Malaria, Dominican Republic: Recent Developments
(Updated: February 23, February 4, January 11, 2005; December 17, December 6, 2004. Released November 24, 2004)
As of February 18, 2005, the Centers for Disease Control and Prevention (CDC) has received reports of 21 cases of malaria in travelers to resort areas of the Dominican Republic. Plasmodium falciparum malaria has been confirmed in 5 patients from the United States, 6 from Canada, and 10 from European countries, all of whom had recently traveled to areas of the Dominican Republic where malaria had not previously been reported. All returned home between November 3, 2004 and January 10, 2005. For more information about some of these cases, see http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5351a1.htm.
CDC continues to recommend that all travelers to La Altagracia Province, including the Punta Cana resort area, should take an antimalarial drug (prophylaxis). In addition, an antimalarial drug is recommended for travelers to rural areas throughout the country. Chloroquine is the recommended drug for the Dominican Republic. Antimalarial drugs taken correctly and consistently, along with other measures to prevent mosquito bites, have been shown to be effective in preventing malaria. Therefore, CDC does not discourage travel to malaria-endemic countries.
However, CDC has rescinded recommendations for malaria prophylaxis for Duarte Province because no new cases have been reported from the area in the last 2 months, the epidemiologic investigation by the Ministry of Health of the Dominican Republic did not reveal any new cases, and their surveillance system did not detect any cases of malaria in the province in recent years.
Chloroquine has a long history of use and safety and has been found to be well tolerated by most people, including children. People with an allergy to chloroquine should discuss an alternative antimalarial drug with their health-care provider. To learn more about chloroquine, see this website: http://www.cdc.gov/travel/malariadrugs.htm. Because antimalarial drugs are not 100% protective, other measures to prevent mosquito bites should also be used, such as insect repellents that contain the ingredient DEET (N,N-diethyl-m-toluamide). To learn more about preventing mosquito bites and the appropriate use of insect repellents, visit these web pages: http://www.cdc.gov/travel/bugs.htm and http://www.cdc.gov/ncidod/dvbid/west...orepellent.htm.
Infection with the type of malaria found in the Dominican Republic, P. falciparum, may rapidly result in a severe, life-threatening illness if not promptly treated. If you have traveled to the Dominican Republic and you become ill with fever and other flu-like symptoms for up to 1 year after returning from areas with malaria, you should immediately seek professional medical care and inform your health-care provider that you have visited a malaria-risk area.
The Ministry of Health in the Dominican Republic has implemented malaria control measures, including intensified surveillance, prompt case management, and intensive mosquito control activities.