Shadow Minister of Health, Dr. Karen Cummings, has flayed the Government’s response to the dengue outbreak, citing incompetence on their part.
More than 3,450 persons in Guyana has contracted the vector borne illness and 2,169 of the cases remaining active; with the developing events of the recent deaths of two (2) children, ages 9 and 11, who were treated at the Georgetown Public Hospital Corporation (GPHC) intensive care unit; and with the rise of cases of Dengue at a steady pace – Guyana seems to be heading towards a public health crisis, the A Partnership of National Unity and Alliance for Change (APNU+AFC) highlighted.
It was further pointed out two weeks ago Region Six recorded in excess of 107 cases of Dengue with 24 cases in twenty-four (24) hours according to the Regional Democratic Council (RDC).
Speaking last Thursday at the Office of the Leader of the Opposition press conference, the Member of Parliament (MP), who is also a physician, noted the APNU+AFC, in the discharge of its Constitutional functions is sounding the alarm Guyana is tottering precariously towards a major health crisis with potentially devastating consequences.
The situation demands that the Government accord the statistics in respect to vector borne illness the urgency required to avert any such impending consequences, she pointed out, warning that circumventing, denial, or diminishing the dangers are risky responses and must be avoided.
Citing data, the MP noted it is very unfortunate the Advisor to the Minister of Health said one or two cases a day is not a phenomenal number but has failed to recognise that 90 to 95 percent of persons with dengue may have symptoms and do not feel the need to seek medical care. “It is the 5 – 10 percent of persons who visit the hospital whose conditions will progress to severe dengue manifested by hemorrhage and shock or severe organ involvement,” Cummings noted.
According to the World Health Organization (WHO) dengue infection, which was recognised in the 1950s, accounts for 2.5 million people at risk of dengue infection globally. Additionally, it is the leading cause of child mortality with most people having asymptomatic infections.
Dengue is a common tropical infection transmitted to man by the Aedes mosquito and exists in two forms namely as Dengue Hemorrhagic Syndrome and Dengue Shock Syndrome. The general symptoms of Dengue include high fever, severe headache, retro-orbital pain, myalgia and arthralgia (muscle and joint) and a rash to the face or thorax-chest. However, Dengue Hemorrhagic fever is present with vomiting, (blood or blood in the stool), abdominal pain and difficulty in breathing. Whereas, the Dengue Shock Syndrome occurs when the circulatory system fails, this is followed by tiredness, restlessness, irritableness, shock, organ impairment and death.
The Ministry of Health informs that 8,000 tests were conducted but only 22 percent of the tests were positive. However, in consideration of the national health care inefficiencies and the sacred responsibility for guarding the health of the nation, it is 22 percent too many, the physician stated.
“Additionally, sensible projections must be made considering that the incubation period for Dengue is usually 4-10 days (3-14 days) while the symptoms are seen for 2-7 days. Of the 4 Dengue Serotypes, DenV1 and DenV2 are the common types.
“Since it is also known that a person who has had one serotype followed by another serotype can increase his or her risk of Dengue, it behooves the Ministry of Health to admit sooner rather than later that there is a public health crisis on our hands and this situation must forthwith be treated with urgent importance. This matter is of public health significance and must be given public health priority.”
To this end Dr. Cummings made the following recommendations:
- Focus on Treatment – Symptomatic and Supportive (the main therapeutic approach) fluids, rest, paracetamol (not aspirin or ibuprofen).
- Early detection – by primary care physicians and attention should be paid to care management practices – better surveillance – in Guyana we should be able to track this type of mosquito for example when it is sporadic and when is the prevalent period?
- Consider Environmental hygiene – elimination of the breeding sites (pesticide application) (adult mosquito –adulticides and bacterial larvicide- to kill the larvae) – There must be an integrated mosquito control – we must be able to find places where the mosquito lay its eggs and with the use of bio-control agents – those that do not cause environmental damage – like predatory cyclops. Fogging is also a possibility.
- Education – community-based education is critical since there is need for an increased awareness of the communities and a strategic approach.
- Community and Control under clean up – clean drains – Among the NDCs and RDCs are necessary. There could be best yard competition to incentivize the community. Agricultural tools, sanitation supplies and cleaning agents should be distributed to the populace, especially vulnerable communities.
- As a result of Accelerated urbanisation – there must be a balance between the urban expansion and development and public health concerns.
Additionally to the recommendation, listed above, the Opposition is calling for responsible behaviour by the government and all citizens to ensure that there is a clean and clear environment and that there is rapid virus detection to provide early prediction of any possible epidemic.
The APNU+AFC also wants citizens to be aware of the fact that frequent international travel and global warming could contribute to increasing the frequency of this dengue virus.
