N Touch
Tuesday 22 October 2019
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Dust and disease

HEALTH Minister Terrence Deyalsingh’s statement that ministerial protocols have been followed in relation to two meningitis deaths is reassuring even if coming in less than desirable circumstances. Nonetheless, the State should keep under constant review all aspects of how its protocols are implemented and assess the degree to which deaths can be made less likely.

That two children have died is a wake-up call. We express our deepest condolences to the families affected. Though health officials seeking to learn from them should carefully scrutinise these cases, it is important for them to be handled without the bias of partisan politics. In fact, if there is one thing all political parties should understand, it is the challenges they have all experienced with the pubic health care system. No administration has ever been able to boast of perfection in this regard. It is true vaccine campaigns for meningitis are limited due to the variety of ways in which the disease is triggered.

But the ministry must not underestimate the usefulness of these campaigns as well as the importance of fostering greater research into possible seasonal factors. In fact, the World Health Organisation (WHO) identifies a “meningitis belt” that stretches across Africa from Senegal to Ethiopia in which populations are at higher risk of the disease from December to June during the dry season.

While exact mechanisms are still murky, there has been some research in Spain suggesting an increased incidence of meningitis after the onset of Sahara dust. This mention is not intended to induce panic, given our experience with the dust haze over the past few days. But complacency is definitely not the best way to treat with the advice given from health authorities on how to respond generally to complaints that can arise from the dust. More specifically, the Ministry of Health’s protocols regarding how to deal with meningitis, appear to be robust, focusing on environmental management, public education, vaccination, as well as identification of at-risk persons who may have come in contact with disease-causing pathogens.

Certainly these policies do not seem inconsistent with WHO guidelines that have been issued to manage meningitis outbreaks in Africa. However, the WHO underlines the need for surveillance, appropriate treatment and care, as well as large-scale vaccination with appropriate follow-up. Such measures may not fit squarely to the conditions here in TT, but it is hoped that part of our response involves looking at how other nations have handled cases.

Meanwhile, we welcome steps taken to close the Fifth Company Baptist Primary School until such time as full sanitisation is complete. However, such an exercise is not a guarantee that future cases cannot occur. Nor is vaccination a complete antidote.

What matters most is identifying the strands of bacterial subgroups involved and assessing vulnerabilities for further transmission. So that as trite as it sounds, public education must be an integral part of the approach and this should be at the local level in accordance with WHO guidelines.

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