Dengue fever being addressed with urgency – Health Minister

Aug 12, 2010 News

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– upsurge in cases detected, deaths not confirmed

There has been an evident upsurge in the prevalence of dengue fever, but according to Minister of Health, Dr Leslie Ramsammy, his Ministry is yet to receive official information that there have been deaths resulting from the disease. Reports suggest that at least two persons have died after experiencing symptoms comparable to those of dengue fever.
The disease manifests as fever of sudden onset associated with headache compounded by muscle and joint pains. A hemorrhagic rash of characteristically bright red pinpoint spots, known as petechiae can occur later during the illness and is associated with thrombocytopenia.
It usually appears first on the lower limbs and the chest. However, in some patients it spreads to cover most of the body. There may also be severe retro-orbital pain, (a pain from behind the eyes that is distinctive to Dengue infections), and gastritis with some combination of associated abdominal pain, nausea, vomiting coffee-grounds-like congealed blood, or diarrhea. Some cases develop much milder symptoms which can be misdiagnosed as influenza or other viral infection when no rash or retro-orbital pain is present.
Dengue fever is a disease caused by a virus carried by the Aedes Aegypti mosquito. According to a Ministry of Health advisory, persons are being urged to get rid of the breeding places of mosquitoes in and around their homes, by covering all water tanks, barrels, drains, storage containers and garbage bins with tightly fitted covers or with wire mesh. In addition, flower pots, vases and other unused containers should be emptied and scrubbed at least once a week to destroy mosquito eggs. Eggs, the advisory noted, can hatch into larvae in three to six days.
Speaking at a press conference yesterday, Minister Ramsammy asserted that dengue is a reportable disease, thus health care providers treating such cases are mandated to report same to the Health Ministry forthwith.
“Not everybody with a fever is a dengue case…You could suspect them, but to include it in the statistics you will have to verify this first.”
The minister revealed that the only way that dengue could be ascertained is to look at the antibodies, a process which is similar to testing for the Human Immuno-deficiency Virus (HIV).
Right now there are two tests – the Rapid and Aliza tests – that are being undertaken to detect the presence of dengue.
The rapid test can be undertaken regionally, but according to Dr. Ramsammy, only the National Public Health Reference Laboratory can carry out the Aliza test.
According to the Minister, his ministry continues to take on an approach of alerting the general populace of the possibilities and is ensuring that they are educated on precautionary measures.
Dr. Ramsammy said the issue of climate change has no little part in the realisation of the prevailing diseases such as dengue globally.
“I have always talked about the diseases we should be looking out for, dengue is one of them. The whole tropical world has discovered that with the climate changes that we are having, one of the major diseases that we are dealing with is dengue.”
He revealed that over the last three years there have been indications that there is an increase in dengue in all of the countries of South America, Central American and the Caribbean. And there have been no exceptions, the Minister asserted, even as he noted that all of the countries have been faced with the challenge.
“As I have always said, I don’t know what would make us so special that we would think that we would face dengue…I have been very open that we have had an increase over the normal epidemiology weeks of surveillance in 2007 over 2006. If we look at the data from 2000 to 2006 there is a fairly constant figure, but in 2007 that figure changed.”
The Ministry’s data reveal that the threat of dengue has increased – figures which have surpassed that of last year. It is the view of the minister that it can be argued that the incidence of the disease has further mounted so far for this year.
“In my view the trend over the last three or four years has increased (but not drastically)…”
However, it has been speculated that the increase in cases could be a reflection of an increased capacity for testing.
The Minister deduced that it can be accepted that “if you are testing more you will find more. We have increased our testing capacity. In fact this week we have received an additional 12,000 tests…”
He nonetheless noted that the Ministry views the situation as a public health concern that must and is being addressed with great urgency. This, he said, comes in the form of awareness through advisories, coupled with a campaign being undertaken by the Vector Control Unit of the Ministry.
“These workers are visiting every household and checking on larvae and treating water where necessary…”
Several Neighbourhood Democratic Councils and Health Centres have also been presented with larvacide to address the situation, the Minister disclosed.
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City Council to procure compactor trucks with $20M Govt. assistance

Government is prepared to dole out a $20M subvention to the Mayor and City Council of Georgetown as part of its continued efforts to assist the process of sustained garbage collection.
This disclosure was made by Minister of Local Government and Regional Development, Kellawan Lall, during a press conference on Wednesday. According to the Minister, officials of the municipality, Acting Town Clerk, Yonette Pluck-Cort, Acting City Treasurer, Andrew Meredith and City Engineer, Gregory Erskine, during a meeting held ahead of Wednesday’s press conference, had informed him of plans that could help to reduce the recurring garbage problem.
“They have a plan to relieve some of the pressure that they have by creating some in-house capability…They have asked me for permission to adjust their work plan on how to use government subvention…”
This development, according to the Minister, should see the municipality procuring two compactor trucks for garbage collection.
In essence, the municipality will be in a position to redefine the scope of work for waste disposal contractors and define the work undertaken directly by municipal workers for the first time, in terms of continuous garbage collection and disposal.
“They have one such truck already, and they want to purchase two more so that will make it three…This will reduce the payment of contractors,” the Minister asserted.
Lall noted too that he was satisfied that the council has been “thinking” in a creative way to deal with the garbage disposal problem. However, he expressed some level of apprehension over the fact that the municipality is pressured to use revenue as it becomes available to pay wages and salaries as they are often challenged by a very aggressive union.
“I am not blaming the managers…but if they don’t pay the unions are always threatening strikes or they go on strikes. We can’t stop them, that is their right…”
The Minister noted that although Government is prepared to help, there is the concern about what will happen to the trucks if the municipality is unable to repair them in a timely fashion thereby hampering the ambitious plan of operation.
“While I am apprehensive, I think I will go ahead and sign the document and approve the purchase with Government’s money, not City Council’s money, to see how it works.”
It is anticipated that the proposed plan will come into place within another four months’ time. In the meantime, Government has decided to instruct the municipality to pay a portion of taxes owed by Government to garbage disposal contractors who resume garbage collection in the city. The contractors recommenced operation two days ago after a near two-month long withdrawal.
“We are trying to save ourselves the embarrassment that we experienced over the last two months by ensuring that Government’s rates and taxes is put aside for the payment of the contractors.”
As it relates to the council and its finances, the Minister revealed that council has always been putting up suggestions. He recalled that it was just recently that talks about a car park were discussed.
“I don’t know how that would go along with the citizens of Georgetown, but I have not said no to it. Let them do the feasibility study, let them come up with a proposal…who is going to fund it and how exactly it is going to go and what it will cost the citizens and do some work with the public and come up with something concrete.”
According to Lall, the idea seems to be okay, but must go beyond merely an idea. And there have been talks by City Mayor Hamilton Green about the production of electricity from waste. The Minister revealed that he has no problem with that idea but expects to see much more.
“I don’t have a problem with that but they have to go far beyond putting up an idea…”
It is his belief that the leadership of the council at the political level has always given the impression that Government is not ready and willing to approve an additional revenue base. “That is not quite true. They have asked us to give them the new assessment of the households in Georgetown. I have not done so because I am constrained. That was a foreign funded project and it was not completed and I don’t think I was, and I am still not, at liberty to divulge or to hand over that to become a public document to be used for purposes of operation at this time.”

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