Old Harbour doctors react to health ministry dengue outbreak declaration

In the last three months experts at the health ministry have observed a re-emergence of Dengue Type 2, a particular strain predominant in 2010.
While dengue-related deaths are rare, the ministry said it is presently investigating six deaths that possibly might have been caused by the mosquito-borne disease.

“The outbreak comes as the ministry’s national surveillance unit advised that Jamaica has surpassed the Dengue epidemic threshold for July and August and is on a trajectory to do the same for the month of September. This means, the country has seen an increase in the number of cases compared to what is normally seen during these months of the year,” the MOHW stated in a press release Saturday.

Two medical doctors from the Old Harbour region later told Old Harbour News that they have noted an increase in suspected dengue cases in recent weeks corroborating the findings of the health ministry’s surveillance team.

“We had one suspected cases that was sent to the hospital but I don’t even know if it was confirmed,” said Dr Francis Kpormego, chief general practitioner, Good Shepherd Medical based here in Old Harbour.

This particular case was “three to four days ago,” he said, before making an important point that other flu-like virus are in the air that comes with similar symptoms like dengue and can oftentimes confused persons.

“We have other flu going around,” he contends. “Like influenza virus is going around which is similar. When we actually find other things that look like dengue then we will refer. We have our tests kits here so we can test quickly and make the diagnoses.”

Observations at Cumberland Medical in Spanish Town have not been dissimilar, said Dr Kurt Waul.

“Dengue is like more viral illnesses. They come and go. There are very few instances where you can get dengue hemorrhagic fever. So we usually check people for that if they are going to develop it. It can cause your blood platelets to fall very, very low and that’s what cause the dengue hemorrhagic fever,” said Dr Waul while bemoaning that “test can be very expensive and it’s not widely available.”

“I don’t really test for dengue firstly. What I want to know is if the person is sick and the fever is lasting longer than usual. Then I’ll check if they are going to develop hemorrhagic fever,” continued Dr Waul, a native of Old Harbour and resident.

Key signs to look for if someone is likely to develop dengue hemorrhagic, Dr Waul added are “bleeding from their ear, nose, throat, in their stool, on the skin, easy bruising or prolonged fever”.

A fever is considered prolonged if it continues unchecked for three to five consecutive days.

Up to last Friday data from the health ministry stated there are 565 cases deem suspected, presumed or confirmed. Of that number, 78 cases had been confirmed with majority of the cases seen in Kingston, St. Andrew, St. Catherine and St. Thomas.

Based on the latest data, that is less than a third of a percent of the population. So is the health ministry overreacting?

“I wouldn’t call it epidemic or pandemic yet. They’re just being cautious. That’s why they send out the press release,” said the Ghanaian Dr Kpormego.

In arguing the point Dr Waul stated: “I don’t know what measures they use to declare an outbreak but I would consider 600 is an outbreak because usually these cases are sporadic.”

Dengue fever is a mosquito-borne disease that is usually a mild illness in which a person may get a fever, headache, joint, and muscle pains. Rest and adequate hydration are usually enough to see one through the period of illness. The recommended treatment for the fever is acetaminophen/paracetamol.
Persons suspected to have dengue should not use aspirin, diclofenac, ibuprofen, or any of the medications/pain relievers known as non-steroidal anti-inflammatory drugs (NSAIDs).  These drugs, when used to treat the fever in dengue, have been known to increase the severity of the disease.

Chief Medical Officer, Dr. Jacquiline Bisasor McKenzie has cautioned that “on occasions the illness can progress to Severe Dengue, which can result in organ failure as well as bleeding (haemorrhage), and severe fluid depletion that can lead to shock and death.”
“Persons experiencing fever, vomiting, severe abdominal pain, bleeding under the skin (petechial rash), feeling very weak, or getting confused, are to seek immediate medical attention,” the CMO added.
Meanwhile, approximately 500 temporary vector control workers have been engaged and deployed across the island to high-risk communities along with 213 permanent workers, the ministry stated. An additionally 600 temporary workers will now be engaged to increase the search and destroy and health education activities.

Minister of Health and Wellness, Dr. Christopher Tufton noted that: “The ministry and the regional health authorities have made the necessary preparations for a possible outbreak.  Since 2019 the Government of Jamaica, through the Ministry of Health & Wellness has made significant investments in the vector control programme with over J$300M in acquisition of vehicles, fogging machines and the expansion of the number of staff dedicated to the vector management programme.”

The ministry said, through resources from the National Health Fund, it will expand the community strategies through the engagement of all stakeholders at the community level.  This engagement will involve the provision of resources to undertake dengue mitigation strategies. These activities will include support for the removal of bulky waste and drain-cleaning exercises across the country.

Since July 2023, the parish health departments have been engaged in enhanced fogging and treatment of breeding sites.  This has resulted in a 7-day extended work week for fogging and other mosquito eradication activities by the team.

The ministry will also extend opening hours for all Type 3–5 health centres to 8:00 p.m. starting Monday, October 2, 2023.  This is to facilitate people visiting these facilities to receive treatment and referrals where necessary.