Dengue

What do the numbers 70, 600 and 1,000 have in common? They are the reported dengue cases in Jamaica, Trinidad and Tobago (T&T) and Guyana respectively for this year. These are diverse figures and the responses to them by the three governments concerned have been dissimilar also.

According to reports emanating from Jamaica on Tuesday, that island’s Ministry of Health is spending millions to prevent a dengue outbreak. The Jamaica Gleaner reported that the ministry has been fogging, clearing breeding sites and carrying out public education programmes in some 300 communities nationwide.

In Trinidad and Tobago, where as at last Friday there had been three confirmed deaths as a result of dengue haemorrhagic fever, the chief medical officer said there was no need for alarm; figures had not yet reached epidemic proportions. However, spraying to keep down the multiplication of the vector carrying the disease had been heightened in areas of the island where the majority of cases were reported and the Ministry of Health has hired more staff for its vector control unit, reports said.

In the case of Guyana, Minister of Health Dr Leslie Ramsammy said while the country was facing the threat of a dengue outbreak there was no need to panic as the health sector was well equipped to deal with any such crisis. He said citizens needed to be careful and to keep their surroundings clean. He added that dengue and other tropical diseases – the result of climate change – would likely increase and cause major problems in the future. There was no indication as to what, if any, additional steps the ministry planned to take to mitigate the risk of a dengue epidemic.

Apart from the difference in the number of people affected in Jamaica, T&T and Guyana and the variance in responses, it should be noted that Jamaica has a population of 2.6 million; T&T 1.3 million and Guyana 763,437 – these figures were as at 2008 according to the World Bank’s World Development Indicators. Aside from having the highest number of dengue cases and the smallest population of the three countries, it should also be noted that Guyana is the only country with an ongoing garbage crisis in its capital and the only one with major drainage issues – ideal conditions for the breeding of the Aedes species of mosquito which spreads dengue. Even though the local Ministry of Health does not want to spread panic unnecessarily, surely it could be, ought to be doing more than it is at the moment.

It is a well-known fact that dengue is not just a problem in Guyana; its incidence has risen the world over in the last decade. Because of its proximity to the Caribbean, Florida has also seen a marked increase in dengue cases this year, and has put systems in place to mitigate its spread. Although the Aedes mosquito, which is also responsible for the spread of yellow fever, is found in the tropics and sub-tropics, dengue fever, because of global travel, has been found in places like Antarctica. The World Health Organisation has had a global alert in place for the disease since the 1950s. It notes that as many as 100 million people worldwide are infected with dengue or dengue haemorrhagic fever every year and since there are no vaccines to prevent it, the most effective preventative measure was to avoid being bitten by mosquitoes. In other words, regardless of how effective a country’s health sector may be at dealing with the virus it is advisable not to contract it in the first place.

This is at odds with what appears to be the local health sector’s laid back attitude to the risk. Dengue has now become an annual occurrence with the rainy season, but that’s not to say that it should be shrugged off like so many other things in this country. Sadly, it would appear that the epidemic that should be feared in Guyana is apathy. It has already manifested in the Local Government Ministry’s approach to the garbage crisis and seems to be spreading across sectors.