The cholera epidemic in Haiti has begun reaching out along the southern peninsula of Haiti. Reports now confirm cholera as far west as Petit Goâve, Ouest. The disease has also been spotted along the border with the Dominican Republic in the Nord-Est department. Grand'Anse, Nippes and Sud are the only departments that have not yet reported cholera. These are also the departments that were the furthest from the original outbreak in Artibonite and those that had some of the worst flooding from Tomas.
Thus far, all reports that I have seen that show the disease in the Port-au-Prince area have limited it to the largest slum. However, limited water availability throughout the city may facilitate its spread into other parts of the capital.
The Dominican Republic is trying to control of people crossing the border, especially those crossing from the Nort-Est department of Haiti. However, the border remains open and illegal crossings of the border continue despite the attempted crack down. Standing water remains a problem on the Dominican Republic side of the border, especially in Monte Christi, Puerto Plata, Valverde, Santiago, Santiago Rodríguez, Dajabón, Elías Piña and San Juan provinces. With all of the standing water, conditions are ripe for the spread of water-borne diseases.
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