JAMAICA: MALARIA UPDATE

C O N F I D E N T I A L KINGSTON 000025 SIPDIS SIPDIS CDC PLEASE PASS FOR PAUL ARGUIN STATE FOR WHA/CAR (RBUDDEN),OES/IHA (DWILUSZ) PORT OF SPAIN FOR CDC (LFITZPATRICK) E.O. 12958: DECL: 01/04/2017 TAGS: SOCI TBIO CASC PGOV AID CDC JM XL SUBJECT: JAMAICA: MALARIA UPDATE REF: A. 06 KINGSTON 2341 ¶B. 06 KINGSTON 2384 Classified By: DCM James T. Heg for reasons 1.5 (b and d) ¶1. (U) Malaria infections (refs A and B) continue to be detected with the latest number of confirmed cases standing at 192 as of January 3. The Ministry of Health (MOH) continues to fog and distribute mosquito netting to at-risk communities. In addition, the MOH has been assisted by USAID which contributed USD 200,000 to the MOH for the purchase of sprayers, foggers, and other equipment. Four Cuban medical doctors have arrived in Jamaica to help with the outbreak. The MOH reported that the number of confirmed cases has fallen to an average of 2 per day (compared to 5-6 per day prior to Christmas). American Citizen Services (ACS) has had no reports of any sickened American; however, they continue to field routine inquiries about travel to Jamaica. Currently, 99 Americans have received the anti-malarial Chloroquine at Post (this number includes direct hires and eligible family members). ¶2. (C) Poloff met with Dr. Ernest Pate, Representative, Pan American Health Organization on January 4 to discuss the ongoing malaria outbreak. Dr. Pate confirmed media reports that the number of cases testing positive has been decreasing. He stated that when the outbreak first started, 12 percent of individuals exhibiting symptoms of malaria tested positive. As of January 3, that number had fallen to 4 percent. Additionally, the average number of new cases had fallen from 5-6 per day to about 2 per day. Dr. Pate reported that all cases of malaria have an epidemiological link to the specific geographical areas reported in refs A and B. The media has reported several cases outside of Kingston; however, medical teams have linked their initial exposure to the impacted areas. Dr. Pate also reported that surveillance has been heightened all over the island and all suspected cases are tested. So far, no individuals have been infected outside the Kingston area although some individuals resides outside Kingston. 3 (C) Dr. Pate believes the Government of Jamaica (GOJ) should be commended on their response to this crisis (although, he also noted that they did not immediately report the first case - ref B). He reported that the MOH has done over 6,000 family interviews (interviewing all relatives and contacts of confirmed cases) and will soon start house-to-house interviewing. He also stated that the GOJ, despite initial hesitation, "ramped up" their response very quickly. Currently, the GOJ is fogging a 2 mile radius extending outwards from each source point of infection. The only constraint on the MOH is resources; however, Dr. Pate noted that the infusion of USD 200,000 from USAID has helped the MOH's program tremendously. (NOTE: According to Dr. Pate, the MOH was the only Ministry in the GOJ to have their budget cut last year. Dr. Pate hopes that the GOJ will re-think their funding priorities in the future. ENDNOTE). ¶4. (C) Dr. Pate told Poloff that he has spoken candidly with the MOH. In particular, he reported to the MOH that "no nation that has previously eradicated malaria has ever been able to eradicate it a second time once it gets a firm foothold." Dr. Pate believes that this fact has mobilized the MOH into quick, aggressive, and relentless action. Dr. Pate stated that if the cases keep falling off for the next 7-10 days, things "look good." Both a Cuban assessment team and the Caribbean Regional Epidemiological Center (CAREC) have undertaken independent analyses of the GOJ's response to the outbreak, and both groups agreed that the GOJ's response has been good. At this time, Dr. Pate is pushing the MOH to release more technical data to public health officials internationally. While he supports the MOH's decision to issue regular press statements and release all data to public health officials, Dr. Pate believes that Jamaica could dramatically improve their world image by adopting a totally transparent approach to this outbreak. This necessarily includes the release of all test results, locations of cases, and other data. For example, the media recently reported a "mini-outbreak" of malaria in one of the remand centers (prisons); however, the technical data shows that the infected inmates were previously in the same region as all other cases. ¶5. (C) COMMENT: Dr. Pate is generally optimistic about the likelihood that this malaria outbreak will be contained shortly. He told Poloff that he expects malaria to be fully-contained long before the Cricket World Cup comes to Jamaica in March. As reported in ref B, the initial case is believed to be a Jamaican who traveled to Haiti to exchange "ganja for guns." That patient claimed to have traveled back and forth no less than 9 times. Travel of this type is often undertaken via a small boat with an outboard motor leaving the dock areas of the harbor. One positive consequence of the malaria outbreak is that the Ministry of National Security has subsequently tightened security in this area in an effort to reduce the number of boats making the trip between Jamaica and Haiti. JOHNSON