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Reports of Malaria in the Dominican RepublicUpdated: April 1, 2005
The Public Health Agency of Canada (PHAC) continues to closely monitor for reports of malaria in tourists who have visited the province of La Altagracia in the Dominican Republic . The Province of New Brunswick recently notified the Public Health Agency of several suspected cases of malaria in Canadian travellers returning from the Dominican Republic . Results from further laboratory analysis conducted at the Toronto General Tropical Medicine Centre and the McGill Centre for Tropical Diseases do not support the diagnosis of malaria. Further diagnostics are ongoing to determine the cause of illness. The Public Health Agency and its Committee to Advise on Tropical Medicine and Travel (CATMAT) continue to provide assistance to New Brunswick provincial public health officials in this matter. At this time, a combined total of 21 cases of malaria have been confirmed in Canadian, American and European travellers. To date, six cases have been reported in Canadian travellers who traveled to Punta Cana, in the Dominican Republic , five cases have been reported in American travellers; four cases from Punta Cana and one case from San Francisco de Macoris. Ten cases have been reported in European travellers; eight cases from Punta Cana, one case from Playa Bavaro, and one case from La Romana Province. The last reported case occurred in an American traveller in early January. The Pan American Health Organization (PAHO) is working with the Ministry of Health in the Dominican Republic to ensure that intensive measures to interrupt transmission of malaria, including intensified surveillance and vector control, are being implemented in the Province of La Altagracia. The Agency continues to collaborate with the US Centers for Disease Control and the Pan American Health Organization in the monitoring and reporting of new cases of malaria in returning travellers from the Dominican Republic. Source: US Centers for Disease Control, TropNetEurop, Pan American Health Organization, Province of New Brunswick Malaria is known to be endemic (i.e., constantly occurring) in rural areas of the Dominican Republic, with the highest risk in areas bordering Haiti. Resort areas are generally not risk areas. However, occasional outbreaks of malaria transmission can occur in these malaria-free areas due to the presence of the mosquito vector and the movement of people from the areas where transmission occurs. The Dominican Republic reports approximately 1000 cases of malaria annually. This year, more than 2000 cases have been reported with an outbreak of cases occurring in previously malaria-free areas. This phenomena may be due to several factors including two recent hurricanes which have affected the island, an increase in the population of the mosquito vector (Anopheles) and the movement of many construction workers from rural areas into tourist areas. In 1998, a localized outbreak of malaria occurred in a tourist area of eastern DR (Bavaro-Punta Cana). Although all malaria in the DR is due to P. falciparum, no drug resistance has been documented. In consultation with the Malaria Sub-Committee of the Committee to Advise on Tropical Medicine and Travel (CATMAT), the Public Health Agency of Canada recommends the following for travellers to the DR at this time: Recommendations The Public Health Agency of Canada strongly recommends that you obtain an individual risk assessment with a travel medicine physician or your family physician to determine both your risk of exposure to malaria and your need for appropriate preventative anti-malarial treatment as determined by your travel itinerary and medical history. Two important measures can help you prevent malaria infection: avoiding mosquito bites and using effective anti-malarial medications. Personal Measures to Avoid Mosquitoes Female Anopheles mosquitoes bite mainly during the evening and night. Using personal insect protective measures will reduce your risk of being bitten by these mosquitoes.
Antimalarial Medication (Prophylaxis) 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 and after travel. Important to Note If you develop a fever within 3 months after returning from an area where malaria occurs, you should seek medical advice immediately. Be sure to inform your physician that you have visited an area where malaria occurs so that you can be tested without delay. Malaria must be ruled out by the examination of one or more blood films under a microscope. For additional information on malaria:
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Last Updated: 2005-04-01 | ![]() |