Turks and Caicos Islands

episodes of dry spells and drought conditions can also contribute to the spread of diseases linked to
inadequate water supply and sanitation.
Air quality can also impact on the health sector. Increased incidence of asthma, influenza, respiratory
diseases and acute respiratory infections due to increases in particulate air pollutants and changing air
composition have been identified in the Inter-governmental Panel for Climate Change (IPCC) Fourth
Assessment for the Health Sector (Confalonieri, et al., 2007). Diphtheria cases have also been reported in
the Turks and Caicos Islands (Kairi Consultants Limited, 2000b) and there was an alert for this disease based
on its resurgence in Haiti after the 2010 earthquake (MOH, 2010). Table 4.4.2 below shows the number of
cases of fever and respiratory symptoms described as acute respiratory infections (ARI) between 2006 to
2009. The data, however, is insufficient to establish any trends, and monthly data would be helpful in
determining if seasonal trends exist. Increase in incidence has shown that the prevalence is highest
between October to March (PAHO, 2007).
Table 4.4.2: Fever and Respiratory Systems (acute respiratory infections) under and over 5 years between 2006 -
2009
Year 2006 2007 2008 2009
Fever and Respiratory symptoms (ARI) < 5 yrs
64
616 341 371 478
Fever and Respiratory symptoms (ARI) ≥ 5 yrs 882 313 286 655
Total no. of cases 1498 654 657 1133
(Source: CAREC, 2008a; CAREC, 2010)
At least in one other Caribbean island, namely Saint Lucia, analysis of disease data for asthma, bronchitis
and respiratory infections showed that there is a seasonal incidence (Amarakoon et al., 2004). Further
research may yield similar trends in other Caribbean islands. Influenza and influenza like cases are also
cause for concern. There were 324 cases of influenza-like illnesses in 2006, but no reported cases in 2007
(CAREC, 2008a) or 2008 (CAREC, 2010). However between July and August 2009, there were 17 new cases
of Influenza A H1N1 reported, eight were from Grand Turk and nine from Providenciales (Government of
Turks and Caicos Islands, 2009c). The resurgence of the disease resulted in health action at a national level.
If air quality can have a significant impact on the health of the local population then, it is reasonable to
expect similar effects on vulnerable travellers (Sanford, 2004) particularly those with respiratory,
pulmonary and cardiac disease conditions.
Water supply, sanitation and associated diseases
Climate change predications indicate the possibility for reduction in overall precipitation in the Turks and
Caicos Islands. This thus results in a reduction in potable water supplies (Climate Change Committee,
2011b). A number of food-borne and water-borne illnesses are associated with water and poor sanitation
and those of relevance for the Turks and Caicos Islands include gastroenteritis, shigellosis, salmonella,
cholera and typhoid fever (PAHO, 2007). Specific mention should be made for gastroenteritis and especially
cases related to the population under five years old. This disease is spread through poor sanitation and
insufficient supply of water. In 2007 there were two significant outbreaks of gastroenteritis in Turks and
Caicos (CAREC, 2008b). Table 4.4.3 below shows that cases of gastroenteritis have increased almost
consistently every year from 2003 - 2009.