Knowledge attitudes and practices contributing to vector proliferation and dengue in Trinidad and Tobago

Aedes aegypti is found breeding on almost every island in the Greater and Lesser Antilles, and is the peri-domestic vector of dengue fever and its clinical sequalae, dengue haemorrhagic fever (DHF) and dengue shock syndrome (DHF) and dengue shock syndrome (DSS). It is also the classic urban vector of yellow fever. Four serotypes of the virus which causes dengue have been isolated and all four have been found in the Caribbean area during the last forty years, beginning in 1952 with a dengue type 2 in Trinidad; dengue type 3 in Puerto Rico (1964); dengue type 1 in Jamaica (1977); and dengue type 4 in St. Maarten (1981). Dengue serotypes 1,2 and 4 are currently circulating in the region. In the last fifteen years there has been a marked increase in the number of reported cases of dengue in the Americas. Recurring epidemics of dengue are causing considerable morbidity and imposing significant financial burdens on the economies of affected countries. Thousands of cases have occured in the Caribbean and have presented mostly as classical dengue (AU)

Cuban neuromyelopathy epidemic

During the last semester of 1991 an unexpected increase in the number of cases of optic neuropathy was detected by the Cuban Epidemiological Surveillance System in the Pina del Rio province of Western Cuba. Reported cases occurred mainly in middle-aged men, usually tobacco farmers with a history of cigarette smoking and moderate alcohol consumption. Patients complained of weight loss, blurred vision, photophobia, and progressive decrease in visual acuity over a period of 1-4 weeks. Examination disclosed the presence of bilateral and usually symmetrical central or cecocentral visual field defects with the loss of red-green colour vision, pallor of temporal border of optic disc and loss of fibres in maculopapillary bundle. A diagnosis of tobacco-alcohol amblyopia or nutritional optic neuropathy was made at the time. By the end of July 1992, a total of 168 cases had been reported (monthly range, 14-36), all confirmed to this province. By December 1992, the number had increases to 472 cases, including reports from five of fourteen provinces of Cuba, mainly in Havana, Sancti Spiritus, Holguin and Santiago de Cuba (AU)

Involvement of the private sector in response to the threat of cholera in Trinidad and Tobago

On Friday January 31st, 1992 the Trinidad and Tobago Minister of Health, the Honourable Mr. John Eckstein, informed the twin island state that "cholera is staring us in the face", following its arrival in neighbouring Venezuela. In his statement to the House of Parliament, he outlined the spread of the disease from the first cases in Peru in January 1991, to epidemics in Ecuador, Colombia, Chile, Brazil, then to the Central American countries of Mexico, Guatemala, El Salvador, Bolivia, Honduras, Nicaragua, and eventually to Venezuela with 58 cases as at January 30, 1992. Calling Venezuela "our backyard", given that it is a mere seven miles away and that there is frequent travel (legal and illegal) between the two countries, Mr. Eckstein reiterated the opinion of experts, that introduction of the disease was inevitable. He therefore placed the nation on a cholera alert and focused the Ministry's attention on containing the spread of the disease and thereby minimising its negative impact (AU)

Importation of wild polio virus from Europe

Canada has recently isolated wild poliovirus type 3 from members of a church community in Alberta that refuses immunization. The members of this community frequently travel back an forth to visit the religious community in the Netherlands which recently had a large poliovirus outbreak. The viruses isolated in Alberta have identical genomic sequences to those isolated in the Netherlands. There are no cases of paralytic poliomyelitis thus far in Canada. This is the first detected importation of wild poliovirus into the Americas since the interruption of indigenous transmission in 1991 (AU)

Heterosexual transmission of HIV in Puerto Rico 1981-1991

Puerto Rico has the second highest overall rate of acquired immunodeficiency syndrome (AIDS) cases among states and territories of the United States and the second highest rate among women (1.2). Although heterosexual transmission of human immunodeficiency virus (HIV) among persons reported with AIDS has increased throughout the United States - accounting for 8 percent of all U. S. AIDS cases diagnosed in 1991 (2.3) - the proportion of cases attributed to heterosexual transmission is highest in Puerto Rico (18 percent). This report summarizes data collected through the Puerto Rico AIDS Surveillance Program to characterize AIDS cases associated with heterosexual transmission during 1981-1991 (AU)

Tuberculosis occurence in the CAREC member-countries 1983-1992

A review of reported Tuberculosis in CAREC member-countries 1983-1992 shows an overall, downward trend in annual numbers of reported cases for the first half of the period followed by an increase in the latter half of the period. The vast majority of cases were reported from eight countries viz. Bahamas, Belize, Dominica, Guyana, Jamaica, Saint Lucia, Suriname and Trinidad and Tobago which together make up 90 percent of the population (AU)

An increase in the number of reported cases of Hepatitis A in the Turks & Caicos Islands

The Chief Medical Officer of the Turks & Caicos islands contacted CAREC on the afternoon of March 1st requesting assistance with the investigation of an outbreak of hepatitis. They estimated there were 17 cases between September 1992 and March 1st 1993. Six of the recent cases were confirmed as Hepatitis A by the Centers for Disease Control. A review of the cases of Hepatits as reported to CAREC over the last thirteen (13) years showed that an average of one to two cases were reported per year. The 17 cases therefore constituted an outbreak. CAREC agreed to provide assistance with the investigation and control of the outbreak (AU)

Diagnosis of measles by clinical case definition in dengue-endemic areas: implications for measles surveillance and control

In many countries measles surveillance relies heavily on the use of a standard clinical case definition; however, the clinical signs ans symptoms of measles are similiar to those of dengue. For example, during 1985, in Puerto Rico, 22 (23 percent) of 94 cases of illness with rashes that met measles clinical case definition were serologically confirmed as measles, but 32 (34 percent) others were serologically confirmed as dengue (AU)

Salmonellosis

Salmonellosis is a term used to define "the clinical manifestations in man and animals resulting from infection by salmonella organisms other than S. typhi or S. paratyphi A, B or C". There are around 2000 Salmonella serotypes. They infect a multitude of hosts, including mammals, birds, reptiles and insects. Removed from their hosts, they often remain viable in the environment even when desiccated and deprived of their ordinary metabolic needs (AU)

Summary report on the ninth meeting of Caribbean EPI managers, held in the Department of Guadeloupe, France November 9-13, 1992

Besides the various topics that will be discussed in the subsequent sections of this report, it is important to state from the onset the tremendous progress made by every country towards the organization and implementation of surveillance system for detection of suspected measles cases. In one year, the countries of the English-speaking Caribbean and Suriname went from a phase in which little active surveillance was occuring to what now may be one of the most sophisticated systems in the world (AU)

A case control of cholera outbreak in Guyana

After an absence of more than 100 years, epiemic cholera reappeared in the Western Hemisphere in Peru in late January in 1991. A long standing economic recession there paved the way for a massive epidemic with some 500,000 cases by the end of October 1992. Initial epidemiological investigation implicated several vehicles of transmission including contaminated municipal water, eating raw fish and shell fish (ceviche), and food and drink from street vendors. From Peru the disease spread rapidly at a rate of approximately one country per month throughout Latin America. The Director of the Pan American Health Organization (PAHO) pointed out that the countries of Latin America were paying a new social debt: that of long neglected attention to water and sanitation and health services (AU)

Dengue fever in Trinidad and Tobago

During the period January 1st through October 31st 1992, four hundred and forty four (444) clinical cases of dengue fever were reported to the National Surveillance Unit of the Ministry of Health. Roughly twenty percent of these notifications were recorded during week number 40, ending October 3rd 1992. Reported morbidity was not confined to any specific geographic area, although the greatest proportion of notified cases originated in County Caroni (AU)

Aids in the CAREC member countries: a statistical update

Between the years 1982 and 1991, 3,132 cases of AIDS and 1,963 deaths were reported to CAREC by its 19 member countries. A year-to-year comparison indicates that the rapid increase in cases continued in 1991, the number reported for that year being 34 percent higher than the figure for 1990. Six countries, Bahamas, Barbados, Bermuda, Jamaica, Guyana and Trinidad and Tobago accounted for 90 percent of all reported cases (AU)

Dengue epidemiologic surveillance report January-December Dominican Republic

In 1991, during the Dengue Surveillance Project (January-December) 627 samples were taken from suspected cases of dengue. Out of those total cases, 24 were serologically confirmed cases of dengue (classified according to clinical symptoms and the required epidemiologic criteria). These results showed that 70-83 percent (17) of the cases were of the classic dengue type, and 29-36 percent (7) cases were dengue haemorraghic. Nine (40 percent) cases were female and Fifteen (60 percent) were males (AU)