Reports of Gastrointestinal Illness in the Dominican
Republic
Released: January 20, 2005
OTTAWA - The Public Health Agency of Canada (PHAC) is aware of
reports of gastrointestinal illness (GI) in returning travellers from
two geographical regions in the Dominican Republic. The first report
involves Canadian travellers returning from Puerto Plata and the second
report involves American travellers returning from Punta Cana.
PHAC consulted with Canadian tour operators and was advised of travellers
returning home with GI illness from Puerto Plata. PHAC has recommended
that Canadian medical health professionals act with increased vigilance
with regard to investigating and reporting GI illness in returning Canadian
travellers from the DR.
The Centers for Disease Control and Prevention (CDC) in the United
States notified the PHAC of a group of 20 tourists from Ohio who returned
home with GI illness from Punta Cana. To date, preliminary laboratory
results indicate norovirus (formerly referred to as Norwalk-like viruses)
as being the causative organism.
PHAC is collaborating closely with the Pan American Health Organization
(PAHO) in the Dominican Republic. An epidemiological investigation is
currently on-going and has confirmed that there is a gastrointestinal
illness outbreak occurring. While the organism has not yet been confirmed
it appears to be viral in nature - possibly norovirus. PAHO has advised
the PHAC that multiple measures have been implemented in resorts including
reinforcing hygiene measures related to the handling of food, water chlorination,
and education for food handlers-re washing of hands. The epidemiological
investigation is ongoing and PAHO will continue to monitor the situation
and the impact of the measures taken.
Source: CDC, PAHO.
If you are travelling internationally, you should be aware that conditions
in other countries, both natural and man-made, may be significantly different
from those in Canada and may affect your health during travel. Standards
of hygiene may be different. Food and water may be contaminated. The
climate or environmental conditions may favour disease organisms which
do not occur in Canada. If you are planning to travel to the tropics,
you may be at risk of developing traveller's diarrhea (also known as "tourista", "Montezuma's
revenge", etc).
Noroviruses are common forms of viral gastroenteritis seen worldwide.
They occur throughout the year, but are more common in the winter. Outbreaks
are common and generally occur where people congregate in close quarters
for extended periods (e.g., at camps, schools, nursing homes, cruise
ships). Outbreaks have been reported in Canada in a variety of settings
including, hospital emergency departments, senior's
residences, day cares and schools
Noroviruses are spread through fecal/oral
exposure. Transmission may occur through contaminated water supplies
or food (e.g., contaminated shell fish, such as clams and oysters),
and through food handled by someone who is ill with norovirus or has
been exposed to norovirus without exercising proper hand-washing procedures.
Transmission can also occur person to person if there has been exposure
to contaminated feces, or to any contaminated surface, followed by
contact with one's mouth.
The incubation period ranges from 10 to 60 hours,
usually between 24to 48 hours. Travellers can transmit the illness during
the acute stage of the illness and up to 48 hours after symptoms disappear.
Generally, these viruses cause only minor illness, with self-limiting,
gastrointestinal symptoms, such as diarrhea and vomiting lasting from
1 to 4 days. The risk of dehydration is more likely to occur in the very
young, the elderly and those with weakened immune systems.
There is no
vaccine or specific treatment for norovirus.
Noroviruses are very hardy,
capable of surviving on practically any surface including door handles,
sinks, railings and glassware. In an outbreak situation, an environmental
cleansing with chlorine must occur to break the cycle of transmission.
Recommendations:
|
