National malaria programme strategic plan 2015-2020

Malaria is a major health problem in Guyana and this report charts the path for malaria control, prevention and elimination over the period 2015-2020. The National Malaria Strategic Plan 2015-2020 is committed to reducing the overall burden of malaria in Guyana by 50% in the affected areas. To achieve this goal, the document addresses the development of the national strategy; the role of stakeholders; a situational analysis; the response to malaria and related gaps and challenges; the guiding principles and strategic framework; monitoring and evaluation; the financial investments and gap analysis; and the implementation and management of the programme.

Chikungunya in Jamaica: Public health effects and clinical features in children / Chikungunya en Jamaica ­ Efectos en la Salud Pública y Características Clínicas en Niños

Chikungunya virus (CHIKV) entered the Caribbean for the first time in 2013 and Jamaica experienced its maiden epidemic with Chikungunya Fever in 2014. We aimed to describe the public health effects and describe the clinical features in children and adolescents in Jamaica. METHODS: This study reviewed the public health effects of the illness in Jamaica by reviewing available data sources and the clinical features in 210 children and adolescents meeting the case definition at two hospitals, Bustamante Hospital for Children and University Hospital of the West Indies between August 23 and October 31, 2014 by chart review. Descriptive analyses and comparisons between groups using the Mann-Whitney U test were performed with SPSS version 22. RESULTS: The majority of households were affected by the illness which caused widespread absenteeism from school and work, loss of productivity and economic losses estimated at 60 billion dollars. The health sector was impacted by increased numbers seen in clinics and emergency departments, increased need for bed space and pharmaceuticals. Ninety-nine per cent of the children were febrile with a median maximal temperature of 102.4 F. Ninety-three per cent had household contacts of 0­20 persons. In addition to fever, maculopapular rash and joint pains, infants six months and younger presented with irritability and groaning (p = 0.00) and those between six months and six years presented with febrile seizures (p = 0.00). Neurologic involvement was noted in 24%. Apart from anaemia, few had other laboratory derangements. Few had severe organ dysfunction and there were no deaths. CONCLUSION: The Chikungunya Fever epidemic had significant public health and economic impact in Jamaica. In children, there were characteristic presentations in neonates and young infants and in children six months to six years. Neurologic involvement was common but other organ dysfunction was rare. These findings underscore the need to prevent further epidemics and the quest for a vaccine.(AU)

Antecedentes: El virus de Chikungunya (CHIKV) entró en el Caribe por primera vez en 2013, y Jamaica experimentó su primera epidemia de fiebre de Chikungunya en 2014. Nos propusimos como objetivo describir sus efectos en la salud pública y describir sus características clínicas en niños y adolescentes en Jamaica. Métodos: Este estudio examinó los efectos de la enfermedad en la salud pública en Jamaica. El examen se realizó mediante la revisión de fuentes de datos disponibles y las características clínicas en 210 niños y adolescentes que cumplían con la definición del caso en dos hospitales ­ Hospital Pediátrico Bustamante y el Hospital Universitario de West Indies ­ entre el 23 de agosto y 31 de octubre de 201, según las historias clínicas. Se realizaron análisis descriptivos y comparaciones entre los grupos usando la prueba U de Mann-Whitney y la versión 22 de SPSS Resultados: La mayoría de los hogares fueron afectados por la enfermedad, que causó un ausentismo generalizado en escuelas y trabajos, pérdida de productividad, y pérdidas económicas estimadas en 60 billones de dólares. El sector de la salud fue afectado por un aumento del número de personas atendidas en clínicas y departamentos de urgencias, y una mayor necesidad de camas en los hospitales y productos farmacéuticos. Noventa y nueve por ciento de los niños presentaron un estado febril con una temperatura mediana máxima de 102.4 F. Un noventa y tres por ciento tuvo contactos domésticos de personas de 0­20. Además de fiebre, erupciones maculopapulares y dolores en las articulaciones, los niños de seis meses o menos edad, presentaron irritabilidad y quejidos (p = 0.00), y aquellos entre seis meses y seis años de edad presentaron convulsiones febriles (p = 0.00). Se observó compromiso neurológico en el 24%. Aparte de anemia, algunos tenían otros trastornos de laboratorio. Otros presentaban una disfunción orgánica severa y no hubo muertes. Conclusión: La epidemia de fiebre de Chikungunya tuvo un impacto significativo tanto en la salud pública como en la economía de Jamaica. Los niños presentaron manifestaciones características, observadas tanto en recién nacidos y bebés pequeños como en niños de seis meses a seis años. El compromiso neurológico fue común, pero cualquiera otra disfunción orgánica fue rara. Estos hallazgos subrayan la necesidad de hacer más por evitar las epidemias y buscar la solución de una vacuna.(AU)

A study to identify the presence of Aedes Spp. using BG-Sentinel® Traps and larval/pupal surveys in communities around Belmopan, Cayo District.

The knowledge of the presence of Aedes Spp. mosquitoes is very important for the prevention and control of emerging and remerging diseases caused by Arboviruses such as: Yellow fever, Dengue, Chikungunya and Zika. While Chikungunya and Dengue are endemic to Belize, Zika is currently a threat with local transmission having been established in several Caribbean and Central American Countries. The objective of the study is to survey the presence of Ae. aegypti and Ae. albopictus in the communities of San Martin, Salvapan and Las Flores, Belmopan City. The study was conducted from March 14 to April 2, 2016 whereby adult mosquitoes were captured using BG-Sentinel® Traps and larvae/pupae collection surveys were also done. Three hundred meter zone(s) were determined within localities and 1 BG-Sentinel® trap was deployed for 3 days at 24-hour intervals both indoors and outdoors at 2 residences randomly selected in each community. Larvae/Pupae collection surveys were done at 5 private premises within the predetermined zones in each of the three communities. Captured larvae and Pupae were reared for 6 days and adults obtained were used for identification. The identification of adult Ae. aegypti and Ae. albopictus was done using a stereoscopic microscope and pictorial keys that are used for the identification of mosquitoes. The presence of Ae. aegypti was identified in all 3 communities through both adult mosquito and larvae/pupae collections. However, Ae. albopictus was present only in San Martin and Salvapan communities. The presence of Ae. aegypti and/or Ae. albopictus will determine which appropriate vector control interventions are needed considering the different characteristic breeding habitats of these mosquitoes.(AU)

Developing systems of excellence: Providing quality accessible health care for all

This 2014 debate presentation was delivered by the Minister of Health, Jamaica, the Honorable Dr. Fenton Ferguson on Tuesday 1st July, 2014. It was entitled, "Developing systems of excellence: Providing quality accessible health care for all." In this debate an overview of the measures taken by the Ministry of Health was discussed and included its response to vector borne diseases such as Dengue and Chikungunya.

Isolation by distance explains genetic structure of BuggyCreek virus, a bird-associated arbovirus

Many of the arthropod-borne viruses (arboviruses) show extensive genetic variability and are widely distributed over large geographic areas. Understanding how virus genetic structure varies in space may yield insight into how these pathogens are adapted to and dispersed by different hosts or vectors, the relative importance of mutation, drift, or selection in generating genetic variability, and where and when epidemics or epizootics are most likely to occur. However, because most arboviruses tend to be sampled opportunistically and often cannot be isolated in large numbers at a given locale, surprisingly little is known about their spatial genetic structure on the local scale at which host/vector/virus interactions typically occur. Here, we examine fine-scale spatial structure of two sympatric lineages of Buggy Creek virus (BCRV, Togaviridae), an alphavirus transmitted by the ectoparasitic swallow bug (Oeciacus vicarius) to colonially nesting cliff swallows (Petrochelidon pyrrhonota) and invasive house sparrows (Passer domesticus) in North America. Data from 377 BCRV isolates at cliff swallow colony sites in western Nebraska showed that both virus lineages were geographically structured. Most haplotypes were detected at a single colony or were shared among nearby colonies, and pair-wise genetic distance increased significantly with geographic distance between colony sites. Genetic structure of both lineages is consistent with isolation by distance. Sites with the most genetically distinct BCRV isolates were occupied by large numbers of house sparrows, suggesting that concentrations of invasive sparrows may represent foci for evolutionary change in BCRV. Our results show that bird-associated arboviruses can show genetic substructure over short geographic distances.

Winter ecology of Buggy Creek virus (Togaviridae, Alphavirus) in the Central Great Plains

A largely unanswered question in the study of arboviruses is the extent to which virus can overwinter in adult vectors during the cold winter months and resume the transmission cycle in summer. Buggy Creek virus (BCRV; Togaviridae, Alphavirus) is an unusual arbovirus that is vectored primarily by the swallow bug (Hemiptera: Cimicidae: Oeciacus vicarius) and amplified by the ectoparasitic bug's main avian hosts, the migratory cliff swallow (Petrochelidon pyrrhonota) and resident house sparrow (Passer domesticus). Bugs are sedentary and overwinter in the swallows' mud nests. We evaluated the prevalence of BCRV and extent of infection in swallow bugs collected at different times in winter (October-early April) in Nebraska and explored other ecological aspects of this virus's overwintering. BCRV was detected in 17% of bug pools sampled in winter. Virus prevalence in bugs in winter at a site was significantly correlated with virus prevalence at that site the previous summer, but winter prevalence did not predict BCRV prevalence there the following summer. Prevalence was higher in bugs taken from house sparrow nests in winter and (in April) at colony sites where sparrows had been present all winter. Virus detected by reverse transcription (RT)-polymerase chain reaction in winter was less cytopathic than in summer, but viral RNA concentrations of samples in winter were not significantly different from those in summer. Both of the BCRV lineages (A, B) overwintered successfully, with lineage A more common at sites with house sparrows and (in contrast to summer) generally more prevalent in winter than lineage B. BCRV's ability to overwinter in its adult vector probably reflects its adaptation to the sedentary, long-lived bug and the ecology of the cliff swallow and swallow bug host-parasite system. Its overwintering mechanisms may provide insight into those of other alphaviruses of public health significance for which such mechanisms are poorly known.

West Nile virus activity in Latin America and the Caribbean

OBJECTIVES: West Nile Virus (Flavivirus: Flaviviridae; WNV) has spread rapidly throughout the Caribbean Basin since its initial detection there in 2001. This report summarizes our current knowledge of WNV transmission in tropical America. METHODS: We reviewed the published literature and consulted with key public health officials to obtain unpublished data. RESULTS: West Nile virus infections first appeared in human residents of the Cayman Islands and the Florida Keys in 2001, and in appparently healthy Jamaican birds sampled early in 2002. Serologic evidence of WNV infection in 2002 was detected in horses, chickens and resident free-ranging birds in Guadeloupe, the Dominican Republic, and eastern Mexico. In 2003, WNV spread in Mexico and northern Central America, and serologic evidence was detected in the Bahamas, Puerto Rico and Cuba. In 2004, the first serologic evidence of WNV activity in South American ecosystems surfaced in September-October in Colombia and Trinidad, where domestic animals circulated WNV-neutralizing antibodies. CONCLUSIONS: The sparse reports of equine, human and avain disease in Latin America and the Caribbean is puzzling. Isolates are needed to evaluate viral attenuation or other possible explanations for reduced disease burden in tropical ecosystems (AU)

Monitoring for activity of arboviruses in Trinidad and Tobago

Paper covers the history and some of the operations of the Trinidad Regional Virus Laboratory

Arbovirus studies in an evergreen seasonal marsh forest in Trinidad, West Indies

Studies carried out in Turure Forest, north-eastern Trinidad, from March, 1966, to March, 1969, resulted in the isolation of 462 arbovirus strains: 198 Venezuelan equine encephalitis (VEE), 42 eastern equine encephalitis (EEE), 75 group C, 136 Guama group, 2 Ilheus, 1 St. Louis encephalitis, 5 Wyeomyia, 1 Maguari, 1 Cocal, and 1 Aruac, Strains of VEE were recovered most frequently from sentinel mice (109) and Culex portesi (82), and the same was true for the group C and Guana group isolates. EEE strains came from sentinel mice (30), C. pedroi (11), and C. portesi (1). Forest rodents yielded only 9 isolates, all group C and Guana group and all from Proechimys guyannensis and Oryzomys capito; however, 21 percent of 639 rodent sera had haemagglutination-inhibiting (HI) antibodies to one or more viruses. VEE HI antibodies were more common in O. capito that in P. guya nnensis. In complement-fixation (CF) tests, 32 percent of O. capito and 8 percent of P. guyannensis reacted with a Guama group antigen. Birds yielded 3 isolates, 2 Iheus and 1 St. Louis, but 10 percent of 1,414 Manacus manacus sera reacted with EEE antigen in HI test. Three of 4 horses had CF antibodies to EEE, and 54 percent of 158 human sera wer HI-positive for one or more of 9 antigens used, including VEE and EEE (AU)

Epidemiological investigation for arboviruses in Jamaica, West Indies

Arbovirus investigation in Jamaica was undertaken between 1960 and 1975. Serological studies showed that antibodies to dengue type virus and St. Louis encephalitis virus (SLE) were prevalent throughout the island for several years. In urban communities, the incidence of dengue antibody was higher than for SLE; however, in children under 10 years of age antibody to both viruses was rarely present. In rural areas, SLE was prevalent in adults and children. This virus was isolated from Culex nigripalpus (mosquitoes) and from a nestling Mockingbird, Mimus polyglottos, in the same rural area, during two epidemic periods, 1963 and 1968. No other group B arbovirus was encountered on the island. Group A arbovirus was virtually absent prior to the eastern equine encephalomyelitis outbreak of 1962. That virus was isolated from brain tissue of humans and equines. Two strains of Cache valley virus from mosquitoes, Anopheles grabhami, one strain from Aedes taeniorhynchus, and a strain of Wad Medani virus from a tick, Amblyomma cajenense, were also isolated (AU)

Serological evidence of infection of tacaribe virus and arboviruses in Trinidadian bats

Sera from 39 species of bats collected in Trinidad between 1972 and 1974 were tested against some or all of 18 arboviruses in hemagglutination inhibition (HI) and/or suckling mouse neutralization (N) tests. A few sera were HI-positive with Mucambo, eastern equine encephalitis (EEE), Oriboca, Restan, Manzanilla, Guama, Bimiti, and Catu. No sera were HI-positive with Mayaro, Caraparu or Maguari. Many sera inhibited one or more of the group B hemagglutinins: Ilheus, St. Louis encephalitis (SLE), dengue 2, and yellow fever (YF), positives occurred in nearly every species of bat, being most frequent with Ilheus. In N tests, a few or single sera were found to protect against Ilheus, Nepuyo, Guama, Bimiti, and Cocal, while none protected against EEE, SLE, YF or Catu. Many sera positive in HI test with Ilheus, SLE or YF failed to neutralize the respective virus. Tacaribe neutralizing antibody was demonstrated in Artibeus jamaicensis and A.lituratus, the sources of past virus isolation, in the fruit bats Sturnira lilium and Vampyrops helleri, and in the vampire bat Desmodus rotundus. Sera from 19 other species gave either negative or inconclusive results. No convincing evidence of Tacaribe antibody was found in 29 human sera, 20 from bat collectors (AU)

Isolation of Rio Bravo and a hitherto undescribed agent, tamana bat virus, from insectivorous bats in Trinidad, with serological evidence of infection in bats and man

Between 1972 and 1974, 3,278 bats of 28 species were processed for virus isolation by suckling mouse (SM) inoculation. Two strains each of two related viruses, not hitherto reported from Trinidad, were isolated from insectovorous bats. Rio Bravo (RB) virus was isolated from salivary glands and saliva of the house bat, Molossus ater. The other virus, isolated from salivary glands, saliva and spleen of the molustache bat, Pteronotus parnollii, is a hitherto undescribed agent herein named Tamana bat virus (TBV). This virus has arbovirus characteristics: sensitivity to ether, pathogenicity for SM, and ability to hemagglutinate goose erythrocytes, but no serological relationship with known arboviruses and other viruses could be detected. In inoculation experiments with TBV, fatal illness was produced only in infant mice and rats, salivary virus excretion was demonstrated in a monkey and in Phyllostomus hastatus bats, and virus was passed in bats by subcutaneous inoculation of infected saliva. Sera of humans and 39 species of bats were tested for hemagglutination inhibition (HI): 46 out of 169 human and 125 out of 887 bat sera reacted with RB antigen, and of the positive bat sera reacted with TBV antigen, positives occurring in 15 bat species comprising insectovorous, fruit-eating and vampire bats, with highest incidence in cave-roosting species. In SM neutralization tests, 18 out of 27 HI-positive human sera protected against RB, 1 out of 10 against TBV; bat sera protective against RB were found in 4 insectovorous species, and against TBV in 8 species including the vampire bat, Desmodus rotundus. No evidence of arthropod transmission of either virus was found (AU)

First isolation of Catu virus from a human in Trinidad

The first isolation of Catu virus from a human in Trinidad is reported. It is also the first human isolate outside of Brazil. A convalescent serum neutralized 5.0 logs of the homologous virus.(AU)

Studies of Patois group arboviruses in Mexico, Guatemala, Honduras, and British Honduras

Patois, Zegla, and Shark River-like arboviruses in the Patois group were isolaed in Mexico, Guatemala, Honduras, and British Honduras during 1963 to 1968. Twenty-three Patois viruses came from mosquitoes, sentinel hamsters, and suckling mice, 21 Zegla viruses from sentinel hamsters and mice and from a wild cotton rat, and two Shark River-like viruses from sentinel hamsters. Hemagglutination-inhibition(HI) and neutralizing antibody tests with Patois virus were positive with human sera from each country, and HI antibody tests were positive with sera from pigs in Mexico, Guatemala, and British Honduras and from small wild mammals, wild birds, and cattle in Mexico.(AU)

The study of small mammal ecology in Turure Forest, Trinidad, with associated virological and parasitology problems

The main arbovirus part of the field programme was conducted with the object of following the epidemiology of rodent-associated viruses by isolation and serological conversions. Parasitology studies were added to this programme in August 1968, and the results can be summarized as follows: From a total of 590 sera or organs processed from 15 species, nine strains of viruses were isolated. Of these, four Guama gp. strains came from Oryzomys laticeps, while two Groups C strain s and three Guama gp. strains came from Proechimys guyannensis. Of 618 sera tested in H I, 115 (18.6 percent) were positive to one or more of the following antigens: VEE, Caraparu, Restan, Oriboca. All were negative to EEE, Una, IIheus and St. Louis antigens. Oryzomys appear to be more commonly infected with Group C agents than with VEE (group A), while with Proechimys the order is reversed. The C.F. tests showed that only Marmosa mitis (1/8), Oryzomys (39/106) and Proechimys (11/134) were found to have been infected with Guama group viruses. Only one serum (Oryzomys laticeps) reacted with Pacui antigen, and none reacted with Cocal. However, in mouse neutralization tests 42 sera, out of 184, were positive for Cocal virus. In the parasitological studies 179 animals have been processed; these have yielded possibly three species of trypanosomes and two species of filariae. In addition, Leishmania has been recovered from three species of small mammals (AU)

The study of small mammal ecology in Turure Forest, Trinidad, with associated virological and parasitological problems: I. Trapping techniques population densities home range and longevity studies

The first part of this paper describes the layout and field techniques employed in a small mammal trapping and release programme carried out in conjunction with the arbovirus studies at Turure Forest, Trinidad, between December 1966 and March 1969. Animals were caught in traps set along two parallel lines and also in two grids. Typically, the data collected from each animal included: sex, maturity, external measurements, weight, date, and exactly locality of capture. In addition, the animals were examined for ectoparasites, dermal lesions, and myiasis. Skin scrapings taken from fresh lesions were checked for leishmania, while blood collected by heart puncture was tested for viruses and antibodies, and screened for haemoparasites. Once the above data had been collected, the animals were marked by toe clipping and released at the point of capture. Inevitably, a few animals died during transportation and processing, and these were then subjected to a thorough internal examination and search for endoparasites. Two of the commoner species were bred in the laboratory, and a comparison of their rate of development with wild-caught specimens has enabled us to assess the age structure of the field population with greater accuracy. So far, it appears that the longevity of O. laticeps under laboratory conditions is about 28 months, close to the figure obtained by Dr. C. Brooke Worth. The work on Proechimys is incomplete. Under natural conditions Proechimys guyannensis can live for at least 20 months, but the enforced closure of the grids prevented further data being collected on O. laticeps. In addition to calculating the population density, the mean home range area for the two species, O. laticeps and P. guyannensis appears to be 0.83 and 0.34 acres respectively (AU)

Dengue type 3 virus isolated from an Antiguan patient during the 1963-64 Caribbean epidemic

A strain of dengue type 3 virus was isolated from the blood of an Antiguan patient in cell cultures of African green-monkey kidney during studies on a dengue outbreak that occured in the Caribbean region in 1963 and 1964. The virus was adapted to mice by blind intracerebral passage. Illness appeared in mice at the 11th mouse-brain passage. Four other agents, presumed to be dengue type 3 strains, were isolated from Antiguan patients. Serologic studies on serum from patients of five Caribbean territories showed that the outbreak was due to a group B arbovirus. (AU)

The investigation of an arbovirus encephalitis

A definition of an arbovirus and a broad idea of the groups and the numbers isolated and causing human infection are given. The small incidence of clinical disease compared with overall infection rates is stressed. The conditions for the successful survival of arboviruses is outlined. The investigation of the illness and origin of infection is described. The role of viral antibody in the development of encephalitis and the use of cortisone in treatment is discussed. The over-wintering of arboviruses and their capacity for latency is considered in relationship to the perpetuation of virus and the pathogenic effects on the hosts involved (Summary)

Hughes virus from Trinidadian ticks and terns

Fifteen strains of Hughes virus were isolated from Soldado Rock, Trinidad, between 1962 and 1965. Seven isolates came from ticks of the Ornithodoros capensis complex and 8 from nestling birds, Sterna fuscata.(AU)