LEPTOSPIROSIS OUTBREAK WIDENS FOLLOWING TROPICAL

UNCLAS SANTO DOMINGO 002601

SIPDIS

SIPDIS

E.O. 12958: N/A
TAGS: TBIO AMED PGOV CDC DR
SUBJECT: LEPTOSPIROSIS OUTBREAK WIDENS FOLLOWING TROPICAL
STORM NOEL


1. Summary. Extensive rains and flooding from Tropical Storm
Noel have resulted in an outbreak of leptospirosis in the
Dominican Republic that has caused the deaths of at least 29
people. As many as 300 cases are suspected across the
country according to news reports, with over 291 confirmed as
of November 21. Dominican Ministry of Health (MOH) officials
have concluded a diagnosis and treatment algorithm to be
printed and posted in all emergency sites, and the Ministries
of Environment, Health and Agriculture are establishing a
plan so adequate measures are taken to stop the outbreak.
USAID has been in contact with the MoH and with the Pan
American Health Organization (PAHO) and offered to contact
the CDC to bring in an epidemiologist and a zoonosis expert.
Although PAHO considered that this support was needed, to
date no formal request has come from the MoH. End Summary.


2. Extensive rains and flooding from Tropical Storm Noel
have resulted in an outbreak of leptospirosis in the
Dominican Republic over the past two weeks that the press is
calling an epidemic. Approximately 300 new cases of
leptospirosis have been reported, although not all confirmed,
since the passage of Noel, resulting in the deaths of at
least 29 people. This recent outbreak also means that the
annual figure of Leptospirosis cases will significantly
exceed last year,s number. This outbreak adds to the
Dominican Republic,s ongoing battle to contain dengue fever
and is putting considerable strain on the health services
infrastructure in the country.


3. Leptospirosis is a bacterial disease that affects humans
and animals. In humans it causes a wide range of symptoms,
including high fever, severe headache, chills, muscle aches,
and vomiting, and may include jaundice, red eyes, abdominal
pain, diarrhea or a rash. If the disease is not treated, the
patient could develop kidney damage, meningitis, liver
failure, and respiratory distress and in rare cases death.
Leptospirosis is usually caused by exposure to water
contaminated with the urine of infected animals, like rats,
pigs, cattle, horses, dogs and wild animals. Humans become
infected through contact with water, food, or soil containing
urine from these infected animals.


4. To deal with this outbreak, MOH officials have concluded
a diagnosis and treatment algorithm to be printed and posted
in all emergency sites. The algorithm is intended to assure
that adequate treatment is given to limit fatalities. In
addition, the Ministries of Environment, Health and
Agriculture are establishing a plan so adequate measures are
taken to stop the outbreak.


5. USAID,s Health and Population technical team has been in
regular communication with officials at both the MOH and the
Pan American Health Organization (PAHO). USAID has offered
to contact CDC to bring in an epidemiologist and a zoonosis
expert. Although PAHO considered that this support was
needed, to date no formal request has come from the MoH. In
the meantime, PAHO has brought in Dr. Raymond Dougas, a
zoonosis expert, who works under the PAHO-CDC agreement in
Guatemala. He arrived November 19 and is already working on
the leptospirosis outbreak.


6. Post,s Health Unit has issued a Management Notice to
Embassy staff advising individuals to take a variety of
precautions to avoid contracting the disease. In addition,
the Consular Section has issued a warden message with similar
information.
BULLEN