7 cases confirmed

As T&T remains on heightened alert against Zika, it has been discovered that the virus can also present itself as the Guillain–Barré syndrome (GBS), a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system.

Dr Clive Tilluckdharry, acting chief medical officer, said yesterday that annually there were about two cases of GBS reported, but since January this year to date this figure has tripled, as there were now seven cases of people being infected, the majority of which were admitted to the Eric Williams Medical Sciences Complex, Mt Hope.

Tilluckdharry made the statement at a press conference at the Ministry of Health’s Park Street, Port-of-Spain, headquarters yesterday.

To date there have been some 215 confirmed Zika cases, but the number of suspected cases is much higher. He said feedback from the National Surveillance Unit also showed there were 176 suspected Zika cases, but this figure was most definitely much higher. Saying that GBS could happen after any acute infection, Tilluckdharry added, “I have seen it years ago where one or two dengue cases present with Guillain–Barré syndrome. It also presented with seizures, epilepsy.” He said Zika could be a mild disease but it could present in many ways, the majority of it being without any symptoms.

“There are cases of high fever, muscle and joint pains and rash, but we have to take all precautionary measures against the transmission of diseases by mosquitoes,” Tilluckdharry said. 

It was also revealed that 78 women had been diagnosed with Zika and that two women had given birth to babies while they had the virus. However, Medical Chief of Staff at Mt Hope Women's Hospital (MHWH), Dr Karen Sohan, said the babies were reported to be normal. She said brain scans performed on the two babies born in March and last week respectively had not revealed any abnormalities. It was also announced that there were five confirmed cases of chikungunya while dengue cases to date stood at 25. And like Zika, Tilluckdharry said the suspected cases of these viruses were also higher, as there were 93 suspected cases of ChikV. 

He said when ChikV first surfaced in this country in 2014 there were 340 confirmed cases, but now there were some sporadic cases.

In 2014 there were just over 5,000 dengue cases and in 2015, 1,600 reported cases. What was even more frightening, Tilluckdharry said, was that in Brazil, the Zika virus was detected in the salivary glands of the Culex mosquito and in T&T over 90 per cent of the mosquitoes belong to that group. 

Dr Roshan Parsaram, specialist medical officer in the Insect Vector Control, said there have been increased intersectoral collaborations specifically with the 14 regional corporations through the establishment of a technical committee. He said technical guidance was also provided regarding pesticide use and vector control activities.

Parsaram said a “state-of-the art geographical system” for the Insect Vector Control Division was expected to be finalised within the next quarter and would assist the division to examine, in real time, disease trends as well as vector habitats and potential breeding sites so as to improve operational efficiency.

Symptoms of GBS

GBS symptoms include weakness of the arms and legs and, in severe cases, can affect the muscles that control breathing. These symptoms can last a few weeks or several months. Most people fully recover from GBS, though some people have permanent damage. Very few people die from GBS.

Source—Centres for Disease Control and Prevention, US

Private testing poor

Health Minister Terrence Deyalsingh, who had been recently diagnosed with dengue, said yesterday that people should be wary of going to private facilities to test for Zika. He said this was especially so for pregnant women, as some of these institutions may not be properly equipped to do such testing. He said the public hospitals had the requisite tests with the requisite sensitivity to detect the Zika virus. “So these false negative tests...you want to avoid that and the Caribbean Public Health Agency is the only institution in Trinidad that has the PCR test (Polymerase Chain Reaction),” Deyalsingh added.

PCR is used to reproduce (amplify) selected sections of DNA or RNA for analysis. Deyalsingh said as countries around the world continued to grapple with lack of resources, it was improbable to test this country’s entire population for Zika as focus continued on the most vulnerable.

On global reports that Zika may be sexually transmitted, Deyalsingh said in larger countries with a much larger population this was detected in a few instances, not in smaller countries like T&T.