“Report all fever cases” – Chief Medical Officer warns

May 29, 2014 News

— as Guyana tackles first cases of Chikungunya virus

Although it is seen as an unorthodox public health threat in this part of the world, the Chikungunya virus which has in recent times been infiltrating a number of Caribbean territories has finally reached Guyana. Two confirmed cases, a four-year-old girl and a 50-year-old woman, both of Canje, Berbice, have been detected, sending the local Health Ministry into overdrive mode to control the potential impact.

Chief Medical Officer, Dr. Shamdeo Persaud

The two cases that were confirmed on Friday are from two separate households – one in Canefield and the other from Cumberland – this publication understands.
And since there is no known vaccine or specific treatment to combat the virus, the health sector is therefore reliant on patient management aimed at relieving symptoms, according to Chief Medical Officer, Dr Shamdeo Persaud.
He disclosed that Chikungunya is a viral disease transmitted by the Aedes aegypti mosquito which is quite common along the coast of Guyana. The disease, which is similar to dengue in many regards, is one that is known to cause a moderate to severe ailment that can be life threatening with symptoms including fever, rash, muscle and joint pains and malaise.
“We are encouraging people with these symptoms such as high fevers above 39 degrees with associated joint pain, back pain, muscle pain, any form of rash to seek medical attention because early intervention can prevent complications from occurring,” said Dr. Persaud.
He disclosed that while Chikungunya itself is not a high cause of death directly, it can have some long term effects that can include prolonged joint pains that can last, at times, as much as three months.
“The resulting fever together with pain, particularly in young children”, Dr. Persaud said, “could lend to bouts of convulsions and even cause dehydration”. According to the CMO, there have even been rare occasions that the virus has been known to be associated with the Guillain Barre Syndrome which is a disease that causes the body to become paralysed.
“Even with medical care, you might still experience this pain depending on how the body reacts beyond the incubation period,” said Dr. Persaud. The incubation period can span two to six days with symptoms usually appearing four to seven days after infection.
Guyana has been on high alert ever since reports surfaced of the virus’ entry into parts of the Caribbean last year. According to Dr. Persaud, on December 12 last year the Caribbean Public Health Agency (CARPHA) Laboratory in Trinidad was informed of 10 transmitted confirmed cases on the French side of the Caribbean island of Saint Martin.
Since then more than 1,800 confirmed cases were reported from Anguilla, Antigua and Barbuda, Aruba, British Virgin Islands, Dominica, Dominican Republic, French Guiana, Martinique Guadeloupe, St. Lucia, St Vincent and the Grenadines, St. Kitts and Nevis, St. Barthelemy, Saint Maarten and St. Martin. Three confirmed resulting deaths were reported by Martinique and St. Martin. “With the introduction of this new virus all of the countries started to monitor their situations…so we had several things going on,” Dr. Persaud said. “Among these”, he said, “were moves to improve regular surveillance systems, whereby intensified efforts were made to monitor, on a daily basis, cases of fever syndromes including fever with rash and fever with joint pain”.

The Aedes aegypti mosquito which transmits the Chikungunya virus

According to Dr. Persaud, this process allowed the Health Ministry to detect, in early May, a spike in the cases of fever syndromes seen at health facilities in Berbice. Moreover, a system was put in place to collect samples for testing.
Although the majority of the cases were negative, Dr. Persaud said that close to 30 samples were sent to the CARPHA Laboratory, with two returning as confirmed cases of Chikungunya. About 20 per cent of the cases tested were confirmed as mild forms of dengue.
“We know that there is circulation of type two dengue in Guyana and we are hoping to confirm the types but as it relates to the Chikungunya virus, we are still doing some investigations regarding travel of these persons and to find out also if people travelled to their households too,” said Dr Persaud.
Meanwhile, the Health Ministry, through its Vector Control Services Department has intensified fogging activities in Berbice as well as other areas across the country to combat the virus. But, according to Dr. Persaud, “vector control is not just about fogging so we would like to get people involved…to protect their environment by keeping it clean in order to keep out mosquitoes. Any place that water stays for more than seven days becomes a breeding site for mosquitoes,” informed Dr Persaud.
Added to this, he said that teams of inspectors will be visiting homes, particularly where the cases have been detected, as well as where increased cases of fever syndromes are reported, to undertake inspections. This will be done, he said, even as continued efforts are made to monitor the various Ports of Entry.