Right Steps & Poui Trees

Jamaica: #Zika At The Beginning of September

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After a hiatus of more than three weeks, Jamaica’s Ministry of Health (MOH) has posted a new zika update on its website. This update gives data received by the MOH as of August 26, 2016, which I have incorporated into the chart below:MOH zika data 26-8-16 - chart(The 8 reports are all posted on the MOH website, in the Press Releases section.)

More cases of zika than the numbers show

The numbers in this chart reflect the changing situation over a two month period regarding the zika outbreak. It is important to note, however, that the actual situation on the ground is vastly different for a variety of frequently articulated reasons:

  • it is estimated that as many as 80% of people who become infected with the zika virus never show any symptoms, and therefore wouldn’t be represented in the  data;
  • many people experience only mild symptoms during a zika infection and do not seek medical care;
  • doctors and other medical staff do not necessarily report all those they suspect of having zika, although it is a Class 1 Notifiable disease, requiring notification within 24 hours.

Increasing numbers in two-month period

The increased numbers being reported are indicative not only of the actually increasing numbers of zika infections, but probably also of increased awareness of the disease, as well as increased reporting. The figures over the two-month period show the following:

  • the numbers of zika notifications and suspected cases of zika have both more than doubled;
  • the number of confirmed cases of zika has more than tripled;
  • there has been a dramatic increase in suspected cases of zika in pregnant women, from 88 to 470;
  • the number of confirmed cases of zika in pregnant women has increased significantly from 4 to 31.

Guillain Barre Syndrome – increased cases & 6 deaths

The number of Guillain Barre Syndrome (GBS) notifications has more than doubled during this two month period, as has the number of suspected cases among these notifications. Suspected cases are those that on further evaluation fit the case definition for GBS based on clinical signs, symptoms and investigation results. To date, zika has been lab confirmed in only 3 of these suspected cases of GBS.

Dr De La HayeHowever, the situation with GBS is of increasing concern, with Acting Chief Medical Officer Dr Winston De La Haye confirming that as of September 2 there have been 6 GBS-related deaths. In none of these cases has it yet been confirmed that the deceased had a zika infection; test results have come back negative in two cases and the results are pending in the others. The first of these GBS-related deaths was on June 26, and in this instance the deceased tested negative for zika, but positive for both dengue and chikungunya. The two most recent deaths occurred this week.

Communication in the context of zika

Earlier this week, the Opposition Spokesman on Health Horace Dalley (who is the former Minister of Health) made a public statement about the death of a patient at the Kingston Public Hospital (KPH) on Tuesday. Initially the MOH was unable to confirm the death. In subsequent interviews, Dr De La Haye said that communication with the MOH was being improved, as it was obviously a problem that Mr Dalley knew of the death at KPH, when he did not.

The MOH is also seeking to increase access to information about zika through the provision of two additional phone numbers that the public can call with questions about zika. This is being done through the MOH’s National Emergency Operation Center (NEOC) and is aimed particularly at providing information for pregnant women. The numbers are 537-1709 & 536-9125 and can be called Mondays to Fridays, 8:00am to 4:00pm.

I was very encouraged when the MOH began to post updates of the zika numbers on its website two months ago, and I was disappointed when the effort seemed to falter. I hope that the MOH will try to post the new figures regularly, perhaps on a weekly basis. This would be one useful – and fairly straightforward way – of providing ongoing data to the public.

 

 

 

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Author: rightpouitree

Navigating the real and virtual worlds and sometimes writing about what I observe...

4 thoughts on “Jamaica: #Zika At The Beginning of September

  1. Reblogged this on Petchary's Blog and commented:
    Here is my fellow blogger Susan Goffe’s latest on the Zika Virus and the Guillain Barre Syndrome, based on figures released by the Ministry of Health. I agree with Susan that regular (if possible weekly) updates should be posted on the Ministry website. This would be very helpful. We need to keep close tabs on the situation.

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    • Thanks for reblogging, Emma. We do need to be paying attention. The GBS situation is of increasing concern. And the MOH has said that it’s births from this month onwards in which there may be babies born with effects of congenital zika syndrome.

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  2. Thanks for keeping up your blog, Susan. Re the case that is dengue and ChikV positive, there is cross reactivity between dengue and Zika, both being flavi viruses. There is a lack of sensitivity in zika tests (ie high false negative rate) so the dengue positivity could suggest zika. The key thing is to know which tests were done, antigen (virus RNA), or antibody. The latter carries the highest false negative problem). And of course of the antibody tests Igm is recent infection igg is previous infection….. though if testing done late in these viral illnesses, the Igg may have had time to turn positive. Have I muddied the waters a bit?

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    • Not muddying the waters at all! Expanding the discussion. The reliability of testing is something that I have wondered about. Initially the MOH reps gave the numbers of samples sent for testing, the number of results returned & whether they were positive or negative for zika, and the test results pending. They haven’t been giving these more recently. I did wonder about the reliability of the tests, given the hundreds of samples being sent for testing and the very small numbers coming back positive.
      Last week I heard Dr De La Haye being interviewed a number of times and I think I did hear him say something about reliability of testing and also whether they were testing for the virus or the antibodies. I will see if I recorded those comments, confirm what I think he said and let you know.
      Quite frankly, I think there is a great deal about the full picture on the ground that we in the public aren’t aware of.

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