Communicable Diseases Feedback Report

Reporting Period: Week Numbers 1-8 of 1997

A review of the communicable diseases reported (Table 1) to CAREC’s Epidemiology Division from its member countries during the first eight weeks of 1997 indicates significant changes in the reported morbidity of some diseases as compared to the epidemiologic situation in 1996. From a sub-regional perspective, reported morbidity due to acute respiratory infections among children under five years of age has been significantly lower in 1997 (1,800 cases as against 4,592 during the corresponding period of 1996), with Grenada contributing roughly 46.0 percent of the total cases notified. To date in 1997, overall reported influenza morbidity for the region has also declined, even though the notifications from the Bahamas have been markedly elevated over those recorded for the corresponding period in 1996.

Case notifications of dengue fever in 1997 are considerably reduced as only 81 cases have been reported compared with 398 for the first eight weeks of 1996. Roughly 89.0 percent of the total reported dengue fever cases in 1997 have been notified from Trinidad and Tobago, where an extensive outbreak involving some 3,983 cases had been recorded during 1996.

Total reported morbidity due to gastroenteritis in 1997 (9,139 cases) is roughly 23 percent higher than that reported for the corresponding period of 1996 (7,459 cases). Significantly increased reporting of gastroenteritis has been noted in Antigua, Bermuda and Jamaica during the first eight weeks of 1997.

As regards the vaccine preventable diseases of the Expanded Programme on Immunisation, marked differences have been noted in the notification of suspected measles as 131 cases have been reported as against 33 cases during the corresponding period of 1996 (Figure 1). While the greatest proportion of these cases has been recorded in Guyana (31.2%), Belize, Trinidad and Tobago and Jamaica have also been major contributors to this epidemiologic picture. It must, however, be emphasised that no laboratory confirmed cases of measles have been documented in the region since 1991.

The reported incidence of rubella in 1997 differs significantly from the 1996 situation as 126 cases have been notified compared with 7 during the corresponding 1996 period (Figure 2). Belize, Trinidad and Tobago and Jamaica are continuing to experience marked rubella virus activity. CAREC’s EPI laboratory has indicated that as at March 31,1997, roughly 39.0, 52.0, 41.0 and 26.0 percent of the clinical specimens referred from Belize, Guyana, Jamaica and Trinidad and Tobago, respectively, under the enhanced rash/fever surveillance system have been confirmed as rubella.

Further, the EPI laboratory has also confirmed 3 cases of congenital rubella syndrome (CRS) during this eight week period, two of which have occurred in Barbados and the other in Belize. Additionally, 4 cases of CRS have been recorded in Jamaica during the first eight weeks of 1997. All countries are being encouraged to actively search for and notify cases of congenital rubella syndrome.