After three months with no new cases of malaria despite what some call “intense epidemiologic surveillance,” the Ministry of Health has ended its investigation into the source of the June outbreak on Great Exuma without actually identifying that source.
One international body has suggested that a community of Haitian immigrants on Exuma may have introduced the disease to the island community.
Director of Public Health Dr. Baldwin Carey told the Journal on Monday that after months of investigation, the Ministry of Health is still not able to state the source of the disease that afflicted 19 people in June.
“It ends that investigation,” Dr. Carey said of the decision to concentrate on heightened surveillance rather than investigation.
Noting that some infected persons entered and left The Bahamas during the course of the outbreak, Dr. Carey said (Bahamian authorities) “still canﾒt say for sure that one of those was not the source.”
However, the Atlanta-based Centers for Disease Control and Prevention had something to say on the possible source of the disease in an article on the outbreak that gave what seemed to be a stamp of approval to the methodology used by the Ministry of Health to deal with the cluster of cases.
The CDC summed up the findings of the Ministry of Health investigation, which revealed that most of those infected were male residents of The Bahamas living around Georgetown and Bahama Sound, living in close proximity to a community of Haitian migrants.
The CDC also revealed that a parasite prevalence survey was conducted on that migrant community, revealing that 29 of those persons were infected with malaria.
“Available evidence indicates that during May ﾖ June 2006 Great Exuma experienced an outbreak of introduced malaria that was successfully contained and terminated,” the CDC article said.
“The observations that all cases were caused by plasmodium falciparum and a substantial proportion of patients were immigrants from Haiti, suggest that malaria was introduced by those immigrants.”
“All patients treated with chloroquine responded to the treatment, which is a further suggestion that the parasites originated from Haiti, where plasmodium falciparum has remained sensitive to chloroquine,” the report added.
According to the CDC, the falciparum strain of the virus causes 99% of malaria on Hispaniola, the island containing Haiti and the Dominican Republic and the only island in the Caribbean where malaria remains endemic.
Dr. Carey told the Journal he was not prepared to identify the ministryﾒs so-called “short list” of viable suspects.
“And I donﾒt think (an identification of the source) will be stated definitively,” he said.
Dr. Carey noted that the CDC has rescinded a travel advisory recommending preventative doses of antimalarial drugs before during and after travel to Exuma.
The CDC also noted the rapid response of the Ministry of Health to the outbreak, pointing out that “fewer than 30 days elapsed between diagnosis of the first identified case and diagnosis of the last case on Exuma.”
Dr. Carey noted that the ministry had had “several discussions with the CDC.”
By: Quincy Parker, The Bahama Journal
