Update: July 24, 2007
The Public Health Agency of Canada (PHAC) continues to monitor an outbreak of malaria in Jamaica. At this time, the number of confirmed cases of malaria in Jamaica has steadily declined since the outbreak peaked in December 2006; however, a small number of cases continue to be reported monthly. For the time being and until further notice, PHAC continues to recommend antimalarial prophylaxis and personal protective measures for persons staying overnight in Kingston, Jamaica – please refer to ‘Recommendations' below. [map]
As of June 30, 2007 the Jamaican Ministry of Health has reported 370 confirmed cases of malaria with the majority occurring in Kingston and St. Andrews (342 cases). Twenty-one cases have been reported in St. Catherine and a small number of cases have been reported in other neighbouring parishes. The latest date of onset of illness among confirmed cases was reported on June 10, 2007.
A single case was reported in a US resident who traveled to Kingston in November 2006. No cases have been reported among Canadian travellers to date. All confirmed cases were caused by infection with Plasmodium falciparum. No deaths have occurred and there is no evidence of chloroquine resistance among treated cases.
Malaria is not endemic to Jamaica. Except for a small number of imported cases each year, Jamaica had been malaria free for the last 41 years. However, Jamaica is susceptible to the reintroduction of local transmission of this disease given its tropical climate, the presence of the mosquito that is capable of transmitting the disease, and its proximity to countries with endemic malaria.
Technical assistance is being provided by the Pan American Health Organization (PAHO) and the Caribbean Epidemiology Center (CAREC). The US Centers for Disease Control and Prevention (CDC) is assisting by strengthening laboratory diagnostic capacity.
Source: Pan American Health Organization, Jamaican Ministry of Health, US Centers for Disease Control and Prevention (CDC)
Malaria
Malaria is an acute flu-like illness caused by one of four species of parasite of the genus Plasmodium; Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale and Plasmodium malariae. Infection with P. falciparum malaria can be fatal. The disease is most commonly transmitted to humans through the bite of an infected female Anopheles mosquito – a dusk-to-dawn biter. Symptoms of malaria include fever and flu-like symptoms such as headache, nausea, vomiting, muscle pain and malaise. Rigors (severe shakes or muscle spasms) and chills often occur.
Malaria is endemic (i.e., constantly present) in most of sub-Saharan Africa; in large areas of the Middle East, South Asia, South East Asia, Oceania, Haiti, Central and South America; and in parts of Mexico, North Africa and the Dominican Republic.
For additional information on the prevention and treatment of malaria, consult the Public Health Agency of Canada’s Disease Information Backgrounder on Malaria.
Recommendations
Given the current localized malaria activity in Jamaica and until further notice, the Public Health Agency of Canada recommends antimalarial prophylaxis (medication) and the use of personal insect protective measures against mosquito bites (between dusk and dawn) for Canadians travellers who may stay overnight in Kingston, Jamaica.
How to prevent malaria infection
Two important measures can help you prevent malaria infection: avoiding mosquito bites and using effective anti-malarial medications.
1. Personal Protective Measures to Prevent Mosquito Bites
Comprehensive information on mosquito-bite avoidance is detailed in CATMAT's " Statement on Personal Protective Measures to Prevent Arthropod Bites”
2. Antimalarial Medication (Prophylaxis)
Chloroquine is the malaria drug of choice for Jamaica. However, atovaquone / proguanil (malarone), doxycycline and mefloquine are equally effective as chloroquine and readily available.
Antimalarial medications decrease the risk of developing symptomatic malaria. However, they do not provide 100% protection against the disease. Your individual need for antimalarial medications should be discussed with your physician or travel medicine professional several weeks before travel.
If your physician or travel medicine clinic prescribes an antimalarial medication, it is important that you take it as directed in order to maximize the protective effect. Each drug has its own dosing regime that should be strictly followed. Because of the incubation period of the disease, these medications must be taken both before, during, and after travel.
Travellers are reminded to complete their prescribed regimen of prophylaxis on their return. Except for atovaquone/proguanil which must be taken for one week after returning from a malaria-endemic area, chloroquine, doxycyline and mefloquine must be taken for four weeks after returning from a malaria-endemic area.
All travellers to an area where malaria occurs or where an outbreak has been reported, regardless of whether or not they have taken malaria prophylaxis, must understand that any fever should be immediately followed up with a medical consultation to rule out malaria.
As a reminder...
The Public Health Agency of Canada routinely recommends that Canadian international travellers consult their personal physician or a travel clinic prior to international travel, regardless of destination, for an individual risk assessment to determine their individual health risks and their need for vaccination, preventative medication, and personal protective measures.
The Public Health Agency of Canada recommends, as well, that travellers who become sick or feel unwell on their return to Canada should seek a medical assessment with their personal physician. Travellers should inform their physician, without being asked, that they have been travelling or living outside of Canada, and where they have been.
For additional information from the Public Health Agency of Canada:
Read the Travel Medicine Program’s previous Travel Health Advisories on malaria at: http://www.phac-aspc.gc.ca/tmp-pmv/info/pal_mal_e.html
Consult the Travel Medicine Program’s document: Immunizations Recommended for Travel Outside of Canada
Consult the Committee to Advise on Tropical Medicine and Travel (CATMAT) Statement on the Prevention and Treatment of Malaria Among International Travellers
Visit Malaria – Frequently Asked Questions
Additional information from other sources:
For information on the Global Malaria Programme (GMP), visit: http://www.who.int/malaria/
