Caribbean - Armed Forces Pest Management Board

islands of the Lesser Antilles as well as on Trinidad and Tobago. Culicoides midges, especially C.
furens, are the vectors. These midges are so small that they can easily pass through the standard mesh
size of window screens and bed nets.
TRIATOMINE-BORNE DISEASE*
Since 1960, Trypanosoma cruzi, blood-sucking triatomine vectors, and wild animals infected with the
parasite have been reported from the islands of Aruba, Curaçao, Jamaica, and Trinidad and Tobago in
the Caribbean. Competent vectors also occur on several other Caribbean islands. The risk of
Chagas’ disease is highest on Trinidad, but some serological surveys in the 1990s indicate that
transmission to humans occurs at extremely low levels. Some triatomines, also known as kissing bugs,
have painful bites. Trypanosoma cruzi is difficult to detect in the bloodstream and may be transmitted
through blood tranfusions.
SNAIL-BORNE DISEASE
The risk of infection with Schistosoma mansoni in the Caribbean is currently confined to freshwater,
primarily in parts of the Dominican Republic, Guadeloupe, Martinique, Montserrat, Puerto Rico, and
St. Lucia. Prevalence of schistosomiasis on Montserrat is low, and the disease is under control on St.
Lucia. Only a few cases of schistosomiasis are annually diagnosed on Martinique. Recent serological
surveys indicate that the prevalence of schistosomiasis on Puerto Rico greatly diminished during the
1990s. Untreated individuals can remain infected for many years. Cases often are not diagnosed until
after returning from endemic areas. Military personnel should avoid contact with potentially
contaminated water.
RODENT-BORNE DISEASE
Leptospirosis should be considered enzootic in most countries of the Caribbean. The spirochete is
transmitted when abraded skin or mucous membranes are contacted by water contaminated with urine
of infected domestic and wild animals, especially rats. Military personnel would be at high risk of
infection from this disease. Troops should never handle rodents and should not sleep or rest near
rodent burrows or swim or bathe in stagnant pools or sluggish streams.
CONJUNCTIVITIS
Bacterial and viral conjunctivitis is common in the Caribbean and has epidemic potential. Several
outbreaks of acute hemorrhagic conjunctivitis caused by enterovirus 70 and coxsackievirus A24 have
occurred in the Caribbean. Prevention and early detection are important, because no effective
treatment exists. Trachoma caused by Chlamydia trachomatis has been demonstrated in patients in
Haiti and may be present in other impoverished parts of the Caribbean. Transmission is normally
through contact with secretions of infected persons or contaminated articles. Eye gnats and flies can
mechanically transmit these pathogens.
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