Caribbean - Armed Forces Pest Management Board

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Typhoid and paratyphoid fevers are also endemic; cholera has not been reported recently from the Caribbean, but outbreaks have occurred in nearby Mexico and Central America. Resistance of enteric pathogens to commonly used antibiotics can complicate treatment, and antibiotic-resistant pathogens have been reported from the region. MOSQUITO-BORNE DISEASE* Malaria has been eradicated throughout the Caribbean except for the island of Hispaniola. Malaria is a major public health problem in Haiti, where risk is present countrywide and year-round at elevations under 500 m. Risk of transmission is higher in the northern parts of Haiti. Malaria occurs in rural areas of the Dominican Republic below 400 m, especially in the provinces bordering Haiti. In both countries, nearly all cases are caused by Plasmodium falciparum. Drug-resistant strains are not a problem and chloroquine is currently recommended for prophylaxis. An outbreak of vivax malaria occurred on Trinidad in the early 1990s, and a cluster of malaria cases caused by P. malariae also occurred on Trinidad during the mid 1990s. Current risk of transmission on Trinidad is unknown but is likely to be very low. Competent malaria vectors are present on most Caribbean islands, and imported cases of malaria are common. Dengue is widespread throughout the Caribbean, including dengue hemorrhagic fever/dengue shock syndrome, and outbreaks occur annually. All 4 serotypes of dengue virus are circulating in the region. In Cuba, major epidemics have resulted in several hundred thousand cases. The introduction and spread of Aedes albopictus in the Caribbean region will increase the risk of transmission. Dengue is the most serious arthropod-borne disease risk to military personnel in the Caribbean. Yellow fever is not a threat to military personnel in the Caribbean due to the low enzootic prevalence of the disease, which may circulate only in forested areas of Trinidad, and the availability of a safe vaccine that provides complete protection against infection with yellow fever virus. Epizootics of mosquito-borne viral encephalitis, including eastern equine encephalitis, St. Louis encephalitis, Venezuelan equine encephalitis and western equine encephalitis, have occurred in the Caribbean, although few human cases have been reported. Of these, Venezuelan equine encephalitis appears to be the most prevalent, although the epidemiology of these arboviruses is poorly known in the region. Risk of transmission appears to be low. Numerous potential vector species, especially in the genus Culex, are widely distributed in the Caribbean. Filariasis, caused by nocturnally periodic Wuchereria bancrofti, is prevalent in Haiti and the Dominican Republic. Filariasis transmission may occur in the Lesser Antilles from Trinidad to Guadeloupe, although incidence of the disease in these islands is rare. The primary if not exclusive vector in most parts of the Caribbean is Culex quinquefasciatus. 8
TICK-BORNE DISEASE* Tick-borne diseases are an insignificant threat to military personnel in the Caribbean. In 1999, a single case of African tick bite fever caused by Rickettsia africae was reported from a tourist who had visited Guadeloupe in the French West Indies. The pathogen was also isolated from the tropical bont tick, Amblyomma variegatum, collected on the island. In 1987, a case of tick-borne-relapsing fever was reported in a park ranger working in the Virgin Islands. Several species of Ornithodoros soft ticks are known from the Caribbean, and many of these are common in caves found on many islands. Human cases of Q fever have not been reported from the Caribbean recently. However, livestock on Trinidad have been found infected with Coxiella burnetii, and the pathogen is probably focally distributed throughout the Caribbean wherever livestock are raised. Troops should avoid consumption of local unpasteurized dairy products and contact with domestic animals. Soldiers should not rest, sleep, or work in or near animal sheds or other areas where livestock have been housed. SAND FLY-BORNE DISEASE* Cutaneous leishmaniasis (CL) is rare in the Caribbean. At least two species of Leishmania cause skin lesions on certain islands of the region. The only country with a current focus of cutaneous leishmaniasis is the Dominican Republic. Most of the cases are of the diffuse clinical type and tend to be negative for the Montenegro skin test, but mild, subclinical cases are apparently common. In the Dominican Republic the black rat, Rattus rattus, has been incriminated as a reservoir of Leishmania mexicana dominica. The suspected sand fly vector of Le. mexicana dominica in the Dominican Republic is Lutzomyia christophei, the only anthropomorphic species on the island. CL may be present in Haiti, but no recent studies have confirmed this. Sporadic indigenous cases of CL have also been reported in Martinique and in Trinidad. Human cases were reported in Trinidad before 1930, but it is not clear if they represent endemic human CL or if they were imported cases. No new cases have been found in the last 70 years, although an enzootic cycle is present on Trinidad involving rodent and marsupial reservoirs, the sand fly Lu. flaviscutellata, and the parasite Le. amazonensis or a closely related species. Sporadic cases of CL have been reported on Martinique, where Lu. atroclavata has been identified as the only indigenous sand fly. No autochthonous cases have been documented in Cuba, although the sand fly Lutzomyia orestes is common in all the provinces of Cuba and is known for persistent and vicious attacks on humans. Consequently, the opportunity for introduction of CL into Cuba is high compared to other islands of the Caribbean. Puerto Rico has had numerous imported cases of CL, but the ecology on this island seems to be unfavorable for endemic transmission because no anthropophilic sand fly species has been found. Visceral leishmaniasis (VL) is essentially unknown from the Caribbean. One apparently indigenous case of VL was reported in Guadeloupe in 1966. However, there have been no recent studies to confirm if VL is endemic on the island. CULICOIDES-BORNE DISEASE* Mansonellosis is caused by infection with the filarial worms Mansonella ozzardi or M. perstans and is largely nonpathogenic. Microfilariae of Mansonella spp. circulating in the peripheral blood may be mistaken for microfilariae of more serious filarial pathogens such as Wuchereria bancrofti. Human infection is highly prevalent in Haiti and the Dominican Republic. Transmission also occurs on some 9
Page 2 and 3: PREFACE Disease Vector Ecology Prof
Page 4 and 5: accuracy of respective arthropod gr
Page 6 and 7: N. Jamaica ........................
Page 8 and 9: Table 3. Distribution of Venomous T
Page 10 and 11: Climate. All Caribbean countries ha
Page 14 and 15: islands of the Lesser Antilles as w
Page 16 and 17: VECTOR-BORNE DISEASES IN THE CARIBB
Page 38 and 39: IV. COUNTRY PROFILES. A. Anguilla.
Page 40 and 41: 2. Climate. Aruba’s climate is tr
Page 42 and 43: 2. Climate. The climate is tropical
Page 44 and 45: 2. Climate. The climate is tropical
Page 46 and 47: untreated industrial wastes, and ag
Page 48 and 49: cooler. The island of Hispaniola is
Page 50 and 51: of the Lesser Antilles, between the
Page 52 and 53: 1,011 km of which are paved, and 13
Page 54 and 55: MINIMUM 19 19 20 21 22 23 23 23 23
Page 56 and 57: diseases occur occasionally, as doe
Page 58 and 59: 2. Climate. Navassa Island’s clim
Page 60 and 61: hydroelectric generators (1.94%). D
Page 62 and 63:
available primarily in or near urba
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generators (32.81%). The economy of
Page 66 and 67:
3. Population and Culture. The popu
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is based on tourism, which accounts
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Disease Distribution. Endemic malar
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homunculus. Twelve cases of P. mala
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humans and domestic animals indoors
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elapses upon their return to the Un
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prominent in the region until the 1
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more. Larvae emerge after eggs have
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per hectare, and that pupal surveys
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During the 1990s, only 6 Latin Amer
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Ae. albopictus into the Americas as
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islands. Outbreaks of EEE are infre
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competent vector of EEE virus, and
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was shown to be different from 2 No
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genetic and antigenic diversity. Th
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Habitat modification can reduce tic
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Mortality is seldom high, but morbi
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manifestations and may remain witho
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Transmission cycle(s). Triatomine b
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quinquefasciatus in Brazil, but hum
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Trinidad and Guadeloupe. The first
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ange in altitude from desert areas
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control on St. Lucia. Only a few ca
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source for B. glabrata. The snail i
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Acute filariasis is the primary mil
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aquasalis, which is a known vector
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Vector Ecology Profiles. In the Car
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sugarcane field workers. Many human
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Mites from one host species rarely
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2. Araneae (spiders). More than 35,
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from unsprayed areas. Ceratopogonid
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Myiasis is classified according to
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most stings requiring medical treat
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cantharidin in their body fluids. C
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symptoms extend beyond 72 hours. An
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Table2. continued Scorpion Species
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Table 2. continued Scorpion Species
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Page 154 and 155:
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11. Simuliidae (black flies, buffal
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Deer flies, about 8 to 15 mm long,
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The bushmaster, Lachesis muta, has
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C. Medical Botany. 1. Plants that C
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To avoid accidental poisoning, they
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IX. Selected References. A. Militar
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Beaty, B.J. and W.C. Marquardt [eds
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Chadee, D.D. and S.C. Rawlins. 1997
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Gomez, J.D., E.A. Malek and M. Varg
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Lovell, C.R. (ed.). 1993. Plants an
Page 176 and 177:
Perich, M.J., M.A. Tidwell, S.E. Do
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Teelucksingh, S., A.S. Mangray, S.
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Appendix A. Vector Ecology Profiles
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insecticide. Physiological resistan
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Diaz, P.C., J.A. Bisset, T. Gonzale
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Tang, C.R., D.D. Montada, A.O. Nava
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Appendix C Sources of Snake Antiven
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Chiggers Brennan, J.M. 1953. A note
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Franke, O.F. 1978. Systematic revis
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Appendix E Personal Protective Meas
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F. Bioscience and State Department
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15. Jamaica. Ambassador Phone: 1-80
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diapause - a period of arrested dev
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(wheals) that are redder or paler t
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10. The CDC’s site for informatio
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14. London School of Hygiene and Tr
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