and Mekalanos said a handful
of victims who contracted cholera in Haiti have now turned up in Venezuela,
the Dominican Republic, and in Boston, Miami and New York, but only in
isolated cases.

How cholera landed in Haiti has been a politically charged topic for more
than a year now, with the United Nations repeatedly refusing to acknowledge
any role in the outbreak despite mounting evidence that international
peacekeepers were the most likely culprits. The UN has already faced
hostility from Haitians who believe peacekeeping troops have abused local
residents without consequence. They now face legal action from relatives of
victims who have petitioned the UN for restitution. And the cholera charge
could further hamper the UN's ability to work effectively there, two years
after the country was hobbled by the earthquake.

Over the summer, Assistant Secretary General Anthony Banbury told ABC News
that the UN sincerely wanted to know if it played a part in the outbreak,
but independent efforts to answer that question had not succeeded. He said
the disease could have just as easily been carried by a backpacker or
civilian aid worker.

Banbury said the UN, through both its peacekeeping mission and its civilian
organizations "are working very hard ... to combat the spread of the disease
and bring assistance to the people. And that's what's important now."

"The scientists say it can't be determined for certainty where it came
from," Banbury said. "So we don't know if it was the U.N. troops or not.
That's the bottom line."

A UN spokeswoman repeated the answer when asked again last week: "The
[scientists] determined it was not possible to be conclusive about how
cholera was introduced into Haiti," said the UN's Anayansi Lopez.

Scientists Trace Cholera Superbug to UN Peacekeepers

But ABC News has interviewed several top scientists involved in researching
the origins of the cholera outbreak, and each expressed little doubt that
the UN troop was responsible. The reason: A genetic analysis of the strain
found in Haiti matches identically the one involved in an outbreak in Nepal
in August and September of 2010; The Nepalese peacekeeping troops deployed
for Haiti at precisely that time; Two weeks before the outbreak, Haitians
had reported sanitary breakdowns at the Nepalese encampment set along a
tributary to the Artibonite River, about 60 miles north of the capital Port
Au Prince. The next month, the earliest cases of cholera surfaced in the
same remote area, from Haitians who had been drinking and bathing in the
river.

"The scientific debate on the origin of cholera in Haiti existed, but it has
been resolved by the accumulation of evidence that unfortunately leave no
doubt about the implication of the Nepalese contingent of the UN
peacekeeping mission in Haiti," said French epidemiologist Renaud Piarroux,
who conducted research on the outbreak for the Centers for Disease Control.

Mekalanos agreed, saying the single strongest piece of evidence came from
the genetic analysis of the strain, which he said was virtually identical to
strains that caused cholera in Nepal around the time that the troops shipped
out. Taken in concert with sanitation problems at the Nepalese base, which
was located near the epicenter of the outbreak, he said "almost any other
explanation I can think of is well behind in confidence to the likelihood
that that strain was introduced by UN troops," he said.

"It's outrageous for the UN to try to deny responsibility for bringing
cholera to Haiti," said Mark Weisbrot, co-director of the Washington-based
Center for Economic and Policy Research, whose group has been monitoring
relief efforts in Haiti. "Was it gross negligence on their part? This is one
of the questions they won't have to answer if they can sweep this whole
thing under the rug."

Experts said understanding the origin of the outbreak is important. Louise
C. Ivers, an infectious disease specialist and professor of global health
and social medicine at Harvard Medical School, published a paper this week
that traced spread of cholera back to the first victim, a mentally ill man
who ingested contaminated river water. She witnessed firsthand the
destruction it caused as hundreds of villagers started dying from an
unfamiliar malady.

"It was overwhelming," she said. "There were no reported cases in Haiti
before 2010, ever. Really people had no idea what was happening. To hear the
fear and the suspicions and the lack of understanding about how this was
happening is very, very sad. The outbreak put a huge stress on what was
already a very fragile health system. I'm afraid it will be a problem for
the foreseeable future."

She said what has made Haiti so vulnerable was a lack of latrines and clean
potable water. She said there have been small outbreaks in the Dominican
Republic, but nothing on the scale of what hit Haiti because conditions are
more modern and sanitary.

Mekalanos said there are steps that the UN and other aid organizations can
and should be taking if they are sending workers from an area where cholera
is active into a region where it has long been absent. In the future, he
said, the UN might consider giving troops a prophylactic dose of antibiotic
before deploying. Or they could do more to insure proper sanitary conditions
at UN encampments.

With the likelihood that cholera will be part of the landscape in Haiti for
decades to come, though, Mekalanos said his hope is that the missteps that
brought the ugly strain of the disease from Asia to the west will not repeat
and lead to its further spread.

"Cholera is a disease of the impoverished," he said. "When the standards of
living are already at the lowest levels, cholera is a killer of historic
proportions. If it spreads to other parts of the world, in those kinds of
settings, I fear there will be a very high rate of death."

UN officials said Banbury is currently in Haiti, "actively discussing with
the Mission what more the UN can do to help Haiti deal with the outbreak."

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