6.4.3. Syndromic Surveillance
Updated 1 October 2025
The syndromes under surveillance in Saint Lucia are: Acute Flaccid paralysis, Acute respiratory illness less than 5 years old (ILI, SARI, ARI, SARS), Fever and respiratory symptoms 5 years and more, Conjunctivitis (non-neonatal), Fever and Hemorrhagic symptoms, Fever and neurologic symptoms, Fever and rash, Gastroenteritis 5years old or more, Gastroenteritis less than 5 years, Undifferentiated fever in 5 years old or more, and less than 5 years.
FEVER AND RESPIRATORY SYMPTOMS | ||||
|---|---|---|---|---|
| Cases definition | Complications | Epidemiological data | ||
| Fever with one of the following symptoms, with or without respiratory distress, cough, sore throat, dyspnea | Pneumonia Respiratory insufficiency Multiorgan- failure | Previously healthy, risk factor for HIV, prior medication, recent travel, contact with animals, contact with similar cases | ||
| Possible diseases and agents | ||||
Influenza A and B Respiratory Syncytial Virus (RSV) Metapneumovirus SARS CoV2 and other viruses | Hantavirus pulmonary syndrome Leptospirosis | Pertussis | Diphtheria Streptococcus Group A | Pneumococcus Hemophilus Influenzae Legionella Anthrax |
| Specimens for lab tests | ||||
| Nasopharyngeal secretion or Throat swab | Acute and/or convalescent serum sera (A) Blood sample | Nasopharyngeal secretion, pleural fluid | Throat swab | Blood Serum, Sputum, Urine | ||
Influenza testing RSV testing, PCR multiplex, SARS Cov2 Ag test | IgM and IgG, PCR, and Immunofluorescence | Direct smear and Gram, Bacterial culture | Direct smear and Gram, Bacterial culture | Bacterial culture | ||
| Barbados National Lab, CARPHA or CDC (Further etiological testing - viral culture, serology, ELISA, PCR, Genome detection). | ||||||
| NOTE: (A) Acute and convalescent serums ≤5 days from onset of symptoms and the second more of 14 days after | ||||||
GASTROENTERITIS / ACUTE DIARRHEAL SYNDROME | ||||||
|---|---|---|---|---|---|---|
| Cases definition | Complications | Epidemiological data | ||||
| Acute onset of diarrhea, with or without fever, and presenting with 3 or more loose stools or watery stools in the past 24 hours, with or without dehydration, vomiting, blood | Moderate/severe dehydration, Sepsis, Shock | Previously healthy person, risk factor for HIV, recent travel, food history, contact with similar cases or sick animals | ||||
| Possible diseases and agents | ||||||
| Rotavirus group A, B, C Norwalk, Adenovirus, Astrovirus, Enterovirus, Calicivirus | Cholera, Enterotoxigenic E. coli, Shigella, Salmonella, Campylobacter, S. typhi Enterohemorragic E. coli, | Entamoeba histolytic, Giardiasis, Cryptosporidium | ||||
| Specimens for lab tests | ||||||
| Frequently stools (sometimes Blood) | ||||||
| Testing using rapid test kits, ELISA | Culture and sensitivity | Parasite demonstration | ||||
| Barbados National Lab, CARPHA or CDC (Further testing, pathogen characterization, typing and/or confirmation) | ||||||
UNDIFFERENTIATED FEVER | |||
|---|---|---|---|
| Cases definition | Complications | Epidemiological data | |
| Fever with two or more of the following symptoms: Headache, retro-orbital pain, arthralgia, myalgia, nausea, vomiting, rash, exanthema | Dehydration and hemoconcentration, liver enlargement, jaundice, pneumonia, possible neurological & hemorrhagic symptoms, sepsis & shock | Previously healthy person, recent travel inside or outside the country, prior medication, contact with insects and rodents, contact with similar cases. | |
| Possible diseases and agents | |||
| Dengue, Measles, Rubella, other Immuno-preventable CD, MPX | Leptospirosis, Viral hepatitis, Other arboviral Zika, CHK, Hantavirus | Brucellosis, Typhoid fever | Malaria, Borreliosis |
| Specimens for lab tests | |||
| Acute and/or convalescent serum sera | Acute and/or convalescent serum sera | Blood and serum | Blood smear serum | |
| Rapid tests, Dengue serology and PCR | Culture, serology, PCR, and genome amplification | Blood culture serology | Parasite demonstration, serology, Rapid tests | |
| Barbados National Lab, CARPHA or CDC (Measles and Rubella must be tested for if rash is present in children, as per the EPI Programme protocol | ||||
FEVER AND NEUROLOGICAL SYMPTOMS | ||||
|---|---|---|---|---|
| Cases definition | Complications | Epidemiological data | ||
| Fever with or without headache and vomiting with at least one of the following: Meningeal irritation, convulsions, altered consciousness, altered sensory manifestations, paralysis (apart from AFP) | Cerebral Oedema, Abscess, Coma, Respiratory arrest, Neurological Sequalae | Previously healthy person, risk factor for HIV, prior medication, recent travel, contact with insects & rodents, contact with similar cases | ||
| Possible diseases and agents | ||||
| Meningitis: Meningoencephalitis Viral (Enterovirus y Poliovirus, Guillain-Barre, WNV, Adenovirus, HSV , VZV, Mumps); Bacterial (Meningococcal, Pneumococcal, Hib, Leptospirosis); Parasitic (Malaria, Trypanosomiasis) | Encephalitis: Rabies, WNV, SLE, Equine Encephalitis, HSV | |||
| Specimens for lab tests | ||||
| CSF, Blood culture, blood smears, throat swab, urine, acute and convalescent serum | CSF, acute and convalescent serum, post-mortem specimens | |||
| National lab: Gram stain, bacterial culture | ||||
| Barbados National Lab, CARPHA or CDC (Antigen detection. Viral culture. Serology. Genome amplification) | ||||
| Note: If patient presents with Acute Flaccid Paralysis (AFP), follow the EPI programme protocol. | ||||
FEVER AND HAEMORRHAGIC SYMPTOMS | ||
|---|---|---|
| Cases definition | Complications | Epidemiological data |
| Fever with at least one hemorrhagic (bleeding) manifestations, with or without jaundice: Purpura, epistaxis, hemoptysis, melena | Kidney and liver insufficiency, moderate or severe bleeding, Acute respiratory failure, shock | Previously healthy person, recent travel, prior medication, contact with insects and rodents, contact with similar cases, no history of coagulation disorder |
| Possible diseases and agents | ||
| Dengue hemorrhagic | Yellow fever, Leptospirosis, Hantaviruses, South American hemorrhagic fevers | Malaria falciparum |
| Specimens for lab tests | ||
| Acute and/or convalescent serum | Acute and convalescent sera | Blood smear, Rapid test |
| Dengue serology and PCR | Serology, IF, PCR | Parasitic demonstration |
| Barbados National Lab, CARPHA or CDC (Viral isolation, Serology, Antigen detection, PCR, Genome detection) | ||