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