Wednesday, April 23, 2008

Dog Meat May Be Spreading Vietnam's Cholera Outbreak

Contaminated dog meat, lax food hygiene practices and the use of human feces as fertilizer may be spreading Vietnam's worst cholera outbreak in at least a decade, health officials said.
Eating dog meat or other food from outlets that serve it is linked to a 20-fold increase in the risk of developing the severe acute watery diarrhea commonly caused by the cholera bacterium, said Jean-Marc Olive, the World Health Organization's representative in Vietnam. Authorities have yet to determine the cause of the outbreak, he said.
``Cholera may become endemic if this continues,'' Olive said by telephone from Hanoi today. Wetter and warmer weather expected in northern Vietnam from August to November may exacerbate the problem, he said.
The disease highlights problems with basic sanitation in Vietnam, where economic growth in excess of 8 percent last year drew people from provinces to the cities. Cholera, rarely seen in industrialized countries for a century, ``remains a global threat to public health,'' the WHO said in an August report.
Cholera, which is treated with fluid and salt replacements and antibiotics, often causes mild or no symptoms. About 20 percent of patients develop profuse watery diarrhea, vomiting and leg cramps. Rapid loss of body fluids can lead to dehydration and shock.
The most recent spate of cases is a fresh wave of an outbreak that started in October, Olive said. Contaminated shrimp sauce caused at least 157 cholera cases in November and December, Vietnam's health ministry said last year.
Human Excrement
Unhygienic practices, including the use of unwashed vegetables from fields fertilized with human excrement, may also be fueling the spread, Olive said. Vietnam's government banned human feces as fertilizer in 1994, a government spokesman said.
Since March 5, 2,490 cases of severe acute watery diarrhea have been reported, mostly in the capital, Hanoi, the WHO said in an April 22 statement on its Web site. Of those, 377 patients tested positive for cholera. None one of the cases was fatal.
In Hanoi, more than 1,000 cases of acute diarrhea have been recorded, the most in half a century, said Nguyen Huy Nga, director of the health ministry's Preventive Medicine Department.
``The cause of the acute diarrhea is a mystery,'' Nga said in a telephone interview today. Uncooked vegetables, dog meat and shrimp sauce were the most likely causes, he said.
Health ministry inspectors shut 63 out of 100 shops selling dog meat in Hanoi and neighboring Ha Dong city last week, Vietnam News reported today, without saying where it got the information.
Shrimp Sauce
Four of five restaurants serving dog meat on Hanoi's Nhat Tan Street, the city's so-called ``dog-meat street,'' were closed after inspectors found dirty chopping boards, unwashed vegetables and shrimp sauce in dirty containers, the report said. In Ha Dong city, 23 dog butchers whose clients are mainly in Hanoi were shut down.
More closures are expected, today's Vietnam News report quoted Tran Dang, director of the food hygiene and safety department, as saying.
To curb the spread, the ministry is stressing better food hygiene and sanitation, water sterilization and isolating patients, Nga said.
Some Vietnamese believe that consuming dog and duck meat in the second half of the lunar month will ward off bad luck. Today is the 18th day of the third lunar month.
To contact the reporters on this story: Simeon Bennett in Singapore at
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