Concerns mount over increase in Chikungunya-like symptoms

The approach being embraced by the Ministry of Health to tackle the Chikungunya virus outbreak is one that currently

Shadow Minister of Health, Dr. George Norton.

borders on negligence. This is the conviction of A Partnership for National Unity (APNU) Shadow Minister, Dr. George Norton, who informed this publication that “I think the Ministry can be guilty of negligence to a large extent if they do not change the way they are dealing with it now.” In fact, Dr. Norton noted that “we somehow got the impression that the Ministry don’t want to talk about it because they (perhaps) don’t have the means of controlling it or treating it.” He alluded to the utterance of Minister of Health, Dr. Bheri Ramsaran, that the Minister is tackling the outbreak with caution so as to not create an alarm.  “We have got to err on the side of caution and it might be better for us to create an alarm than have persons coming down with this virus,” theorised a concerned Dr. Norton. From all indications, the Ministry of Health, in recent weeks, has been divulging little to no information regarding the outbreak which was reportedly first detected in May of this year. This publication has on several recent occasions attempted to solicit comments regarding the outbreak from senior key Ministry of Health officials, including Minister of Health, Dr. Bheri Ramsaran, to no avail. This lack of communication comes at a time when there is reportedly an increase in the number of persons, countrywide, suffering from Chikungunya-like symptoms which range from joint and muscle pains, rashes about the body, headache, nausea and high fever. Although Guyana has in place a National Reference Laboratory complete with equipment to test for various viruses, the facility is currently not able to test for the Chikungunya virus. This is in light of the fact that there are no trained personnel to carry out such tests. However, Resident Representative of the Pan American Health Organisation (PAHO), Dr. William Adu Krow, has confirmed that PAHO is collaborating with the Health Ministry to train at least two local laboratory personnel to test for the virus here. In the interim, Guyana, like a number of other Caribbean territories that have been plagued by the virus, has been utilising the services of the Caribbean Public Health Agency (CARPHA) in Trinidad. Although the Ministry of Health has only publicly informed of 31 confirmed cases, this publication has been reliably informed that the actual number of cases surpasses this reported amount.  In fact, reports are that there are even a greater number of unreported cases since the Ministry has only been facilitating random testing of persons manifesting symptoms of the virus. Some persons have expressed concerns to this publication that although they turn up at public health facilities with Chikungunya-like symptoms, no blood sample is taken from them for further testing.  It was related that the approach that has been adopted by (identified) health facilities is to simply give medications such as panadol to treat the symptoms of the virus.

The Aedes Aegypti mosquito which transmits the Chikungunya virus

But according to Dr. Norton, treatment should never be administered to patients without first confirming their condition. “One has got to be careful with treatment like panadol because for instance if it is dengue and it is haemorrhagic, panadol anti-inflammatory can cause an increase in the haemorrhage…so you’ve got to be careful with just giving these symptomatic treatments,” said Dr. Norton. What should have obtained, according to him, is a move by the Health Ministry to establish a protocol to be issued countrywide to educate the general public that if anyone is found to have the symptoms of the disease they should present themselves to a health facility. This, he noted, should have been in place to allow for blood samples to be taken and sent to a specified location where they could be sent to Trinidad in bulk. In fact Norton noted that the ideal situation should have seen the Ministry organising even a makeshift process where the samples were tested right here. He continued that in spite of the fact that Guyana does not have the capable personnel to undertake such processes, the Health Ministry should have solicited support from PAHO to contract expertise. “Let PAHO come on board, let them bring in somebody to work in Guyana for a few months…I don’t think that is difficult to be done…” said Dr. Norton as he pointed to the impact the virus has had in St. Lucia. St. Lucia, according to reports, has had to struggle to combat the disease so much so that health officials were at one point unable to issue the number of actual cases. The Chikungunya is a viral disease transmitted by the Aedes Aegypti mosquito and in practically the same conditions in which dengue fever is spread. And according to Dr. Norton care must also be taken in treating patients with related symptoms since there are instances that persons could be plagued with both conditions simultaneously. “Because we have to depend on clinical symptoms alone to decide on whether we are dealing with the Chikungunya or dengue…we tend to believe that there is an increase in the Chikungunya because the clinical manifestation of this virus is much more pronounced than it has ever been before,” said Dr Norton. As part of the pronounced manifestation of the disease, he noted is the presence of rash and joint and muscle pains that are being seen not only along the coast but in interior locations as well, the Shadow Health Minister said. Although health officials have informed that the Chikungunya virus is not life threatening, there are reports that failure to treat it early could be detrimental. And since the transmitting vector is known to thrive in relatively clean but stagnant water, calls have been made by the Health sector for residents across the country to ensure that they remove all possible breeding grounds. Even before the onset of the outbreak, when there were reports of the virus in some Caribbean territories, the Ministry of Health’s Vector Control Unit had started to conduct fogging and spraying activities in the city. Similar activities were also undertaken in Region Six where the virus was first detected.