After some time away from the news, Zika has made a comeback. The world of athletics has decided that there is nothing wrong with sending over ten thousand virile young men and women into an area where there is an outbreak of a highly infectious disease, transmitted by sexual contact and that can paralyse adults and cause major and permanent damage to unborn children.
Some athletes keep saying they will not be sexually active during the two or three weeks they will be in the Rio Olympics which is akin to saying that little boys will not stone mango. Do little boys still stone mango? Not in Port-of-Spain but perhaps in Tobago?
The idea that attractive young men and women in their prime will be living side by side in stressful circumstances with defeat and triumph, depression or financial success, just around the corner and not have sex is laughable. Perhaps if they were in Afghanistan, but Brazil?
Others have said they are going to Rio but do not intend to come out of their apartments except to train at midday or to compete. So lock up in your apartment and do what? Watch porn? Read religious tracts?
In addition, since the Zika virus hides in the body for several weeks after the acute infection, there is the risk of bringing it back to your country and unwittingly spreading the disease.
We won't have that situation because Zika is already here. Our problem is that Zika is difficult to diagnose, most cases are asymptomatic and there is no easy or easily available test. There are only about 100 labs in the world that can do and interpret the test for Zika.
The Zika virus is closely related to dengue, West Nile, Japanese encephalitis, and yellow fever viruses. Test results can be difficult to interpret because of cross-reactivity with those other viruses, especially when the person previously was infected with or vaccinated against a related virus.
Most people in T&T have been vaccinated against yellow fever or should be because WHO has advised that there is a high risk of a world wide outbreak of yellow fever within the next year and there is a shortage of yellow fever vaccine. If you have not had it, go and get the vaccine now! And as we all know if you live in T&T and haven't got dengue at least once, you're not a Trinidadian. Some people get it six and seven times, a biological impossibility but who is me to contradict a determined Trini?
So it was not surprising to have a gentleman come into the office with his febrile, rashy child some time ago and tell me that someone in his family had Zika. When I asked how the diagnosis was made, the answer was that the doctor did a blood test which was positive. Some surprise was expressed. No, no!, said the gentleman, the doctor showed me the machine that did the test, "a big grey ting in the corner."
So now you know. If you think you have Zika just go by the friendly doctor at the corner office and have a Zika test done. The only country in the world that offers this service! Then get some antibiotics to kill the "virus" and you good to go.
The truth is there is only one lab in the country that can do the Zika test and it is the one at the Caribbean Public Health Association building in Federation Park, where the Public Health Lab and CAREC used to be. It is not a commercial lab so does not accept walk-ins, the blood has to be taken by a doctor and the test results take some days to come back. That explains why we seem to be having so few cases of Zika. There is no commercial test.
However in Puerto Rico, where there have been over 700 confirmed cases of the Zika virus, including 65 pregnant women with symptoms of the virus and one death and five cases of the paralising nerve disorder Guillain-Barre syndrome, they have began testing blood donors for the virus and found that one per cent of them have been infected. With a population of three and a half million, that could mean over 35,000 Puerto Ricans have had Zika and do not know. It might be the same here.
While we are on this subject it is time that control over the country's labs is established. As it is any Jose, Harry or Melanie can set up some equipment in a corner and claim they doing lab tests. Utter nonsense! A corollary to this is the habit of Trinis going into such a lab, getting a result, being told some nonsense by the "technician," panicking and rushing off to a doctor for interpretation of what usually turns out to be a normal test.
This happens particularly with children and apart from unnecessary testing being a form of child abuse, holding down a screaming child while a half-trained person struggles to take blood, the computers that "internet" the test results are set to adult values and as everyone knows children are not little adults. They are different. They have different lab test values. But again, perhaps no one recognises that.
Deciding when to do a lab test is an art. One does not order lab tests just "to make sure." In fact, the more lab tests a doctor does, the less she knows what she is doing.