Pregnancies first

Health authorities step up Zika response

Pregnant women are to be given priority for testing, as health officials today stepped up the national alert for the Zika virus in the wake of a fourth confirmed case on the island.

During a press conference at the Ministry of Health this morning, Acting Chief Medical Officer Dr Kenneth George said pregnant women with symptoms would be tested first. Dr George had earlier said that the authorities would not be advising Barbadian women of childbearing age to postpone pregnancies due to the Zika virus.

From left, Acting Chief Medical Officer Dr Kenneth George, Minister of Health John Boyce and Permanent Secretary in the Ministry of Health Tennyson Springer.
From left, Acting Chief Medical Officer Dr Kenneth George, Minister of Health John Boyce and Permanent Secretary in the Ministry of Health Tennyson Springer.

“We will certainly be prioritizing our ability to test. Therefore the first priority would be pregnant women . . .,” said Dr George.

Minister of Health John Boyce, who also spoke of the threat to pregnant women, said his Ministry had issued interim guidelines to health care providers caring for pregnant women deemed to be at risk of Zika infection. These include recommendations for prevention, treatment, testing and management of suspended and confirmed cases of the virus in pregnant women.

“Women who are pregnant and develop symptoms of Zika virus infection are advised to contact their doctor as soon as possible for advice on testing and further management,” said Boyce.

The United States health agency, the Centers for Disease Control and Prevention (CDC) has issued a Level 2 warning to pregnant women and those of childbearing age about travelling to countries that have reported cases of the virus. A Level 2 warning means the agency is issuing a caution, but stops short of telling people to avoid travel to these countries.

Ordinarily, Zika is nothing more than a mild irritation. The symptoms are a mild fever, skin rashes, and conjunctivitis. In fact, the CDC said four out of five people who contract Zika do not have any symptoms.

The World Health Organization (WHO) on Monday declared an international public health emergency because of suspected links to microcephaly, a condition which causes babies to be born with abnormally small heads.

The association was made after microcephaly cases spiked in Brazil at the same time that the country was experiencing a rapid rise in Zika cases.

However, some health authorities have begun to cast doubt on the link between the virus and microcephaly.

Colombia’s health minister Alejandro Gaviria, while not dismissing the link, has made it clear that there had been no cases of the congenital condition associated with incomplete brain development in his country despite having over 20,000 Zika cases, the second highest number behind Brazil.

He added that either Colombia would start seeing microcephaly cases soon, or there were factors in Brazil that predisposed patients to it that did not exist in Colombia.

At the same time, the science journal Nature has reported that researchers of birth defects in Latin America were questioning the real size of the apparent surge in the number of microcephaly in Brazilian children.

It quoted two officials from the Latin American Collaborative Study of Congenital Malformations (ECLAMC) as suggesting that the baseline may have been underestimated and that heightened awareness of the birth defect because of the possible link with Zika, may have led to an increase in reported cases.

Meantime, health officials here confirmed at today’s news conference that of the 27 samples sent to the Trinidad-based Caribbean Public Health Agency (CARPHA) for further testing, 18 were reported this morning to be negative, with nine results still pending.

Government has also announced plans to step up efforts to eradicate mosquito-breeding sites.

In this regard, a strategic management team is to be established to oversee the rollout of an intensive integrated management strategy in response to Zika, Dengue Fever and Chikungunya, all transmitted by the Aedes Aegypti mosquito.

“The components of the programme include social communication, epidemiological surveillance, laboratory diagnoses, environmental management, clinical case management and integrated vector management,” Boyce said.

He also indicated that there would be a “fair but firm” application of the Health Services Act 1969 in the prosecution of persons found breeding mosquitoes
on their premises.

The introduction of permethrin fog in schools and health care facilities, intensification of public education to focus both on mosquito control and behaviour modification at the household level and strengthened laboratory capacity to support surveillance and outbreak investigation are also included in the programme.

“[There will be] collaboration with partners in tourism – the Ministry of Tourism, BHTA [the Barbados Hotel and Tourism Association], Barbados Tourism Product Authority, constituency councils, faith-based organizations and other community groups to provide updated information and to identify and eliminate mosquito breeding places in communities,” the minister added.

At the same time, he urged the public to take all the necessary steps to avoid being bitten by mosquitoes, including wearing clothes that cover the skin and using insect repellents containing DEET, picaridin and IR3535, all of which are safe for pregnant women; while suggesting that eucalyptus and lemon oils were natural alternatives.

“The use of insect screens is also recommended. Most of all I want to strongly urge the householders to eliminate mosquito-breeding sites around the home and work environment. Remember, no breeding places, no mosquitoes, no disease,” Boyce said.

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