Pursuant to the news release dated September 16, 2016, which stated that the Federation has three (3) confirmed cases of Zika Virus (Zika- V), this release from the office of the Chief Medical Officer (CMO), The Ministry of Health serves to provide information on the infection.
The Caribbean Public Health Agency (CARPHA) is monitoring the ZIKA – V epidemic in the Latin America & Caribbean Region and recently indicated (in its update dated September 8, 2016) an overall, downward trend in the number of cases of Zika – V infection. However, this would not be the case for our newly affected Federation, where you will be seeing new cases at this time. It is important to emphasize that there is an overall, decline in the number of cases in the region and there is no need for alarm.
Zika -V Infection
This illness is caused by a virus from the Flavivirus genus. It is important to note that most or about 70 – 80% of infected persons will not experience symptoms. Symptoms appear 3 to 12 days after the bite of an infected mosquito.
This disease is characterized mainly by: a generalized rash along with a low grade fever; redness of the eyes; muscle pains; joint pains and headache. Symptoms are usually mild and last 2 – 7 days.
Pregnant females are particularly vulnerable because if infected by the Zika-V during pregnancy, they have an increased risk of miscarriages, offspring with abnormally small head or microcephaly and other adverse pregnancy outcomes.
A small number of infected persons may develop the complication – Guillain Barre´Syndrome (GBS) which is a rare condition marked by inflammation of peripheral nerves in the body that
control movement and nerves responsible for sensation and feelings of pain. The global incidence of GBS is 1 – 4 cases per 100,000 annually.
Persons with GBS experience: tingling & ‘pins & needle’ sensations in the legs and /or arms; muscle weakness; loss of sensation and sometimes inability to walk. Persons with any of these symptoms should seek medical care urgently because early treatment makes a difference in outcome.
Locally, Zika- V is mainly transmitted by Aedes aegypti mosquitoes. These mosquitoes live near people, in and around homes, schools and work places. They are day time biters and their peak hours for biting humans are early to mid- morning and before dusk. However, they can bite at any time. These mosquitoes typically lay eggs in stagnant, clean water in buckets, bowls, dish drainers, refrigerator drip pans, drums, old tyres, flower pots, flower pot saucers, vases, animal dishes, water bowls for pets, drains, and gutters. The mosquitoes become infected after they feed on persons already infected with the Zika- V. The infected mosquito then spreads the virus to other persons through bites.
Case Management & Treatment
There is no cure for this disease and there are no vaccines available as yet to prevent it. Treatment is primarily symptomatic. Persons affected by this disease should seek medical care especially all infected pregnant females, children under 5 years and older adults 65 years and over. Affected pregnant females should attend scheduled antenatal clinic appointments.
All other pregnant females without symptoms are advised to keep their antenatal clinic appointments whereby they will be monitored for possible Zika- V exposure. All men are advised to use barrier protection at every sexual encounter.
Personal Protection & Prevention
All infected persons are especially advised to protect themselves from further mosquito bites for at least the first week of illness using personal protection measures in order to reduce the risk of human -to mosquito -to- human transmission. Personal prevention measures include:
• Application of safe insect repellents like OFF® that contains DEET / diethyltoluamide. This repellent may be applied to skin or clothes and should be used according to label instructions.
• Wear light coloured clothes that cover as much of the body as possible
• Use physical barriers: close windows and doors, use mesh screens and mosquito nets
• Eliminate mosquito breeding sites inside, outside your house and your immediate environment
• All pregnant females should follow strict measures to prevent mosquito bites and should even consult their health care provider for advice.
• All pregnant females should practice safer sex including the use of condoms or abstaining throughout pregnancy to protect the unborn child.
Public Health Control Measures
Since earlier this year, our Ministry of Health embarked on an integrated vector control program including the following strategies & measures:
1. Health Education: Conduct health educational activities like presentations at schools and distribution of brochures to increase public awareness about the need to eliminate mosquito breeding sites
2. Source Reduction: Inspection of premises to eliminate mosquito breeding sites
3. Ovi-trapping: Setting of traps to determine hotspots which in turn guides the decision for fogging. This measure also facilitates routine collection of mosquito eggs for resistance testing.
4. Chemical control: This strategy is two pronged and involves (1) larviciding which is the application of insecticide called temephos or abate ® to stagnant water, and (2) fogging or spraying with insecticide (Kontrol 4-4 ®) to eliminate adult mosquitoes, however this has been delayed.
5. Biological control: Use of fish to consume mosquito larvae in collections of water
6. Port Surveillance:
• WHO procedures are followed to prevent the importation and exportation of diseases.
• Ovitraps and adult mosquito traps (with assistance from Ross University) are positioned at all three ports of entry.
• All imported tyres are fumigated
The way forward
In order to control the local Zika – V outbreak, the above measures must be continued and most importantly, we must be aggressive in eliminating all mosquito breeding sites. No Aedes aegypti mosquito means no Zika-V infection. To achieve this, you and I must be active in eliminating mosquito breeding sites in and around our homes. This will also require community efforts to rid common areas of mosquito breeding sites. This will require a national effort involving government ministries and the private sector. Remember – No Aedes aegypti mosquito means no Zika-V infection. Let us come together and eliminate all mosquito breeding sites.
MINISTRY OF HEALTH, SOCIAL SERVICES, COMMUNITY DEVELOPMENT & GENDER AFFAIRS
September 21, 2016