An epidemiological description of illness in passengers and crew at the Bridgetown Barbados port and cruise terminal

OBJECTIVE: To describe and analyse the epidemiology of illnesses experienced by passengers and crew arriving at the Bridgetown Port, Barbados between 2009 and 2013. DESIGN AND METHODS: Data were extracted from the passenger and crew arrival registers and passenger and crew illness logs. This was done for all vessels arriving at the Bridgetown Port between January 2009 and December 2013. Data were entered into an Epi Info database and analysis done using Epi Info Version 7. RESULTS: There were 1031 cases of illness from over 3 million passenger visits and 1 million crew. The overall event rate for communicable illnesses was 15.7 (95% CI 14.4 - 17.1) per 100,000 passengers, and for crew was 24.0 (21.6 - 26.6) per 100, 000 crew. Gastroenteritis was the predominant illness experienced by passengers and crew followed by influenza. The event rate for gastroenteritis among passengers was 13.7 (12.5 -15.0) per 100,000 and 14.4 (12.6, 16.5) for crew. The event rate for non-communicable illnesses was 3.4 per 100,000 passengers with myocardial infarction being the main diagnosis. The event rate for non-communicable illnesses among crew was 2.1 per 100,000, the leading cause being injuries. CONCLUSIONS: The predominant illnesses reported were gastroenteritis and influenza similar to previous published reports from around the world, but gastroenteritis was the predominant illness, unlike most other published studies. There is a role for Port Health Officers to assist the food safety and sanitation efforts on cruise liners and more frequent inspections and investigations of diseases outbreaks may be helpful.

Evaluation of rapid screening assay for the direct detection of Haemophilus influenzae type b antigen in cerebrospinal fluid in paediatric meningitis

OBJECTIVE: To evaluate the use of a rapid antigen detection assay for detection of Haemophilus influenzae type b (Hib) antigen in cerebrospinal fluid (CSF) from children with meningitis. DESIGN AND METHODS: CSF specimens from children with meningitis were tested for bacterial antigens using latex agglutination (LA) tests and a novel rapid antigen test after all other investigations were completed. The analytical sensitivity of the antigen assays was compared using sterile CSF to which Hib was added. RESULTS: Hib meningitis was confirmed by culture in 4/10 (3.3 percent) of paediatric patients and in none of 29 neonates. The sensitivity and specificity of both LA and the rapid antigen test were 100 percent and 98.6 percent, respectively. The rapid screening assay also gave a positive result in a case of meningococcal meningitis. In CSF spiked with Hib, LA detected 4.2 x 10 5 cfu, while the rapid assay detected 100 cfu. CONCLUSIONS: Both LA and the rapid antigen assay detected all cases of Hib meningitis, but the analytical sensitivity of the rapid screening assay was much greater. Prospective studies of the rapid test for detection of other bacterial pathogens are required.(Au)

Post-disaster epidemiological surveillance following Hurricane Hugo in Montserrat - abstract

Hurricane Hugo struck the island of Montserrat during the night of 17th September, 1989. Sustained winds of 130 mph were experienced for 8 hours with damage to 93 per cent of buildings; 50 per cent seriously and 20 per cent destroyed. The main hospital lost its roof and most health centres were severely affected. Two thousand five hundred persons were rendered homeless, of whom 1,000 were housed in shelters. Three days after, environmental health surveillance revealed unsatisfactory conditions in shelters with inadequate water supplies and faecal disposal. Water was trucked to shelters and a pit latrine programme commenced so that by the first week of October, all shelters had acceptable faecal disposal facilities. Island-wide, symptom-based daily reports of disease surveillance was introduced 9 days after the hurricane for respiratory infections and gastroenteritis. This allowed daily monitoring of disease occurrence by locality, targeting of health education and environmental health measures, and made it easier to dispel rumors which occurred after the hurricane. There was an increase in gastroenteritis 10 - 14 days after, but this subsided as potable water supplies were established. One month after, 30 cases of fever of unknown origin were detected. At first suspected to be dengue fever, it turned out to be influenza A (hl, N1) (AU)

An outbreak of influenza in Jamaica (1986)

An outbreak of febrile illness at the Police Training Academy in St. Catherine, Jamaica in October, 1986 is described. Influenza A similar to type A/Taiwan/86 (H1N1) was confirmed serologically in 33 cases, and Influenza B similar to typeB/Ann Arbor/86 in 1 case. Clinical findings included upper respiratory symptoms (97 percent) headache (74 percent), fever (68 percent), joint pains (39 percent) and retro-orbital pain (26 percent). The role of vaccination and chemoprophylaxis in the prevention of influenza is discussed, and the importance of surveillance is stressed (AU)

Influenza A virus associated neurological disorders in Jamaica

During 1979, three cases of influenza A virus infection associated with neurological disorders were observed. In all three cases the virus was isolated from the cerebrospinal fluid. A mechanism for the development of post-influenzal encephalopathy is postulated (AU)

Virological investigations during the 1966 epidemic of influenza in Trinidad

Virological investigations of an influenza epidemic in Trinidad, W>I>, during the year 1966 are presented. Four strains of influenza A (Asian) virus were isolated in tissue culture and eighteen cases were diagnosed by serological methods (AU)

An epidemic of para-influenza infection in Trinidad - abstract

An outbreak of acute respiratory disease occurred among infants and children in northern Trinidad during the last quarter of 1967. Between October 1 and December 31, six hundred children were admitted to Port-of-Spain General Hospital. Approximately one half of these patients were less than two years of age. Clinical syndromes ranged from severe acute upper respiratory infections to bronchitis and pneumonia. Profuse muco-purulent upper respiratory secretions and severe bronchospasm were prominent clinical manifestations. There were six deaths. Hemabsorbing agents were isolated from 60 patients. To date, 31 have been identified as para-influenza I, eight as para-influenza III and one as para-influenza II. Although para-influenza viruses have been implicated as the cause of sporadic respiratory illnesses in Trinidad in the past, the occurrence of a large outbreak due to these agents is an epidemiologic pattern not previously recognized in the Eastern Caribbean(AU)

Respiratory viruses in Jamaica: a virologic and seriologic study. 3. Hemagglutination-inhibiting antibodies to type B and C influenza viruses in the sera of Jamaicans

The results presented in this paper described a survey for hemagglutination-inhibiting antibodies to one type C and 2 type B influenza viruses in Jamaica sera. Antibodies to all 3 strains were found to be very common and the distribution by age of influenza B antibodies indicates that infections by the type B viruses occur in Jamaica primarily in the 5-to 9-year and 10- to 14 year age groups. A fairly widespread immunity to influenza B infection is evident in early adult life. The incidence and titer levels of hemagglutination-inhibiting antibodies to type C influenza virus increase throughout life. Primary infections is acquired during childhood and the increasing antibody titer levels with age suggest that reinfections are not uncommon. (AU)

Respiratory viruses in Jamaica: a virological and serological study. 2. Hemagglutination-inhibiting antibodies to influenza A viruses in the sera of Jamaicans

The incidence and level of hemagglutination-inhibiting antibodies to 4 group A infleunza viruses in the population of Jamaica has shown that there is an approximately similar age distribution of antibodies to the different infleunza strains as has been encountered else-where. Antibody titres to A/Swine/1976/31 were highest in sera from older Jamaicans; antibodies titres to A1/Fort Manmouth/1/47 were maximal in the younger segment of the population and antibody titres to A/Puerto Rico/8/34 reached their highest levels in sera from intermediate age groups. The greatest incidences and levels of hemagluttination-inhibiting antibody in almost all age groups were observed against infleunza A2/Jamaica/2/63, a locally recovered type A2 strain.(Summary)

Respiratory viruses in Jamaica: a virologic and serologic study. 1. Virus isolations and serological studies on clinical specimens

A survey of respiratory viruses and their antibodies in the Caribbean island of Jamaica has revealed that infleunza A, B and C viruses, parainfleunza type 1 and 3 viruses, respiratory syncytial virus and several types of adenovirus are causing respiratory infections in the Jamaican population. Respiratory virus infections were detected in Jamaica more frequently in the cooler months of the year, October through March, than in the warmer months. Adenoviruses were observed to be causing infections at all times of the year, but some evidence that parainfleunza type 1 infections are occurring at intervals only was obtained. Almost all infections by respiratory syncytial virus were obtained in infants and young children with severe lower respiratory tract disease.(Summary)

Laboratory investigation of the 1963 influenza epidemic in Jamaica, West Indies

An epidemic of influenza due to type A2 virus occurred in Jamaica during the early months of 1963. Cases were reported from all the parishes with highest incidence in Westmoreland, Clarendon, St. Ann and St. Mary. All age groups were involved, with highest attack rate in the 0-9 and 25-64 age groups and the lowest in the 10-24 year age group (AU)

Intradermal immunization against Asian influenza (abstract only)

Influenza virus undergoes continuous antigenic alterations which at times become so profound that the antigens in the available vaccines can not protect against newly emerging variants. Such a state of affairs makes it difficult if not impossible to furnish effective vaccines in adequate amounts during outbreaks caused by such variants. When vaccine is in short supply, one asks the question about the efficacy of reduced dosages. The present report relates information which shows that using proper spacing of injections, even small amounts of antigens, may engender antibody response in various age groups, including children (AU)

Virological investigations during the 1959 outbreak of influenza in Trinidad

Six strains of Asian influenza virus were isolated during an outbreak of influenza in Trinidad. Serological studies on eleven cases are reported (Summary)

The isolation of influenza virus during an epidemic in Trinidad, British West Indies

Ten isolates of influenza virus were obtained from throat washings collected from patients during an epidemic in Trinidad, British West Indies. These isolates were shown to be closely related to the Far East isolate, A/Asian/Japan/305/57. Serological investigations on acute and convalescent sera from 28 cases are reported. (AU)