It seems the Ministry of Health has narrowed down the number of likely sources of plasmodium falciparum malaria that suddenly cropped up on Exuma in early June, but health officials are not prepared or able to go public.
And, based on the focus of the ministryﾒs “mop-up” operations, it appears that the ministry is considering the Haitian population in Exuma among the likely sources.
Those “mop-up” operations have included treatment of all the residents in a Haitian village in Exuma because the residents have lived in one of the 21 endemic countries in the region.
This way, according to Director of Public Health Dr. Baldwin Carey, it does not matter if there are Anopheles mosquitoes or not. Dr. Carey was quick to add that the population of Anopheles mosquito ﾖ the sole transporting agent of malaria and not native to The Bahamas ﾖ has been eliminated.
“Weﾒve eliminated the Anopheles mosquito at the present time, but we canﾒt say it wonﾒt come back. So what weﾒve done is decide to eliminate the pool of possible malaria cases or people who have been infected with malaria in the past,” Dr. Carey explained.
“So a team went in to treat the Haitian population in Exuma because they do come from an endemic area.”
That Ministry of Health team returned to Nassau on Monday night after five days in Exuma treating what Dr. Carey described as “several hundred” people in that “very mobile” Haitian population.
“And we have a residual team in Exuma who will continue to treat (people) as they are able to identify (Haitian nationals),” he said.
Dr. Carey further explained that there is not a pool of people from endemic countries except the Haitians.
“We are not at the point where we are prepared or able to say who it is,” according to Director of Public Health Dr. Baldwin Carey.
“It isnﾒt that we are not working on it, and (it isnﾒt that) weﾒve not narrowed it down, but weﾒre not in a position to state that this is where it came from.”
Dr. Carey reiterated that malaria is not endemic to The Bahamas, which means that the disease had to have been imported from a country where it is endemic. Nearby countries include Haiti, the Dominican Republic and Guyana, but there are a total of 21 countries in the region where malaria is endemic.
The Ministry of Health identified 17 cases of malaria on Great Exuma from June 6 through June 19. Tracing the source has proved difficult.
“It becomes a matter now of epidemiology; we go to our records, which are now monumental, collected over the last couple of weeks. We have to look very carefully at dates; we have to look at onset of symptoms ﾖ not just when somebody was diagnosed or when they came forwardﾅTie that in with when we knew the Anopheles mosquito to be present, and in that way we work backwards and see who was possibly the first case or cases,” Dr. Carey explained.
“It may not have been one person. But we know malaria is not endemic in The Bahamas, so obviously it had to be imported. So we just have to work back until we identify that source.”
Dr. Carey pointed out that Health Minister Dr. Bernard Nottage will return to The Bahamas on Thursday, and is likely to hold a press conference early next week at which it is possible that the ministry may announce that it has identified the source of the cluster of malaria cases on Exuma.
By: Quincy Parker, The Bahama Journal
