JAMAICA: MALARIAL OUTBREAK UPDATE

C O N F I D E N T I A L KINGSTON 002384

SIPDIS

SIPDIS

STATE PLEASE PASS FOR WHA/CAR (RBUDDEN),OES/IHA (DWILUSZ)
PORT OF SPAIN PLEASE PASS FOR CDC (LFITZPATRICK)

E.O. 12958: DECL: 12/08/2016
TAGS: SOCI TBIO CASC PGOV AID CDC JM XL
SUBJECT: JAMAICA: MALARIAL OUTBREAK UPDATE

REF: KINGSTON 2314

Classified By: CDA James T. Heg for reasons 1.5 (b) and (d)


1. (C) Summary: The Jamaican malaria outbreak (reftel) will
likely get worse before it gets better, according to Pan
American Health Organization (PAHO) Country Director Dr.
Ernest Pate. In private discussions with Embassy officials
on December 8, Pate said that there are 53 confirmed cases,
but that there are some 750 people exhibiting symptoms
"consistent with the disease." The strain, transmitted by
the Anopheles mosquito, is Plasmodium falciparum (P.f.),the
most virulent strain of malaria. This strain is common in
Haiti, which is believed to be the source for this outbreak.
The Jamaican Ministry of Health (MOH) revealed that they had
confirmed the first case of malaria as far back as early
November, but had not alerted anyone. Pate also revealed
that the GOJ has underestimated the geographical expansion of
the outbreak. Nevertheless, despite the GOJ's failings, he
stated that it seemed that they had now recognized the scale
of the problem and were making strides. He further noted
that P.f. has a longer incubation period, so that they had a
"window of opportunity" to prevent further spread of the
disease. End summary.


2. (C) At a meeting on December 8, the Director of the
Pan-American Health Organization (PAHO) in Jamaica, Dr.
Ernest Pate, told Embassy officials that the malaria outbreak
(reftel) on the island would certainly get worse before it
gets better. He stated that there were 53 confirmed cases as
of December 7, but that there were some 750 people exhibiting
symptoms "consistent with the disease." Jamaica currently
lacks the ability to comprehensively test those numbers;
consequently, there is a current backlog of approximately 500
slides awaiting testing. At a reception on December 7, Pate
told econoff that the tests had been coming back positive
"about 20 to 25 percent of the time."


3. (C) Pate confirmed that the strain, transmitted by the
Anopheles mosquito, was Plasmodium falciparum (P.f.),the
most virulent strain of malaria. This strain is common in
Haiti, which is believed to be the source for this outbreak.
Pate stated that he had interviewed two of the index cases
personally, and that one had told him that he made regular
runs between Jamaica and Haiti, taking local marijuana for
sale there, and using the proceeds to buy guns, which were
then smuggled back into Jamaica. Pate also noted, however,
that Nigerian nurses here to work were also known to be
carriers and thus it was difficult to be conclusive about the
origin.


4. (C) He said that the Jamaican response was extremely slow
at first. He claimed that officials at the Ministry of
Health (MOH) revealed that they had confirmed the first case
of malaria as far back as November 2nd, but had not alerted
anyone; nor had they heightened their alert system. Pate
believed that this "ostrich mentality" arose from fears that
the tourism industry would suffer.


5. (C) Pate also revealed that the GOJ was reluctant to
acknowledge the geographical expansion of the outbreak.
While the government is characterizing a tightly localized
situation, in reality the highly mobile nature of the
Jamaican population means that the potential spread is
island-wide. No cases have been reported on the
tourist-heavy North and West coasts, but Pate believes it is
just a matter of time. He further stated that PAHO
scientists performed dip-tests along a wide swath of drainage
canal in Kingston and registered results positive for P.
falciparum at 348 of 350 sites. He noted that the prevalence
was in Kingston districts 12, 13 and 14 ) approximating
Trench Town and Tivoli Gardens.


6. (SBU) On a positive note, despite the GOJ's failings, he
stated that it seemed that they had recognized the scale of
the problem and were making strides. Pyrethroid insecticide
and fogging are being used extensively, with aerial mapping
of problem areas by helicopter and satellite. PAHO has
sourced 100,000 doses of Chloroquine and Primaquine for
treatment. He noted that human resource capacity was a major
problem and that the MOH needed lab technicians experienced
in reading malarial slides. Mission's USAID Director Karen
Turner said she would contact relevant USG entities for
assistance.


7. (U) He further noted that P. falciparum has a longer
incubation period, so that they had a "window of opportunity"
to prevent further spread of the disease. Approximately 40
six-man teams from the MOH were going house-to-house in
affected areas to inquire about symptoms, to educate, to
apply vector control measures, and to identify travelers.
This effort has been largely successful in mapping possible
future problem areas.

Comment


8. (C) Post expects this outbreak to continue to spread for
the near and medium term. The worst-case scenario of 25
percent positive of the 750 possibles outlined by Pate means
a minimum of approximately 240 cases (adding in the 53
confirmed). Furthermore, with up to a fourteen-day
incubation period in humans, there could well be hundreds
more people who have yet to show symptoms. Pate seemed
optimistic that if the GOJ continues to be as aggressive as
possible, that the outbreak can be brought under control.
Since the outbreak became public, the GOJ has shown signs of
taking it as seriously as it should. Post worries, however,
that the GOJ's response will continue to be affected by
concerns over alarming the tourist market.
HEG