November 30, 1998
Dengue Fever
Further to our earlier communications in which it was noted that dengue virus type 3
was circulating in Belize, Puerto Rico and Jamaica, we wish to indicate that CAREC's
laboratories have identified and confirmed single cases of type 3 infection each in St.
Christopher/Nevis and Barbados.
Barbados is therefore the first CAREC member country in which all four dengue virus
types have been found circulating during 1998. Concurrent circulation of dengue virus
types 1 and 2 has been reported to CAREC's Epidemiology Division from Martinique, while
type 4 activity has been exclusively documented in the Bahamas. Dengue virus type 2 has
been the predominant aetiologic agent in Trinidad and Tobago, Barbados and St. Vincent and
the Grenadines.
It must be noted that a significant proportion of the Caribbean population is
susceptible to dengue virus type 3, as this serotype was last documented in the region
during 1978. Additionally, opportunities for expanded transmission could occur as students
from the University of the West Indies travel from Jamaica to their respective countries
for the Christmas vacation. Even at this time, it is well recognised that many persons
from the southern Caribbean do travel to Puerto Rico to take advantage of Thanksgiving
holiday sales, and could therefore have become exposed there.
Cholera
On November 20, 1998, Ministry of Health officials reported the occurrence of an
outbreak of cholera in St. Martin village, in the Cayo District of Belize. Eleven
suspected cases were notified, of which five were confirmed as cholera. One case, which
occurred in a 78 year-old male, was fatal. Contaminated creek water was suspected to be
the source of the infection.
Cholera is also being notified from El Salvador, Guatemala, Honduras and Nicaragua in
Central America. Recent increased morbidity has been attributed to the situations created
by Hurricane Mitch.
The Ministry of Health and Social Assistance in Venezuela has also notified the
occurrence of 212 clinical cases of cholera in the state of Delta Amacuro (eastern
Venezuela) between epidemiological week numbers 43-46. Nearly all of these reported
cholera cases (203/212) were five years or older in age. Three deaths have also been
recorded, all of which have been in children under five years of age.
Yellow Fever
Further to an earlier communication concerning yellow fever in Venezuela [14 cases and
3 deaths] during October 1998, we wish to advise that yellow fever activity has been
documented in Brazil [Roraima State] in areas close to its borders with Guyana. As at
October 21, 1998, a total of 32 confirmed cases with 13 deaths have been reported by
Brazilian health authorities to the Pan American Health Organisation. Although no human
case of yellow fever has been identified in Guyana, vaccination is strongly recommended
for persons travelling to the interior regions of that country. The Ministry of Health,
Guyana, has already initiated a yellow fever vaccination programme, commencing with high
risk populations along its border with Brazil.
