182893 Malaria Outbreak investigation in Jamaica

Monday, October 27, 2008: 1:20 PM

Pauline L. Weir, MBBS, DA, MPH , Kingston and St Andrew Public Health Department, Kingston 5, Jamaica
Eva Lewis-Fuller, MBBS, DPH, MBA , Director Health Promotion and Protection Division, Ministry of Health, Kingston, Jamaica
Karen Ruth Webster, MBBS MPH , Medical Officer of Health, Kingston and St Andrew Public Health Department, Kingston 5, Jamaica
Sandra Patricia Chambers, MD MPH , Medical Officer of Health, Kingston and St Andrew Public Health Department, Kingston 5, Jamaica
D'Oyen Shawn Smith, MBBS MPH , Medical Officer of Health, Kingston and St Andrew Public Health Department, Kingston 5, Jamaica
Erica Elizabeth Hedmann, MBBS MPH , Medical Officer of Health- Surveillance Unit, Ministry of Health, Kingston, Jamaica
Karen Lewis-Bell, MBBS MPH , Director, Family Health Services, Ministry of Health, Kingston, Jamaica
Marion Bullock-DuCasse, MBBS MPH , Director Emergency Disaster Management Services, Ministry of Health, Kingston, Jamaica
Debbie Angelique Carrington, MBBS MPH , Medical Officer of Health, Kingston and St Andrew Public Health Department, Kingston 5, Jamaica
Adrian Booth, BSC-Biology, MPH , Program Development Officer, South East Regional Health Authority, Kingston 10, Jamaica
Kathryn Grace Mitchell, BSC -Biochem , Regional Surveillance Officer, South East Regional Health Authority, Kingston 10, Jamaica
Everton Lawrence Baker, BSc Environmenta , Chief Environmental Health Officer, Kingston and St Andrew Health Department, Kingston 5, Jamaica
Sherine Sophia Huntley, MSc Medical Ento , Program Manager, Vector Control Program, Health Promotion and Protection Division, Ministry of Health, Kingston, Jamaica
Jamaica was declared malaria-free by the World Health Organization in 1965. After four decades of eradication a malaria outbreak was declared on November 30, 2006. This peaked in the second week of December 2006 and slowly declined to June, 2007 at which point the cumulative number of confirmed cased was 370.

As a tropical country Jamaica has the climate, rainfall and other environmental conditions conducive to the transmission of malaria. With the persistence of the vector, Anopheles albimanus mosquito, and the frequent travel of visitors and nationals to and from malaria-endemic countries, all the ingredients for an epidemic exist. The country continued to have 3 14 imported cases of malaria annually. In 2004 and 2005 there were 141 and 88 imported cases, respectively. These cases resulted from a massive influx of Haitian refugees.

The malaria parasite isolated in this outbreak was Plasmodium falciparum. The main symptoms were vomiting, fever, chills and muscle pains. No deaths were attributed to the outbreak. The cases were clustered in the inner city communities of Kingston and St. Andrew. As of January 31, 2008, there were 374 cases with ages ranging from 7 months to 93 years.

The epidemiological strategies employed involved Early Case identification and Treatment through intense Fever Surveillance from door to door in the affected communities and health facilities. This was backed up by continuous systematic cyclical vector surveillance measures, public education, personal and individual protection, inter-sectoral collaboration and partnerships at the national, regional and international levels.

Learning Objectives:
To remind Public Health Practioners and Policy Makers of the importance of having effective control measures in place to prevent an outbreak especially when there are pre-existing risks.

Keywords: Epidemiology, Outbreaks

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Coordinating Medical Officer of Health for the Health Department that has been directly involved in the outbreak investigation since November 2006.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Outbreak Investigations
See more of: Epidemiology