Image copyright Getty Images Image caption A 16-year-old boy has developed a rare fast-spreading virus in his toes and has been diagnosed in the UK
Hospital cases of the Dominican Republic’s vibrio vulnificus virus – a diarrheal illness spread by raw shellfish – have surged in recent months.
Sensitivities are high among many Dominicans who are still recovering from the flooding of the 2010 hurricane.
But the problem is not due to the hurricane – although it did bring a temporary increase in the number of cases – but to wastewater effluent from sources such as oil refineries, oil fields and dairy farms.
Dominican government officials say the virus which killed at least three children last year is spreading again this year because of sewage collection failures.
In February, the BBC’s Global Latin America service visited a suburb of Santo Domingo, where residents say the sewage pipe running to an oil refinery failed during the flooding.
Image copyright AFP Image caption The tank was also full of geysers of foul black and yellowish water, some containing a strong smell.
Residents saw the results for themselves on 15 February – when a 15-year-old boy developed a flu-like illness, then a more severe form of the virus known as vibrio vulnificus.
The boy was diagnosed in May in the UK with a potentially fatal severe version of the virus.
What is vibrio vulnificus?
Vibrio vulnificus, which also causes ear infections, is transmitted to humans through eating raw or undercooked shellfish or through exposure to raw or undercooked coastal water.
In addition to the 50-60 cases seen in the Dominican Republic every year, 200-300 cases are reported in neighbouring Haiti each year, the WHO says.
Image copyright Getty Images Image caption A bucket containing contaminated water is moved to a temporary indoor water system in Santo Domingo
Vibrio vulnificus also causes aquaculture illnesses among people whose livelihood depends on catching shrimp or sea croakers.
Recent figures obtained by the BBC suggest 60 new cases of vibrio vulnificus have been reported in Dominica – almost triple the usual number – since April.
That number reflects a wider “epidemic” in the region, according to Dominica’s Health Minister Alrick Ngwenya. He has reported a recorded 325 cases of vibrio vulnificus so far this year.
Image copyright Getty Images Image caption A nurse pours bleach onto a victim in Santo Domingo last year during the outbreak
In the country’s capital of Santo Domingo, cases of the vibrio vulnificus infection have been reported at a rate of 42 a day, the highest since the last outbreak.
Vibrio vulnificus can be contracted even if patients have not eaten raw or undercooked shellfish or had contact with contaminated water.
Confirmed cases can cause up to 36-48 hours of sickness and can lead to kidney failure, while complications can include pneumonias, chest infections and infection of the brain. The toll of people killed by vibrio vulnificus in the region can often top 100 per year.