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Eurosurveillance, Volume 11, Issue 50, 14 December 2006
Articles

Citation style for this article: Lawrence J, Chiodini P. Plasmodium falciparum malaria in Jamaica, October – December 2006. Euro Surveill. 2006;11(50):pii=3096. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3096

Plasmodium falciparum malaria in Jamaica, October – December 2006

Jo Lawrence1 (joanne.lawrence@hpa.org.uk), Peter Chiodini2

1Travel and Migrant Health Section, Health Protection Agency Centre for Infections, London, United Kingdom
2Department of Clinical Parasitology , Hospital for Tropical Diseases, London, United Kingdom

As of 13 December 2006, 56 confirmed malaria infections, caused by Plasmodium falciparum, have been reported from the city of Kingston in Jamaica [1]. Most cases occurred in the areas of Delacree Park, Denham Town, Tivoli Gardens and Trench Town. Two cases have been reported in Sydenham, in the adjacent province of St Catherines. Of the 21 cases that had been reported by 6 December, known dates of onset were between 27 September and 30 November, and 16 cases were in females and five in males, with ages ranging from five to 72 years [2,3]. One case was in a United States resident who travelled to the island from 29 October to 6 November 2006.

The Ministry of Health in Jamaica has put together an action plan in order to prevent further transmission. It involves redeveloping case definitions, diagnostic criteria and patient management protocols, and conducting house to house fever surveillance and epidemiological investigations. A multidisciplinary team of emergency health staff, consultants, and other health professionals including an epidemiologist and an entomologist has been established. A vector control strategy has also been implemented, which includes pesticide fogging to kill adult mosquitoes and the destruction of potential breeding sites [2].

Like most Caribbean countries, except for the Dominican Republic and Haiti, Jamaica is not considered endemic for malaria. The mosquitoes capable of transmitting malaria are, however, present on the island, and small localised clusters may occur from time to time as a result of onward transmission from an imported case, provided the environmental conditions for the malaria parasite to develop within the mosquito are optimal, as recent examples in Corsica and the Bahamas have illustrated [4,5].

The current cluster has not changed European recommendations for malaria chemoprophylaxis for travel to Jamaica. To our knowledge, preventive medication has not been recommended by any European national health authorities. Awareness to possible importation of cases has been raised. For example, in the UK, the Health Protection Agency’s Advisory Committee for Malaria Prevention in UK Travellers (ACMP) has not recommended preventive malaria medication for travellers from the United Kingdom to Jamaica, but updated national advice in the UK is that travellers to Jamaica, in particular to the Kingston area, should be aware of the risk and protect themselves against evening and night-time biting mosquitoes [6]. Travellers who develops a febrile illness during travel, or for up to a year following their return to their home country, should be promptly evaluated and have a blood test for malaria without delay [7]. In the unlikely event that any travellers do contract malaria after visiting Jamaica, the appropriate treatment is chloroquine. As yet, no new malaria cases related to travel to Jamaica have been seen by the European Network on Imported Infectious Disaease Surveillance (TropNetEurop, http://www.tropnet.net/) [personal communication, Tomas Jelinek, December 2006]. Many tourists from Europe travel to Jamaica for holidays or to visit friends and family. Data from the World Tourism Organization show, for example, that around 160 000 people from the UK, 18 000 from Germany, 25 000 from Italy and 10 000 from Spain visited Jamaica in 2004 [8].

The US Centers for Disease Control and Prevention has temporarily recommended that travellers who intend to stay overnight in Kingston take prophylactic antimalarial medication [9], and the Public Health Agency of Canada has made similar temporary recommendations [10]

References:
  1. Public Health Agency of Canada. Malaria in Kingston, Jamaica. Travel Health Advisory 13 December 2006 [online] [cited 14 December 2006]. (http://www.phac-aspc.gc.ca/tmp-pmv/2006/mal_jam061213_e.html)
  2. Ministry of Health [Kingston, Jamaica]. HEALTH MINISTRY IMPLEMENTS MALARIA ACTION PLAN. News, 6 December 2006. (http://www.moh.gov.jm/LatestNews.html) [accessed 13 December 2006]
  3. Health Protection Agency. Plasmodium falciparum malaria in Jamaica. CDR Weekly 2006; 16(49): news. (http://www.hpa.org.uk/cdr/archives/2006/cdr4906.pdf)
  4. Armengaud A, Legros F, Quatresous I, Barre H, Valayer P, Fanton Y, D'Ortenzio E, Schaffner F. A case of autochthonous Plasmodium vivax malaria, Corsica, August 2006. Euro Surveill 2006;11(11):E061116.3. Available from: http://www.eurosurveillance.org/ew/2006/061116.asp#3
  5. Centers for Disease Control and Prevention (CDC). Malaria--Great Exuma, Bahamas, May-June 2006. MMWR Morb Mortal Wkly Rep. 2006 Sep 22;55(37):1013-6. (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5537a1.htm)
  6. The National Travel Health Network and Centre. Clinical update: Plasmodium falciparum malaria in Jamaica, 6 December 2006 [online] [cited 6 December 2006]. London: NaTHNaC, 2006. (http://www.nathnac.org/pro/clinical_updates/malaria_061206.htm).
  7. Insect bite avoidance. [online] [accessed 6 December 2006]. London: NaTHNaC, 2006. (http://www.nathnac.org/pro/factsheets/iba.htm).
  8. World Tourism Organization (WTO). Yearbook of tourism statistics, 2005 [CD ROM]. Madrid: WTO, 2006.
  9. Centers for Disease Control and Prevention. Malaria in Kingston, Jamaica: recommendations for travelers. Outbreak Notice 4 December 2006 [online] [cited 6 December 2006]. (http://www.cdc.gov/travel/other/2006/malaria_jamaica.htm)
  10. Public Health Agency of Canada. Notices and International Reports : 2006. Malaria in Kingston, Jamaica. 4 December 2006. (http://www.phac-aspc.gc.ca/tmp-pmv/2006/mal_jam061204_e.html ) [accessed 14 December 2006]

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