In Port of Spain, Trinidad, yesterday, the Caribbean Public Health Agency (CARPHA) held a media conference to give an update regarding the Zika virus in the region. Ms Carlon Kirton, Communications Manager, who chaired the briefing, explained the reason for it being held:
“As you may know, CARPHA is the sole public health agency for the Caribbean and our functions include the coordination of effective responses to public health crises in the Caribbean, as well as the provision of accurate, reliable, timely and relevant public health information. It is therefore important that we clear the air on issues pertaining to the Zika virus.”
Five presentations followed:
Dr C. James Hospedales, Executive Director, gave a regional perspective on Zika in the Caribbean (text).
“Zika, like Chikungunya in 2014/15, is historic as only rarely does a new disease emerge and spread through a population. And CARPHA, like CAREC before, has a major part of its mission as the discovery and monitoring of the spread of new diseases, with the support of health workers who are on the front line, the laboratories, and regional airlines which cooperate in transporting diagnostic specimens from our 24 member states….
As a new disease in this population, it’s not completely clear how it will behave. The situation is rapidly evolving as new information comes to light. In terms of context, we already have Dengue fever — for generations, and ChikV. We also have Leptospirosis and Malaria, in some countries, which can have similar symptoms to Zika. Doctors and health workers need to consider these possibilities when seeing patients with Zika-like disease. “
Dr Karen Polson-Edwards, Senior Technical Officer, Vector-Borne & Neglected Tropical Diseases, presented on Zika – the disease (text).
“Zika is transmitted primarily by the Aedes aegypti mosquito, the same mosquito which transmits chikungunya, dengue and yellow fever and which is present in every country of the Caribbean. Mosquitoes become infected when they feed on a person during the first week of infection with the virus and in turn these infected mosquitoes can then spread the virus to other people through bites.
The symptoms of Zika are similar to other mosquito-borne infections such as dengue and chikungunya, and include fever, skin rashes, conjunctivitis, headache, muscle and joint pain, and a general feeling of being unwell. Only 1 in 4 persons infected with Zika virus may develop symptoms which are usually mild and last for 2-7 days. However, serious complications can sometimes occur in persons who are infected.”
Dr Lisa Indar, Programme Manager for the Tourism and Health Programme, spoke about Zika and Tourism (text).
“The Caribbean is the one of the most tourism dependent regions in the world, thus travel related diseases like Zika have the huge potential to negatively affect the economies and tourism destination reputation of Caribbean countries. In fact, according to our partners, the Caribbean Tourism Organization (CTO) and Caribbean Hotel and Tourism association (CHTA), there are already reports of travel cancellations in the Caribbean due Zika….
CARPHA, through its integrated regional Tourism and Health program, and in collaboration with its partners, CTO and CHTA, is taking a holistic aggressive approach to travel-related Zika (and other mosquito borne infections) through prevention and control….”
Dr Derrick Aarons, Ethicist, made a brief statement on Ethical Issues – Zika virus in the Caribbean (text)
“To limit the effects of any possible epidemic, good early communication, and adequate community engagement and collaboration are required. Our communication must therefore outline sufficient details for persons to realize its relevance to them individually before the onset of the illness within their country or community. And so – at the governmental level, good, helpful information about the zika virus and effective measures to minimize infection through eliminating mosquito breeding sites and measures to avoid being bitten by a mosquito – should occur. This helps to avoid confusion, mis-communication, and misunderstanding.
Further, as in every infectious disease, our relevant authorities should not downplay the risks – as this could lead to higher rates of preventable infections. Neither should we overstate the risks, as we would not want any panic or any lack of public trust occurring subsequently, as this can be long-lasting. It is always good to provide timely, adequate and appropriate information, as we are now doing. And so we are telling you of the nature of the disease, the types of interventions to be implemented, and the reasons for these interventions.”
Dr Joy St John, Director, Surveillance, Disease Prevention & Control, reported on Strengthening the Health Sector Response to Zika (text).
“It is important to note that the laboratory testing for ZIKV is not geared toward identifying EVERY SINGLE case of ZIKV which may occur in a country, as many persons may have mild disease and may not come to clinical care or require a test, at all. The numbers of clinically confirmed cases are therefore not intended to reflect the actual number of cases in any given country; rather, lab confirmation of ZIKV circulation is meant to keep track of the appearance of ZIKV in new areas and provide updates on the spread of the virus. In most cases, physicians will need to use clinical criteria (patients’ signs and symptoms) as well as epidemiologic data on the circulation of ZIKV in the areas from which their patients present, in order to come to a diagnosis of suspected ZIKV.
Special attention is warranted in the follow-up of patients for varying types of neurological sequelae after ZIKV infection and particular attention should be paid to follow up of pregnant patients who present with febrile illness compatible with ZIKV, and their offspring, in light of current concerns regarding a potential connection between ZIKV infection in pregnancy and the development of microcephaly in infants of affected mothers. CARPHA is currently in the process of piloting systems to facilitate the documentation of such cases, should they occur, so as to detect any similar patterns of association, in the Caribbean region, as early as possible. Barbados has been chosen as a pilot site for this activity.
It is important that we follow the course of this disease in the Caribbean very closely from more than one perspective. The first is that it is new to this region and its potential impact is still largely unknown.”
After the presentations, there was a question and answer session. A video of the media conference is posted online.
As the Zika virus continues to spread throughout the Caribbean, CARPHA is one source of information for the region. Their website is carpha.org.