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:(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.
However, 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.