MINISTRY OF HEALTH
PRESS STATEMENT

RE:  MALARIA

June 16, 2006 

On Friday June 9^th, I informed you that a case of malaria was detected in Exuma and that the victim had been admitted to the Princess Margaret Hospital to begin therapy. At that time the Ministry of Health’s surveillance team was on the ground in Exuma carrying out their case finding activities and scrutinizing the log books of the Steventon and George Town clinics for any patients who had reported symptoms suggestive of Malaria. 

At the same time, I informed you that a team, from Environmental Health, led by Mr. Andrew Thompson, Chief Health Inspector, was also on the ground investigating the conditions. Their job was to set the mosquito traps to determine the mosquito count, to detect evidence of mosquito larvae and to bait mosquitoes to bite them to determine specifically whether the anopheles mosquito, which is the only species that transmits the Malaria parasite was present.  They were later joined by Dr. Christian Fredericsson, an expert entomologist made available from CAREC by PAHO to assist us in our efforts.

Additionally, as a result of the publication of the Ministry’s request that persons in Exuma who had fever, chills, body aches and pains, respiratory symptoms, diarrhoea etc. should report to the clinic, and the active work of our surveillance team, a number of persons with suggestive symptoms attended the clinic. After examination, all persons who had clinical evidence of Malaria had blood specimens taken and were sent to Nassau for evaluation and where necessary admission to hospital. Patients, who were not ‘sick’, had the blood samples taken and remained in Exuma pending the results of their tests. 

On Saturday June 10^th, accompanied by the Director of Public Health, the Ministry’s Epidemiologist and the Principal Nursing Officer in the Department of Public Health, I visited Exuma and met with the teams working there to assess the situation for myself. During that visit, I received reports that the general mosquito counts were not elevated, in fact were low. More importantly, there were few Anopheles mosquito larvae detected in the mosquito traps. One was found in the Farmer’s Hill area, and three or four in the George Town area. There were also few adult Anopheles mosquitoes detected in either location, even when members of the team used themselves as human bait and exposed areas of their bodies that the mosquito usually bites. 

We also took the opportunity to have an aerial survey of Exuma done, by the Environmental health team, to enable them to locate all the collections of water to ensure that they would be treated. We also took the opportunity to communicate with the local community by way of the local radio station. 

During that visit, the medical team found three additional persons who had indicative symptoms. Blood samples were taken from them and one patient was brought to Nassau for further evaluation. 

To date there are twelve persons who have tested positive for Malaria. Nine of them were admitted to hospital. All of them are being treated. I am happy to report that all patients have responded well to the therapy. Six persons will complete their treatment tomorrow. Some of them, who do not need hospitalization are being treated in Exuma. 

Presently we are following the CAREC gold standard guidelines for Malaria Case investigation. We have stepped up our reporting and investigation procedures as well as our control and prevention activities. 

We have medical teams going house to house in the areas where the known patients live and work and for a one mile radius therefrom. We are paying special attention to the travel history of all affected persons and others around them who may have traveled.  

Thick and thin blood smears are being taken from each person and these are currently being sent to the Princess Margaret Hospital for analysis. To speed up this process we have secured the services of additional laboratory technologists with the assistance of PAHO to enable us to carry out our reading of smears on location in Exuma. They should be arriving in Exuma tomorrow. They will be assisting our local experts who have been working tirelessly since we began this surveillance effort. 

This afternoon, a fresh team of Public Health physicians and nurses arrived in Exuma to help the teams already on island with their screening efforts. This brings the combined team up to six physicians, eight public health nurses and eight Environmental Health Officers. 

We are undertaking the following:

I am happy to inform the public that the Environmental Health Officers indicate that the preventative measures instituted to date (including fogging to the airport area, the natural ponds and other areas with large water collections) have been successful. No more larvae or adult Anopheles mosquitoes have been identified. 

Dr. Fredericsson has also stated that there is no further active transmission. This is good news!! 

However we ask the public to continue to assist us with the investigations. Given that the incubation period is between 7 and 14 days, other cases may still present over the next few weeks. 

We remind the public that Malaria is not endemic in the Bahamas. It is an imported disease. Persons in Exuma should continue to take precautions, discard stagnant water, cover their bodies at night and use insecticide spray. 

June 13, 2006