Suspected dengue death under probe

Dr Leslie Ramsammy
Dr Leslie Ramsammy

The Ministry of Health is investigating a recent suspected dengue death at a private hospital, Minister of Health Dr Ramsammy disclosed yesterday and he said the fear of an outbreak in Guyana is “real.”

Leslie Ramsammy
Leslie Ramsammy

Stabroek News understands that a female associated with a popular Georgetown restaurant succumbed some time last week at the private institution.

Ramsammy said his ministry is investigating the death but would first have to ascertain whether the woman indeed died from dengue. He said while persons may be diagnosed with dengue it does not mean the disease caused their death.

The minister said if indeed the woman died from dengue it would have been from dengue haemorrhagic fever (DHF), which was deadly. While Guyana has seen DHF deaths before, the minister said, they were traced to other countries as the persons were frequent travellers.
He said his ministry would have to ascertain the person’s travel history and if in fact the woman was in Guyana all the time “then we would have to take it very seriously” as it would mean that Guyana has DHF.

Ramsammy confirmed, as was previously reported this week in this newspaper, that 115 persons have been diagnosed with dengue for the first five weeks of this year compared to the 43 for the same period last year.

He said the most affected areas are Georgetown, Lethem and the East Coast Demerara.

While the minister acknowledged that more persons have been tested and that January is usually a month that would see an increase in dengue cases, he said that the “increase may be real” and that there is much cause for concern.
“We don’t have a crisis as yet but we have to do something to ensure that we do not reach that stage,” the minister told Stabroek News.
He said there would be increased fogging, which will commence in Georgetown from tomorrow and surveillance will be stepped up.
He recalled that he had spoken about the disease since last year as there was a fear since it was becoming a problem in Caribbean countries.
Trinidad has seen a quite a number of suspected deaths in recent times and late last year relatives of ten persons were issued with death certificates indicating that their relatives died from DHF.

Earlier this week Chief Medical Officer (CMO) Dr Shamdeo Persaud had given Stabroek News the figures for the year but he had said there is no fear of an outbreak.
According to Dr Persaud the figure of 115 is for the first five weeks of the year and 468 persons were tested. For the same period last year 154 persons were tested and 43 were found to be positive. He was careful to stress that there was no “outbreak” of dengue fever and the cases were taken from both private and public institutions.

The CMO had said that the ministry has stepped up its surveillance from mid last year since neighbouring countries such as Trinidad and Brazil have seen increases in the number of persons affected.

Of the positive cases 65 are from Region Four (Demerara/Mahaica), 27 from Region Nine (Upper Takutu/Upper Essequibo) and of that number 14 were visiting Brazilians. Region Three (Essequibo Islands/West Demerara) saw eight cases, Regions Five (Mahaica/Berbice) and Six (East Berbice/Corentyne) had three cases.
Region Two (Pomeroon/ Supenaam) had one case, Persaud had said, a child who was hospitalised and had to be closely monitored by health officials. The child had no travel history and it means that someone with the disease had travelled to the area where the child lives. The CMO said they have been impressing on patients to inform health officials about their travels so that they can keep track of them.

There are four types of dengue virus and Persaud had said that Guyana has only seen type two which is a relatively mild one. He said if a person contracts two types at the same time it would be very serious as that is when a person has the DHF.

In 2007 a Barbadian was hospitalised with type three but Persaud had noted that was the first and only such case and there has been no other recorded case.
Persaud had disclosed that the ministry has also reinforced its port health regulations.

“We are actively going after dengue fever and we are doing a lot more community-wise by following up on cases and visiting homes to sensitise other occupants of the household. We also advise people who have dengue to sleep under nets even during the day…” Dr Persaud said.

According to the World Health Organisation (WHO) website dengue is transmitted by the bite of an Aedes mosquito infected with any one of the four dengue viruses. It occurs in tropical and sub-tropical areas of the world and symptoms appear three to 14 days after the infective bite. Dengue fever is said to be a febrile illness that affects infants, young children and adults.
The website said that symptoms range from a mild fever to incapacitating high fever with severe headache, pain behind the eyes, muscle and joint pain, and rash. There are no specific antiviral medicines for dengue but it is important to maintain hydration.

Use of acetylsalicylic acid (eg aspirin) and non- steroidal anti-inflammatory drugs (eg Ibuprofen) is not recommended.
It was stated that DHF (fever, abdominal pain, vomiting, bleeding) is a potentially lethal complication, affecting mainly children. Early clinical diagnosis and careful clinical management by experienced physicians and nurses increase survival of patients.

There are four distinct, but closely related, viruses that cause dengue. Recovery from infection by one provides lifelong immunity against that virus but confers only partial and transient protection against subsequent infection by the other three viruses.