View Full Version : Malaria problem in PUJ

8th Dec 2004, 00:03
Two with malaria fight for their lives
Dozens returning from Dominican Republic at risk, Toronto doctor says

A leading authority on tropical diseases confirmed to thestar.com today that two people suffering from malaria are fighting for their lives in Toronto-area hospitals after coming back from the Dominican Republic.
And dozens more people are at risk.
Dr. Jay Keystone, a physician in the Tropical Disease Unit at the University Health Network, said this afternoon that two people are in critical condition and there are fears there could be many more as more flights return from the Caribbean island.
“There are several cases in B.C. and several in Ontario. We have two in intensive care units in Toronto with severe malaria,” Keystone said.
“The issue is that this is a potentially fatal yet potentially preventable disease. People need to know that they need to take antimalarial pills. It’s a real concern because we haven’t had malaria in the Dominican Republic for at least four years and now it’s at tourist resorts. I think it’s important not to scare the hell out of travellers, but to make them aware that it is preventable.”
Malaria is not a contagious disease, so it can’t be transferred from person to person. It is acquired through an insect bite.
The federal Ministry of Health has admitted that as many as 14 people, including four Canadians, are being treated for malaria after returning from the Dominican Republic.
At least two Americans and eight Europeans are also being treated for malaria after having vacationed in Punta Cana and San Francisco de Macoris.
“The public health department has received only two reports to date in the province of confirmed malaria originating from the Dominican Republic,” Dan Strasbourg, a spokesperson for the Ontario health ministry, told thestar.com today, but he didn’t have specifics on where they were being treated or how serious their conditions were.
“I believe they’re in the Toronto area,” he said.
An official from the Toronto Public Health Department couldn’t confirm any cases.
The national Centers for Disease Control and Prevention in Ottawa says it is monitoring the situation.
The malaria alarm was raised initially a week ago by the B.C. Centre for Disease Control which issued a warning after two Vancouver travellers to the Dominican came down with the most severe form of the illness upon their return.
In fact, the centre went so far as to advise recent travellers to the Dominican Republic that they may be at risk and to see a doctor immediately.
Malaria has, in the past, mostly been found in rural areas of the Dominican Republic and resorts were previously considered to be low-risk.
The CDC recommends that all travellers to La Altagracia Province and Duarte Province, including travellers to the Punta Cana resort area, take an antimalarial drug that will combat the disease.
Travellers to the Dominican Republic who become ill with fever and other flu-like symptoms should immediately seek medical care and tell your doctor that you may have been in a malaria-risk area, the CDC reports.
Malaria is a disease that can be treated in just 48 hours, yet it can cause fatal complications if the diagnosis and treatment are delayed.
Symptoms may include fever and flu-like illness, including chills, headache, muscle aches, and fatigue. Malaria may cause anemia and jaundice. Malaria can often be prevented by using antimalarial drugs and by using personal protection measures to prevent mosquito bites. However, in spite of all protective measures, travelers may still develop malaria, the CDC says.
Malaria symptoms will occur at least seven to nine days after being bitten by an infected mosquito. Fever in the first week of travel in a malaria-risk area is unlikely to be malaria; however, any fever should be promptly evaluated, the website says.
Visit CDC’s Travellers’ Health website at www.cdc.gov/travel/regionalmalaria/Caribean for information on malaria risk and prevention in the Dominican Republic.

Old King Coal
8th Dec 2004, 07:39
Some of the ignorance that's out there about infectious diseases is genuinely astounding – wherein many supposedly civilised travellers really should make themselves more aware of the risks; though remembering that at least for them there is 1st world medical help available, but where for much of the rest of the world there’s nought more than tlc and / or the grave, e.g. w.r.t. Malaria (http://www.who.int/mediacentre/factsheets/fs094/en/): Approximately 40% of the world's population are at risk from malaria, mostly those living in the poorest countries throughout the tropical and sub-tropical regions.
Annually there are at least 300 million acute cases of malaria ( i.e. at any one moment, approximately 5% of the planet’s population will be suffering from it in various measures ).
Year on year, more than one million people will die as a result of Malaria.
Around 90% of the deaths occur in Africa, where it predominantly kills young children - an African child dies from it every 30 seconds ( i.e. approximately 4 children will die as a result of malaria, during the time it takes you to read this post ) - and it is Africa's leading cause of under-five's mortality.
Of the more than 500,000 African children who develop 'cerebral malaria' (a severe form of the disease that affects the brain) each year, 10-20% of those will die and approximately 7% ( that's ~35,000 ) are left with permanent neurological / brain damage and learning impairments.
Children with malaria typically develop fever, vomiting, headache and flu-like symptoms. If untreated, the disease may progress rapidly (often within 24 hours) to convulsions, coma, and death.
Malaria is a major cause of anaemia in many parts of the world. Chronic anaemia may adversely affect a child’s growth and intellectual development. Repeated episodes of malaria may lead to severe, life-threatening anaemia. Blood transfusions may save lives in these circumstances, but also expose the child to the risk of HIV and other blood-borne infections. Nb. Pregnant women and their unborn children are also particularly vulnerable to malaria, which is a major cause of perinatal mortality, low birth weight and maternal anaemia.
Malaria constitutes 10% of the African continent's overall disease burden for which it accounts for 40% of all public health expenditure, 30-50% of In-Patient admissions, and up to 50% of outpatient visits ( in areas with high malaria transmission ).
Malaria also presents major obstacles to social and economic development. Malaria has been estimated to cost Africa more than US$ 12 billion every year in lost GDP; even though it could be controlled, and many of the deaths prevented, for a fraction of that sum !The above figures provided by the World Health Organisation / WHO (http://www.who.int)

… and I haven’t even touched on Dengue Fever, Cholera, Hepatitis’ A B and C, Japan Encephalitis, Polio, Tuberculosis, and Yellow. :rolleyes:

8th Dec 2004, 07:48
Let's hope they make a speedy recovery.

The malaria debate has been mooted several times in the "medical and health" forum. There is a general resistance for some aircrew to take prophylactic medication, as they consider the risk / benefit ratio, to be too high, although, as the report above points out, the results of ignorance can be catastrophic.

Bite avoidance is very important, the School's of Tropical Medicine recommend substances containing deet or eucalyptis oil.

May I suggest that specialist advice is sought regarding anti-malaria tablets, as some of the older, (and effective), drugs are contra-indicated in "people who undertake precision activities."