By Sharmain Grainger
Aside from struggling to deal with the regular complexities of trying to heal the sick and maintain gains made
over the years, the health sector has had to deal with a number of emerging viruses.
From battling the then little known, Chikungunya virus in 2014, and simultaneously warding off entry of the Ebola virus, to putting into motion ramped up tactics to tackle threats of both the Zika and H1N1 viruses last year, the Public Health sector has undeniably been hard taxed.
It could be easily deduced that this is the sector on whose shoulder the country’s development rests. Without healthy citizens a country’s development is nothing but doomed.
Moreover, it has not been optional for the health sector to take on the emerging threats at whatever costs. And sizeable sums have been plugged into such efforts.
Even more has been plugged into the sector with the detection of the Zika virus and the fact that one of our own was recently sent to an early grave because of complications evoked by the H1N1 virus (which is referred to as the swine flu).
While the H1N1 case has been deemed an imported case, the case of the Zika virus is a bit more troubling as the infected person did not travel outside of Guyana during the perceived period of infection.
“Obviously there might be more people walking around with this virus. So I have alerted all of the institutions in Regions Ten, Six, Five, Four and Three to continue to do surveillance work so that the doctors can look out for symptoms and signs so that we pick up cases early,” said Chief Medical Officer with the Public Health Ministry, Dr. Shamdeo Persaud.
He noted that while the disease might be milder in adults with good immune system it has been discovered that those likely to be most at risk, if infected, are women during the early stage of pregnancy.
“We have learnt that it can have some adverse effects on the developing fetus such as small heads…the babies heads don’t develop,” related Dr. Persaud.
CLOSE TO HOME
An outbreak of the Zika virus, which is transmitted through the bites of infected Aedes species of mosquitoes (Aedes aegypti and Aedes albopictus), was reported in Brazil last year causing Guyana to take close note. The mosquito can only become infected if it bites an infected person.
And according to Dr. Persaud, the period between bite and occurrence of symptoms is between three to 12 days.
“That is our biggest challenge, dealing with the Aedes mosquito,” said Dr. Persaud during an interview.
According to him, the health sector has long been trying to control the presence of the Aedes mosquitoes through fogging activities and raising awareness among members of the public of ways to reduce the prevalence of the Aedes mosquitoes. These mosquitoes have credited with transmitting the Chikungunya virus and dengue fever here.
Since conditions here are conducive for the Zika vector to thrive, the aim of the health sector, according to Dr. Persaud was to engage prevention measures by denying it access at the port of entries.
Brazil is Guyana’s neighbour to the south. Therefore the outbreak there caused the local public health sector to be on high alert and put preventative measures in place. Precautions were being taken especially at the ports of entry.
But detecting the entry of cases is not an easy task. While the public health sector has embraced an approach whereby blood samples are taken and sent to the Caribbean Public Health Agency (CARPHA) in Trinidad for testing, the reality of the situation is that samples cannot be taken from all patients presenting with symptoms consistent with the emerging viruses.
This therefore could mean that some patients could be misdiagnosed and administered incorrect treatment as a result. Moreover, battling emerging health challenges such as Zika is invariably no small task for a developing country.
In the National Assembly on Thursday, a sombre Minister of Public Health, Dr George Norton made the first official announcement of the presence of the Zika Virus in Guyana. He said that a blood sample sent to CARPHA tested positive for the Virus.
The victim, a 27-year-old woman who presented with very mild fever, a skin rash and conjunctivitis (red eye), was seen at a private health facility.
According to the Centres for Diseases Control, symptoms consistent with the Zika virus include: fever, rash, joint pain, and or conjunctivitis. Other known symptoms are muscle pain, headache, pain behind the eyes and vomiting.
Because of the associated risk, the Public Health Ministry has been distributing treated mosquito nets to all pregnant women throughout the country who attend antenatal clinics.
While Guyana is now learning about the virus, Dr. Persaud disclosed that it has been affecting sections of the world for many years.
“It is a rather old virus…Many years ago there were outbreaks across Micronesia, while in 2013 there were reports of cases in French Polynesia. Then there was an outbreak in Brazil, South American last year.”
He disclosed too that there have since been reports of outbreaks across South America including in Colombia, Venezuela, Suriname and French Guiana.
“Since the outbreak in South America we have been sampling persons who fit the criteria,” said Dr. Persaud who noted that since the symptoms of Zika are very similar to that of dengue and Chikungunya that cases were cautiously sent to CARPHA.
Guyana is a signatory to CARPHA which was established by the Caribbean Community (CARICOM) in 2011 to service member states.
Added to this care must be taken that one single territory does not over overwhelm CARPHA with cases. “We certainly can’t test and take samples from everybody but as the criteria fits we have been sending samples,” said Dr. Persaud who noted that it was from among a batch of four samples that the positive result was detected.
The positive sample was collected on January 4, 2016 and returned on January 12, 2016. And according to Dr. Persaud, efforts to contain the virus have already commenced including fogging and examining those close to the infected patient.
The patient, the CMO said, has two listed addresses – Rose Hall Town, Berbice and Covent Garden, East Bank Demerara. “We have teams going out doing household inspections and checking for breathing sites.
As we know the Aedes mosquito is domesticated, it lives around house…in vases, discarded tyres and other vessels,” the CMO informed.
DEALING WITH H1N1
Meanwhile, the Ministry is currently encouraging regular hand-washing and sanitising of the hands to help guard against further cases of H1N1.
According to Dr. Persaud, the viral influenza is predominantly spread by direct contact with persons who are infected.
“Most of the time it is spread by droplets. Those droplets can get on the hands, they can get on door handles, car seats, in public transportations and pretty much everywhere…So one of the principle things that we are encouraging everyone to do, including health workers is to wash your hands as frequently as you can,” the CMO cautioned.
According to him taking hygienic precautions could in fact reduce a person’s chance of being infected with H1N1 by as much as 99 per cent. “There is a small chance you can get it from the air but most infection is through direct contact,” added Dr. Persaud.
The World Health Organisation (WHO) has reported that the H1N1 virus is one thought to have originated in swine. WHO has noted that most human infections have been mild and the viruses have not spread further to other people.
A businessman was the recent casualty of the virus and Dr. Persaud has asserted that no one else has been found to be infected with the virus. He however noted, “We are continuing to maintain surveillance of the persons who came in contact with that person. We have done follow up and so far we have not had anyone who has come down with it.
“There were people who developed respiratory symptoms but no samples were tested positive,” the CMO assured.
Nevertheless, preventative treatment was administered to at least four persons who were exposed to the victim.
Dr. Persaud disclosed that the Public Health Ministry has been seeking to forge closer collaborations with private institutions in order to encourage efficient reporting of the Zika and H1N1 viruses as well as all other all emerging cases.
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