Ontario Ministry of Health and Long-Term Care - Health Update

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Health Update

December 3, 2004
Dear Doctor/Health Care Provider :

Re : Malaria in the Dominican Republic

The Travel Medicine Program of Health Canada, in cooperation with the Pan American Health Organization (PAHO), is currently monitoring cases of malaria in travelers returning from resort areas of the Dominican Republic (DR). In consultation with the Malaria Sub-Committee of the Committee to Advise on Tropical Medicine and Travel (CATMAT), the Public Health Agency of Canada recommends the following for travelers to the DR at this time :

The Public Health Agency of Canada recommends malaria prophylaxis (medication) and the use of personal insect protective measures (e.g., repellants) against mosquito bites for travelers who will be traveling to rural areas overnight. The Agency also recommends that Canadians traveling to resort areas in the province of La Altagracia take malaria prophylaxis (medication) and use personal insect protective measures against mosquito bites. The province of La Altagracia is located in the southeastern part of the country.
Note : Chloroquine is the malaria drug of choice for the Dominican Republic.

The travel alert can be viewed in its entirety at The Travel Medicine Program of Health Canada website
(http://www.phac-aspc.gc.ca/tmp-pmv/2004/mal_dr_e.html).

The CDC has expanded the recommendations to include travel to all areas of Duarta Province.

Due to the severity of illness in some of these people, Health Canada will be sending alerts to emergency medicine sites in Canada and they would be grateful for any assistance we can provide regarding timely updates on diagnosed cases of malaria in travelers returning from the Dominican Republic. They are particularly interested in strains of plasmodium identified and details of travel while on the island. This will enable them to update or expand the travel advisory. To date, there have been two such reports from Ontario.
Health Care Providers are reminded to have malaria in mind for symptomatic travelers returning from the Dominican Republic so that correct therapy can be promptly initiated.

Please contact your local health unit to report any cases meeting the above description and for further information and clarification.

Sincerely,

(original signed by)
Karim Kurji, MB, BS, MSc, MRCGP, FFPHM, FRCPC
Associate Chief Medical Officer of Health



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