UNC: Is government doing enough to prevent dengue deaths?

OPPOSITION MP Dr Lackram Bodoe is asking if the government is doing its best to prevent dengue deaths.

He asked if the government ignored the warnings CARPHA issued in November and did not put preventative measures in place.

Speaking at the UNC’s Sunday media conference at its Chaguanas headquarters on August 11, Bodoe said CARPHA had urged its member states to take definitive action to reduce dengue and place greater emphasis on mosquito control in homes and communities.

“The Insect Vector Control Division (IVCD), under the Health Ministry, is responsible for mosquito control in homes and communities. The ministry admitted that this outbreak was expected, based on the seven-ten year cycles attributed to dengue outbreaks.

“What measures were put in place to ensure that the country was prepared? Was the IVCD properly resourced with funding, vehicles, chemicals, etc., to ensure it could adequately meet increased demands for spraying? How many cycles of perifocal work were done?

“These are the home inspections where IVCD officers would inspect your house and leave notifications, give advice or even citations to ensure you eliminated breeding sites.I’m reliably informed over the last five years very little of this has been done.”

Bodoe asked about the frequency of spraying. He said the Health Minister consistently said there was a risk of mosquitoes building up resistance to pesticides.

“There is anecdotal evidence from residents suggesting only infrequent spraying has been taking place over recent years. How can insecticide resistance develop if spraying is limited and there was no more exposure to chemicals?”

He said the ministry could not absolve itself by passing the responsibility for source reduction solely to the public.

He asked whether the numbers of cases and deaths were being under-reported.

“Statistics are important in managing a crisis. We are being told that the confirmed-case figures only include cases confirmed by CARPHA, and while this is important, cases confirmed by other sources need to be included.

“Will the private labs be accredited to test for confirmed cases so we can have reliable figures? How timely is data collection from private labs? I’m told this data is only collected once a month.

“Are the numbers of people who visited private doctors, tested positive, and died from dengue included?”

Bodoe said it was important to know if the epidemiological profile of people who died from dengue over the years has changed.

He advised the public of the symptoms of dengue, saying most cases are mild.

“The classic dengue symptoms in those exposed to the virus are fever, headaches, retro-orbital pain – which means pain behind the eyes, muscle and joint pains, nausea and vomiting, a rash, itching of palms and soles, and what are called haemorrhagic manifestations. These would normally be bleeding or bruising of the skin and gums, bleeding from the nose, and blood in vomit, stool and urine.”

He said having haemorrhagic manifestations did not mean someone could develop dengue haemorrhagic fever or dengue shock syndrome. He said this usually developed in days four, five or six after the onset of symptoms.

“Dengue haemorrhagic fever is complications which, if not treated in a timely manner, can lead to death. In addition to the bleeding, you have a drop in the platelet count below 100,000. There is fever, bleeding, low platelet count, and plasma leakage. This can be determined by the presence or lack of certain factors in the blood count.

“Dengue shock syndrome has to be treated quickly, urgently and appropriately if lives are to be saved. Symptoms are severe abdominal pain in the stomach area or the right side over the liver, persistent vomiting, restlessness or drowsiness, and an abrupt change where the fever disappears and you can go hypothermic (have an unusually low temperature), accompanied by prostration and sweating.”

Bodoe urged the public to continue to eliminate mosquito breeding sites, wear protective clothing, use mosquito repellent and nets, and to maintain vigilance in the young, the elderly, pregnant women, immune-compromised people, and those with comorbidities.

He urged the government to continue spraying, to make diagnosis and treatment easier, cut down on wait times and ensure there are experienced and competent staff on the front lines to pick up and treat the symptoms of dengue haemorrhagic fever and dengue shock syndrome.

Up to August 10, there had been eight laboratory-confirmed dengue-related deaths and 712 laboratory-confirmed cases.