It was perhaps inevitable that the chikungunya would make landfall in T&T. The sheer volume of cases in the Caribbean region ensured that there would inevitably be a time that the virus would find its way into the countryTrinidad and Tobago has gone quickly from its first case to "endemic" status, as described by the director of the Caribbean Public Health Agency (Carpha), Dr James Hospedales.
Dr Hospedales noted that Carpha was continuing its testing according to public health guidelines, confirming where the virus is present and circulating.The Ministry of Health has confirmed 42 cases in Trinidad and one in Tobago, but the chairman of the Diego Martin Regional Corporation Darryl Smith, claimed that there were 34 cases in his district, while deputy Mayor of the Port-of-Spain Regional Corporation Keron Valentine confirmed 24 cases.
The press release from the Health Ministry rather cagily noted that "Reports that have indicated larger numbers are based on unverified information and suspected cases."In describing this country as endemic, Dr Hospedales explained that chikungunya once introduced to the local environment, will, like dengue, always be here.Once Carpha has confirmed the presence of a circulating virus, the business of identifying specific cases based on medical diagnosis becomes the responsibility of an attending physician.
With 37 deaths reported in the Caribbean, Dr Hospedales was careful to warn that the virus should not be taken lightly and advised individuals to ensure that their homes and surroundings were cleaned.That's a start, but it's only a beginning.
If T&T is to make any real advances in managing the debilitating effects that the lingering presence of chikungunya and dengue will bring to this country on a regular basis, it's clear that far more needs to be done in managing the carrier of both potentially deadly viruses, the aedes aegypti mosquito.
Insecticides have always been a solution of diminishing returns. Insects that survive chemical attacks eventually lead to strains that can't be killed that way.Given Dr Hospedales' clear warning that fogging simply doesn't work the way that the public has long hoped it does, what's needed is a national commitment, on the personal and community level, to destroy the breeding grounds for mosquitoes, particularly in heavily populated areas.
The speed with which chikungunya took root in Belmont and swept that community sends a clear message that beyond fogging, which has long given the illusion that the state can handle mosquito infestations, every home and every street needs to take responsibility for their surroundings.
Port-of-Spain mayor Raymond Tim-Kee, the councillor for Belmont took the unusual step of putting boots on the ground to inspect each of the 178 vacant lots in East Port-of-Spain to eradicate breeding grounds for mosquitoes.The next step will be to put the force of law behind the traditionally gentle cajoling of the public health inspectors charged with helping citizens to get their premises in order. It's also going to mean more visits by more officers on a far more frequent basis before such habits take hold.
If nothing can really be done about either virus, then this country needs to take more direct and sustained steps to control its real problem, the ease of transfer through the vector of mosquitoes.