MALARIA OUTBREAK IN THE BAHAMAS

UNCLAS NASSAU 000940 SIPDIS SIPDIS STATE FOR WHA/CAR WBENT, CA/OCS/ACS SCRAWFORD E.O. 12958: N/A TAGS: TBIO CASC PREL BF SUBJECT: MALARIA OUTBREAK IN THE BAHAMAS REF: NASSAU 616 ¶1. SUMMARY: As of June 14, 2005, The Bahamas Ministry of Health and the Centers for Disease Control have confirmed 16 cases of malaria on Great Exuma Island, approximately 120 miles from Nassau. An American tourist who visited Exuma has now contracted Malaria. All confirmed cases appear to have been contracted on Great Exuma. Health experts speculate that malaria, which had been eradicated in The Bahamas, was carried from Haiti by migrants. Following initial openness regarding the outbreak, the Ministry of Health has been more cautious and even to withhold information to minimize potential impact to The Bahamas' vital tourism industry. END SUMMARY. Malaria Outbreak on Great Exuma Island -------------- ¶2. According to Dr. Baldwin Carey, Director of Public Health for the Bahamas Ministry of Health, as of June 14, the Ministry of Health had confirmed 15 cases of plasmodium falciparum, malaria, on Great Exuma Island. Dr. Carey confirmed that the infected persons had not traveled outside of Exuma, stating that the transmission appeared to occur on Exuma between May 24-30. Apart from these 15 locally confirmed cases, Dr. Phuc Nguyen-Dinh of the Division of Parasitic Diseases for the Centers for Disease Control reports that an American tourist visited Exuma May 4-7 and developed malaria after his return to Virginia. The tourist had not visited any other malaria endemic regions. Unconfirmed, unscientific local reports on June 16 place the number of infected persons as high as 52. ¶3. Dr. Carey reports that the Ministry of Health is taking necessary measures to contain the outbreak, including widespread testing, treatment, insecticide spraying, larviciding, source reduction and malaria education. The Ministry of Health is receiving technical assistance from WHO/PAHO and the Caribbean Epidemiology Center has been in contact with the Centers for Disease Control. CDC and Embassy to Issue Notices -------------- ¶4. Great Exuma Island, located approximately 120 miles from Nassau, is home to approximately 3,500 persons and major tourist areas, including a Four Seasons Resort and other hotels frequented by American tourists. It is also located along a common migration route for persons traveling from Haiti to The Bahamas and to Florida. Dr. Carey and Dr. Nguyen-Dinh expressed concern that the source of the infection could be immigrant workers from Haiti, where malaria is endemic and seepage of infection along migration routes is not uncommon. ¶5. The CDC has said it will issue a notice recommending prophylaxis with chloroquine for travelers to Exuma. Post is provding prophylaxis to employees who travel to Exuma, and will issue a warden message regarding the outbreak when cleared by CA. Ministry of Health Does About-Face -------------- ¶6. Following initial openness with Post, CDC and local media about the outbreak, inquiries have now been directed away from Dr. Carey to Dr. Dahl-Regis, a political appointee serving as Chief Medical Officer for The Bahamas. Contrary to confirmed reports, Dr. Dahl-Regis has now asserted no malaria transmission on Exuma, has claimed that the Virginia tourist must have traveled somewhere else, and said that all other cases must have been contracted in Haiti. Anthony Moss, the Member of Parliament from Exuma, has repeated these denials, including a denial of use of insecticide in Exuma. ¶7. COMMENT: There is no current threat to Nassau, and prospects for containing the outbreak to Great Exuma appear good. The initial openness of the Ministry of Health, and its strong public health response, were encouraging. However, concerns regarding the impact of an outbreak on tourism have driven the subsequent reversal in cooperation. This suppression of response to a potential public health issue was also seen recently in The Bahamas' response to a bird flu scare (reftel). END COMMENT. HARDT