Wed | Aug 15, 2018

All hands needed on deck to arrest chik-v

Published:Sunday | September 14, 2014 | 12:00 AM
Haiti's Health Minister Florence Duperval Guillaume reads the information on a box in a warehouse housing a donation of kits to treat chikungunya, in the Cite Soleil slum, in Port-au-Prince, Haiti, last Wednesday. The millions of kits donated by the United States medical group Direct Relief, include oral rehydration packs, mosquito spray and the pain reliever acetaminophen for a disease that has sickened tens of thousands of people in recent months. -AP
Five-year-old Karla Sepulveda, who suffers chikungunya fever symptoms, waits with her grandmother for treatment in the paediatric area of a public hospital in the coastal town of Boca Chica, Dominican Republic, recently. -File

Dr Fenton Ferguson, Contributor

I am happy that we have been having robust discussion in Jamaica about chikungunya because it speaks to a high level of awareness of our citizens. I am, however, concerned about the misinformation that has been circulating and the political football that it has become.

The ministry's response to chikungunya and other public health issues is in keeping with the guidelines of the World Health Organisation, which is the international body put in place by governments worldwide to set standards and policies for public-health response. The Ministry of Health is the authority for all matters related to public health and has trained experts in this highly specialised area for which we cannot depend on anecdotes and opinions. We have to respond to facts and evidence.

We are guided by the response strategy developed since 2012, in collaboration with the Pan American Health Organisation, the United States Centre for Disease Control, the French Government, and 22 Caribbean countries. We have been implementing the Caribbean Sub-regional Plan that countries developed to respond to chikungunya and dengue.

The Ministry confirmed its first imported case of chikungunya on July 17, 2014. At that time, the Emergency Operations Centre, which is essentially the command centre, was activated and continues to operate. The Centre provides national leadership to the response and management and oversight for activities that are being undertaken islandwide. Persons can make reports, requests and get information by calling us at 922-8619, 922-8622 and 1-888-663-5683 (1-888-ONE-LOVE), Monday to Friday. They can also report cases to their parish health departments.

Up to the week ending September 6, 2014, we reviewed 225 notifications, of which 120 met the case definition, which means that they had the appropriate symptoms and have been deemed suspected cases of chikungunya. Of the 120 suspected cases, 22 tested negative and have been discarded, 24 are laboratory confirmed, 47 are linked to lab-confirmed cases, and the others remain suspected cases. Let me point out that international surveillance best practice dictates that we do not test every case. If we already have established spread in a community, there is no need to test all community members.

Other illnesses

This is the time of year when we experience increased cases of dengue fever and influenza. In order to have a clear picture of the viruses circulating, I am urging doctors to ensure that they rule out these illnesses and others such as leptospirosis, which have similar symptoms. We also need them to report cases they believe to be chikungunya, otherwise those will not be represented in our figures.

I applaud the health team, which has been working systematically and non-stop since chikungunya was introduced in Jamaica in July. We have done a number of community, and house-to-house activities since then, and we have had meetings with several stakeholders, including the Central Health Committee, which is the advisory body to the minister; the Quarantine Authority to deal with the points of entry; the International Health Regulations National Focal Point Stakeholder Advisory Group; the Ministry of Education; and our own technical team.

I had dialogue with the Opposition Spokesman on Health Dr Ken Baugh on Tuesday, September 9, 2014, prior to the Jamaica Labour Party's press conference on Wednesday, September 10, 2014. During this meeting, which also involved the acting permanent secretary, Dr Kevin Harvey, and the acting chief medical officer, Dr Marion Bullock DuCasse, we discussed in depth the ministry's strategies, current activities and plans in response to the outbreak of chikungunya in five parishes.

I was, therefore, surprised to hear that he was calling on the ministry to do the very same things that we had indicated that we were already doing. I urge Dr Baugh and other politicians to recognise that reducing the spread of chikungunya requires a concerted effort and partnership from every sector of the society. We cannot allow political considerations to get in the way of managing public health. This is a serious matter.

I have to emphasise that it is up to each of us to ensure that we do not create the environment for mosquitoes to breed, especially since the Aedes Eegypti mosquito, which transmits chikungunya and dengue, breeds in containers around where people gather - the home, schools, business places, and places of worship. Gullies, drains and other waterways provide breeding grounds for mosquitoes, but not typically the type that spreads chikungunya and dengue.

I am calling on every Jamaican to stand firm with the Ministry of Health, and let us take a day to clean up our communities, business places, schools, and churches as we would for labour day. Let us work together to reduce the spread of chikungunya and other vector-borne diseases and restore national pride.