Malaria in Kingston, Jamaica

Update: December 7, 2006

The Public Health Agency of Canada (PHAC) is closely monitoring an outbreak of P. falciparum malaria in Jamaica.  At this time, 21 cases have been confirmed.  Most cases (18) have occurred in the areas of Delacree Park, Denham Town, Tivoli Gardens and Trench Town all part of the greater corporate area specifically known as the Kingston and St. Andrew Corporation.  Two cases have been reported in Sydenham, in the adjacent province of St. Catherines.  One case has been reported in a returning US traveller who travelled to the geographic regions in Kingston and St. Andrew Corporation where the local cases are being reported. [map]

Malaria is not endemic to Jamaica.  Except for a small number of  imported cases each year, Jamaica has been malaria free for the last 41 years. However, Jamaica, like other countries in Central America and the Caribbean can be susceptible to localized and isolated outbreaks given their tropical climates, presence of the mosquito that transmits the disease, and proximity to countries where malaria does occur.

The Jamaican Ministry of Health is undertaking intensive measures to control and contain the outbreak, including active case detection and treatment; mosquito control including insecticide spraying, larviciding, source reduction; and health education of the local population.

Technical assistance is being provided by the Pan American Health Organization (PAHO) and the Caribbean Epidemiology Center (CAREC).

Source: Pan American Health Organization, Jamaican Ministry of Health, Centers for Disease Control (CDC), Foreign Affairs and International Trade Canada

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 mosquito, specifically the female Anopheles mosquito, a dusk-to-dawn biter.

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 comprehensive information, please refer to the Public Health Agency of Canada's Disease Information Backgrounder on malaria.

Recommendations

Until further information is available on the localized malaria activity in Jamaica, 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 and St. Andrew Corporation.

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 “Canadian Recommendations for the Prevention and Treatment of Malaria Among International Travellers”.

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 on malaria

• Consult the Public Health Agency of Canada's Malaria information page
• The Committee to Advise on Tropical Medicine and Travel (CATMAT) produces evidence based statements and guidelines. For maps of malaria-endemic areas and other information about malaria, visit CATMAT's Canadian recommendations for the prevention and treatment of malaria among international travellers as published in the Canada Communicable Disease Report - Supplement (Vol. 30, June 2004).
• Malaria – Frequently Asked Questions