Disease in DR

Has anyone heard of a disease outbreak in DR? I heard second hand that there is some highly contagious disease in DR right now. If you have please let me know.

Thanks.

I guess you are thinking of the polio. A cluster of cases have been reported and is believed to be due to an oral polio vaccination that has mutated and spread among those with insufficient immunisation.

How does this affect you? Probably not at all. Most people from the industrialized world have been immunized during childhood. This protection is usually lifelong. If you have not, or if you are in doubt, contact your doctor. If necessary he will then give you a booster.

Regards,
Susanne

Heidi, consult the archives for disease information in the DR. There is a wealth of information. Regards, PJT

You need to contact your doctor. There are things such as HepA/B, polio...that they will be able advise you on. There are no disease "outbreaks" that I know of.

I, like Susanne, think you are probably hearing about polio. There have been some cases here on the island recently, as she described. Although immunized as children, we were given a polio shot before moving here as advised by our doctor. As is usual, they were probably erring on the safe side.

Check with your doctor.

marc

Heidi
There are no current outbreaks of anything in the DR. The polio (small cluster of less than ten cases) occured over a year ago. No malaria out breaks. No hepatitis outbreaks. Nothing but sun, sand, sea and serenity.
Don't bother checking with your family doc. If he is like most he will not have a clue as to what is going on in a foreign country except what he reads in the paper. Your local PUBLIC HEALTH officials MAY know what is going on but if you really want the straight skinny, check the CDC (Centers for Disease Control) in Atlanta. A U.S. government agency and they DO have a web site. They also tell you what immunizations are advisable.
Come on down. The only "disease" you are likely to get is "LOVE SICK" OVER THE ISLAND and what a great vacation spot.

Hi Doc,

I thought you might be interested in this. It is taken from the Promedmail (a global surveillance of outbreaks, CDC is part of it) one of the last couple of days. It describes the polio situation in the island of Hispaniola.

BTW - if you are interested in Promedmail, there webadress is www.promedmail.org (link below). It is aimed at professionals such as yourself.

Quote:

"POLIOMYELITIS - DOMINICAN REPUBLIC & HAITI
************************************************** *
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases

Date: 5 Oct 2001
From: ProMED-mail
Source: MMWR 50(39);855-6. Public Health Dispatch: Update: Outbreak of
Poliomyelitis - Dominican Republic and Haiti, 2000--2001 [edited]


From 12 Jul 2000 - 18 Sep 2001, a total of 21 cases of poliomyelitis
(including 2 fatal cases) were reported from the Caribbean island of
Hispaniola, divided between Haiti and the Dominican Republic. In the
Dominican Republic, 13 of 168 reported cases of acute flaccid paralysis
(AFP) were confirmed as polio by isolation of poliovirus type 1 from either
patients or their healthy contacts. The median age of the patients was 3
years (range: 9 months--14 years). None was vaccinated adequately.

The most recent confirmed case-patient in the Dominican Republic had
paralysis onset on 25 Jan 2001. In Haiti, 8 of 40 AFP cases were confirmed
virologically; 7 of the confirmed cases occurred during January--July 2001.
The median age of the patients was 7 years (range: 2--12 years). One
patient had received at least 3 doses of oral poliovirus vaccine (OPV). The
most recent confirmed case occurred in Haiti and the patient had paralysis
onset on 12 Jul 2001. Currently 18 AFP cases from the Dominican Republic
and 3 from Haiti are pending final classification.

This outbreak was the first in the Americas since 1991 and was associated
with the circulation of a type 1 OPV-derived virus, having substitutions
affecting 1.8% to 4.1% of nucleotides encoding the major capsid protein
(VP1). The circulating vaccine-derived poliovirus associated with the
outbreak recovered the capacity to cause paralytic disease and widespread
person-to-person transmission and was biologically indistinguishable from
type 1 wild poliovirus. Contemporary vaccine-derived poliovirus isolates
from persons with AFP cases in other countries of the Americas are more
closely related (>99.5% VP1 sequence similarity) to the respective OPV
strains, are unrelated to the Hispaniola outbreak viruses, and show no
evidence of extensive person-to-person transmission. The outbreak in
Hispaniola occurred in areas of very low OPV coverage.

In response to the outbreak, health authorities in both countries conducted
house-to-house vaccination with OPV. In December 2000, and February and
April 2001, 3 rounds of mass vaccination campaigns were conducted in the
Dominican Republic. In each round, approximately 1.2 million OPV doses were
administered to an estimated population of 1.1 million children aged <5
years. Haiti conducted 2 rounds of mass vaccination in February and March
2001. However, these campaigns were hampered by logistic difficulties and
heavy rains and reached an estimated 40% of the 1.2 million children aged
<5 years. During May--July 2001, a door-to-door and school-based campaign
among all 2.3 million children aged <10 years was conducted sequentially in
all of the country's departments. Preliminary results suggest that 2.4
million OPV doses were administered, and a second door-to-door campaign is
under way.

Travelers to the Dominican Republic and Haiti who are not vaccinated
adequately are at risk for polio. Travelers should have received poliovirus
vaccination according to national vaccination policies.

References:
------------
CDC. Outbreak of poliomyelitis---Dominican Republic and Haiti, 2000. MMWR
2000;49: 1094--103.
CDC. Outbreak of poliomyelitis---Dominican Republic and Haiti, 2000--2001.
MMWR 2001;50:147--8.
CDC. Poliomyelitis prevention in the United States: updated recommendations
of the Advisory Committee on Immunization Practices (ACIP). MMWR
2000;49(no.RR-5).

--
ProMED-mail


[It is unclear from this report if transmission of the type 1 OPV-derived
virus has been interrupted on Hispaniola. The date of onset of the last
confirmed case in the Dominican Republic was January 2001, and the last
case in Haiti is reported as 12 Jul 2001, but there are still 18 cases in
the Dominican Republic and 3 cases in Haiti pending confirmation for which
the dates of onset have not been given.

In the ProMED-mail posting this past January (2001), there was a report on
the circulation of a type 2 OPV-derived virus during the period 1988-1993
resulting in 32 cases of poliomyelitis. One hopes that the massive
vaccination campaign efforts conducted on Hispaniola will result in
interruption of transmission of this current outbreak."

Best regards,
Susanne

Thanks Susanne. Very interesting report and I appreciate the web link.
I know about the massive immunization program as my University Medical School participated and did most of the physicians on the island (DR).
These small clusters of cases are RARE and are due to improperly immunized individuals.
I still maintain that if you are properly immunized from your country of origin you have nothing to worry about.

I would be more concerned about Tuberculosis as it is making a comeback. There are probably quite a few people that have it and are not aware of it or have been quarantined, etc.

You hit the nail on the head JUAN PABLO.
Tuberculosis is very dangerous albeit a treatable disease BUT you must have good tuberculosis control and education in the country which this place does not have. PROBABLY, but not for sure, there are more people walking around with active tuberculosis than with AIDS or Hepatitis. Mention PPD tests and most people don't know what you are talking about.

We agree. I think this is also what Promedmail concludes at the very end of the message.

I mainly posted because of general interest - and to stop people from running scared. Too many people panic about somewhat exotic and very rare diseases and yet forget to protect themselves against the much more likely cases of Hep. A etc.

Regards,
Susanne