title: Success in controlling a major outbreak of malaria because of Plasmodium falciparum in Jamaica.
abstract: In 2006, after 44 years of eradication of malaria, Jamaica had an outbreak of Plasmodium falciparum: 406 confirmed cases between September 2006 and December 2009 with a peak of the epidemic in December 2006. In response to the outbreak, the Ministry of Health launched an emergency response through early detection and prompt treatment of cases, vector control, public education and intersectoral collaboration. Ninety percent (361) of cases were residents of Kingston, and 63.6% were identified through house to house surveillance visits. For 56% of the confirmed cases, treatment with chloroquine was initiated within a week of onset of symptoms. Only one (0.3%) of 358 cases who had a post-treatment smear on day 7 had a persistent asexual parasitaemia, while none of the 149 persons who had a follow-up smear on day 28 was positive. The outbreak highlighted the need for increased institutional capacity for surveillance, confirmation and treatment of malaria as well as effective prevention and control of outbreaks which can occur after elimination. Jamaica appears to have successfully eliminated malaria after its reintroduction.
authors.affiliation: Kingston and St. Andrew Health Department, Ministry of Health, Kingston, Jamaica. kwebsterkerr@yahoo.com
authors.forename: Karen
authors.initials: K
authors.lastname: Webster-Kerr
authors.forename: J
authors.initials: J
authors.lastname: Peter Figueroa
authors.forename: Pauline L
authors.initials: PL
authors.lastname: Weir
authors.forename: Karen
authors.initials: K
authors.lastname: Lewis-Bell
authors.forename: Everton
authors.initials: E
authors.lastname: Baker
authors.forename: Jeannette
authors.initials: J
authors.lastname: Horner-Bryce
authors.forename: Eva
authors.initials: E
authors.lastname: Lewis-Fuller
authors.forename: Marion
authors.initials: M
authors.lastname: Bullock Ducasse
authors.forename: Keith H
authors.initials: KH
authors.lastname: Carter
authors.forename: Sheila
authors.initials: S
authors.lastname: Campbell-Forrester
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000852:Anopheles; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D042241:Early Diagnosis; D005260:Female; D006266:Health Education / Q000379:methods; D006801:Humans; D007223:Infant; D007303:Insect Vectors; D007563:Jamaica / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy / Q000635:transmission; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000379:methods; D011159:Population Surveillance; D017678:Sex Distribution; D055815:Young Adult