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