Turks and Caicos Islands

2000). Thus, despite the fact that CAREC data indicates that the incidence of dengue fever in the Turks and
Caicos is very low, with one case being reported in 2006, none in 2007, 2008 or 2009 (CAREC, 2008a;
CAREC, 2010) the potential exists for an increase in incidence of the disease. The economic, social and
environmental factors can also affect the occurrence and transmission of the disease (Hopp and Foley,
2001).
Dengue fever is endemic to the Caribbean region and is thus a major public health problem which can
affect both locals and tourists (Castle et al., 1999; Pinheiro and Corber, 1997; Wichmann, Mühlberger, &
Jelinek, 2003). Allwinn et al. (2008) have found that the risk to travellers has been underestimated. In fact it
is the second most reported disease of tourists returning from tropical destinations (Wilder-Smith and
Schwartz, 2005) and air travel has been linked with its spread (Jelinek, 2000). This vector-borne disease has
affected the region since as early as the 1800’s (Pinheiro and Corber, 1997).
In Jamaica, Chadee et al. (2009) found that large storage drums used during dry spells and drought
conditions were the main breeding sites of the vector, Aedes aegypti, accounting for a third of their
breeding sites. Traditional targets of source reduction in Jamaica, i.e. small miscellaneous containers, were
found to contain negligible numbers of pupae. However, if drought conditions become commonplace in the
future due to climate change the use of large water storage drums may be used and thus may provide
suitable breeding sites for the vector Aedes aegypti. Water storage and mosquito breeding are also very
important in the Turks and Caicos Islands due to the high number of cistern usage employed on this island.
Malaria - Malaria is another vector-borne disease which is believed to be sensitive to climate change
(Githeko & A.Woodward, 2003; Martens, et al., 2007). The potential for disease transmission of malaria in
the Turks and Caicos Islands is thought to be very low because in a study of malaria in the Caribbean, none
of the 29 species of Anopheles – the mosquito responsible for the spread of malaria – present in the region
were identified in Turks and Caicos. There were however, 4 reported imported cases during 2001-2005
(PAHO, 2007), 1 reported imported case in 2007 (CAREC, 2008a) but no reported cases in 2008 and 2009
(CAREC, 2010). Imported cases represent a threat to the complete prevention of malaria in the territory.
The study stressed the point that although no mosquito species were recorded, this did not necessarily
signify an absence of the vector (Rawlins et al., 2008).
Leptospirosis - Aside from mosquito vectors, rodents present a health threat due to their ability to harbour
and spread diseases. The likelihood of these events are difficult to predict because while rainfall patterns
are expected to decrease, storms and hurricanes can dump high volumes of water on the island in short
time frames, creating suitable conditions for rodent infestation. One disease of note that is transmitted by
rodents is leptospirosis. Gubler et al. (2001) define leptospirosis as “an acute febrile infection caused by
bacterial species of Leptospira that affect the liver and kidneys.” After heavy rains brought on by hurricanes
and tropical storms leptospirosis preparations are undertaken to protect against the spread of this disease
in the Turks and Caicos Islands (PAHO, 2011). Flood waters contaminated with faecal matter and urine from
infected rats is often associated with, and is one of the main causes of leptospirosis outbreaks and spread
(Gubler, et al., 2001; Hales, et al., 2002; Moreno, 2006; Sachan and Singh, 2010). CAREC data indicates that
between 1980 and 2009 there was only one case of leptospirosis in 1998 (CAREC, 2008a; CAREC 2008c;
CAREC, 2010).
Drought, air quality and respiratory illnesses
The Turks and Caicos Islands is prone to drought conditions. GCM projections indicate a tendency for the
likely reduction in precipitation in the Turks and Caicos Islands by the 2080’s. RCM simulations also driven
by HadCM3 boundary conditions indicate a large decrease whereas that driven by ECHAM4 indicates a
small increase in annual precipitation (See Section 3). This constitutes a vulnerability to the health sector as
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