Fast-breaking News from AABB PulsePoints The following has been reproduced from the June 16, 2006 AABB PulsePoints, an electronic news alert provided by the American Association of Blood Banks.

June 16, 2006
No. 746

CDC Recommends Malaria Chemoprophylaxis For Travelers to Bahamian Island
Donor Deferral also Prescribed by AABB Standards

AABB PulsePoints

The Centers for Disease Control and Prevention (CDC) has notified AABB and other blood collection agencies that, until further notice, it is recommending malaria chemoprophylaxis for travelers visiting Great Exuma island in the Bahamas. CDC took this precaution as a result of the following information it received from Baldwin Carey, director of public health, and Merceline Dahl-Regis, chief medical officer, of the Bahamas Ministry of Health (MOH):

1. As of June 15, 2006, the Ministry of Health had, through active case detection and microscopy confirmation, identified 13 cases of Plasmodium falciparum on Great Exuma island during the previous week.
2. All of these cases were in residents of the Bahamas (including non-Bahamian citizens), many of whom reportedly had no history of travel in a malaria-endemic area during the past months. Some of the individuals who developed malaria may have recently traveled from Haiti, where chloroquine-sensitive Plasmodium falciparum is endemic.
3. The MOH suspects that most transmission occurred during the period May 24-30, 2006.
4. All cases in the Bahamas are being treated with chloroquine, with good response to date.
5. A U.S. tourist visited Great Exuma May 4-7, 2006, and developed malaria after his return to Virginia, confirmed May 24, 2006, with a blood smear and PCR positive for Plasmodium falciparum. This traveler had reportedly not visited any other malaria-endemic area in the recent past.
6. In Great Exuma, the MOH and other ministries are conducting combined control measures, including active case detection and treatment (see above), spatial insecticide spraying, larviciding, source reduction, and health education of the local population. They are receiving technical assistance from CAREC (Caribbean Epidemiology Center http://www.carec.org/) and PAHO/WHO.
7. This is a marked increase in the number of malaria cases in the Bahamas, where only one case was reported in 2005, and no cases had been reported during the five previous years. Ongoing investigations by the MOH will assess the temporal and geographic extent of the transmission. The preliminary findings by the MOH appear to indicate that local transmission of Plasmodium falciparum malaria might be occurring on the island of Great Exuma in the Bahamas. It appears that the MOH is taking all necessary measures to contain the outbreak.

While waiting for further information, public health agencies and clinicians in the U.S. should be alert to the possibility of malaria in travelers returning from Great Exuma and other islands of the Bahamas with symptoms compatible with malaria. Plasmodium falciparum malaria is a potentially fatal disease that can progress rapidly if left untreated. All patients with suspected malaria should be promptly diagnosed (Giemsa-stained blood film) and treated with appropriate antimalarial drugs.

Blood donors should be deferred for 12 months following travel to Great Exuma (AABB Reference Standard 5.4.1A 9(f), Standards for Blood Banks and Transfusion Services–22nd Edition.). Based on the likelihood that transmission first occurred in early May and to allow for the possibility that transmission could have occurred prior to the first detected case, deferral should be implemented for travel as of April 1, 2006.