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Chikungunya virus reaches T&T

Wednesday, July 16, 2014

Three people who recently travelled to Caribbean countries and who are from Diego Martin, South Oropouche and Barataria have been diagnosed with the Chikungunya virus. This was confirmed on Monday by officials of the Ministry of Health, who revealed the islands visited included Dominica and Bequia. Within a few days of arriving back in T&T, the three developed fever and mild joint pains.



However, one official said, “They were pretty normal other than that and they all displayed mild symptoms.” Officials have warned that people over the age of 65 and under five, as well as pregnant patients and people diagnosed with co-morbid conditions such as diabetes and hypertension are more likely to exhibit severe symptoms. People diagnosed with diabetes and hypertension are also at greater risk as their immune systems are already weakened.


It is not yet known if it is possible for a person to contract both Chikungunya and dengue fever at the same time, as there are no reported cases in the Caribbean. Chikungunya is spread by the Aedes aegypti and Aedes albopictus mosquitoes—the very same mosquitoes that spread dengue fever.


The three cases were imported, and according to Specialist Medical Officer, Insect Vector Control Division (IVCD), Ministry of Health, Dr Roshan Parasram, “We are lucky in that we don’t have any local spread. If we clean up our surroundings and take the necessary precautions early, we can stop it from becoming endemic to T&T.”



Next few months are critical
During an interview at his Cunupia office yesterday, Parasram referred to the next few months as the “critical period.” He said with many people heading abroad for vacation, there was a greater possibility of the virus spreading as they returned to T&T. Parasram said the symptoms closely resembled that of dengue fever and were almost indistinguishable “even to a trained physician.” 



The symptoms include fever, a rash or red blotchy appearance of the skin, lethargy, a general feeling of being unwell, nausea, headaches and joint pains. He said while the joints tend to be targeted by the virus, people with arthritic or old sporting injuries can be exacerbated by the virus. Confirming that tests are done to determine if a person is suffering from dengue fever or Chikungunya, Parasram said the Trinidad Public Health Lab (TPHL) had the capability to test for and confirm cases of dengue fever.


However, the TPHL does not have the capacity to test for Chikungunya, so the Caribbean Public Health Agency (CARPHA) has been charged with the responsibility for testing in the region. “We want clinicians to know the earlier you test, the better,” Parasram said. To this end, the ministry will host a stakeholder meeting at the Radisson Hotel, Port-of-Spain tomorrow, to discuss the issue and to alert doctors and other medical professionals about the gravity of the situation.


With just over 5,000 reported cases in the Caribbean, Parasram said, “The morbidity rate is much less than dengue.” He stressed that with dengue mortality standing as low as .02 per cent in T&T in the last few years, “Chikungunya is even less than that.” He said it was not known if there were any deaths in the region, as a result of chikungunya. Asked about the treatment options, Parasram said it was important to stay away from non-steroidal anti-inflammatories as is the case with dengue fever. 


He advised the use of drugs containing acetaminophen as alternatives to treat fever, along with plenty of fluids.



Steps to take
“If you have a fever and with a travel history, we have to presume it’s chikungunya and you should seek urgent medical attention,” Parasram said. Assuring the public that the IVCD was dealing with “suspected cases” and not waiting for confirmation, Parasram said the IVCD’s 800 staff members were equipped and ready to respond to any reports, as he urged the public to call 612-IVCD (4823) or 627-0010 ext 1609.


Listing source reduction as the main factor in curbing the spread of the virus, Parasram advised home-owners to cut their grass and to clean out brick holes, guttering, vases, sliding shower tracks, barrels, drains, flush infrequently used toilets more often, and other receptacles that collect water. Another suggestion was the installation of mosquito screens over operable windows and doors, the use of certain repellants and candles, as well as the use of electrical devices to swat mosquitoes. 


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