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Trinidad: Dengue outbreak

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  • #16
    Re: Trinidad: Dengue outbreak


    Dengue victim's family members hospitalised
    Rohandra John

    Friday, December 19th 2008

    AT LEAST two more members of Camille Ramcharan's family had to be rushed to the Eric Williams Medical Sciences Complex in Mt Hope yesterday to be treated for dengue.

    Camille Ramcharan, a 22-year-old UWI engineering student, passed away last week after losing the battle with dengue.

    Yesterday, her aunt, Merlyn Ramcharan, said her elder sister, Vilma Khan and husband, Habib Khan, had been experiencing dengue-like symptoms over the past few days and were "rushed to the emergency at the Mt Hope hospital" after visiting a private doctor earlier.

    "They went to the doctor yesterday because they were experiencing all the symptoms, high fever, headache, body pains, they had no appetite, and while there, the doctor called the Mt Hope Hospital and told them to expect two of them, and they were immediately rushed to the hospital," Merlyn said.

    Only two days ago, the residents of Frederick Settlement Caroni, where Camille once resided with her relatives, staged a protest to highlight what they described as a "deadly dengue outbreak in their community". The residents, irked by Camille's death, said Health Minister Jerry Narace was being less than truthful by claiming there was no dengue outbreak in the country. They also cast blame on the authorities for the situation in their village, saying they had neglected to clean the drains in and around the village for several years now. They said those drains were now filled with silt and stagnant water and have become the breeding ground for mosquitoes.

    Camille's father, Freddy Ramcharan, who also contracted dengue but survived the ordeal, said more than 50 persons in the village have tested positive for dengue for the year to date. Camille's mother, Shakera Mohammed, has also tested positive for the disease and is being treated at the Mt Hope hospital.

    Merlyn said they were "all hurting" and want the authorities to intervene and deal with the situation urgently "because people are dying".

    When contacted yesterday just before noon for comment on this matter, Narace asked the Express to pass on the information to his secretary because he was at a "Cabinet luncheon" and unable to respond to questions. When contacted again later on in the evening, Narace said he had been "extremely busy for the entire day" and had not gotten a chance to read the report about the residents' plight, but would try to do so today and provide a response on the matter.


    • #17
      Re: Trinidad: Dengue outbreak


      Community sprayed after protest over dengue death
      Rohandra John

      Saturday, December 20th 2008

      Protest action over dengue has brought action for the residents of Frederick Settlement, Caroni.

      A crew from the Health Ministry's Insect Vector Control Unit rolled into the area yesterday to spray following a protest earlier this week to highlight a dengue outbreak in their community.

      Their protest action was mainly sparked by the death of 22-year-old UWI engineer student, Camille Ramcharan, the latest victim of dengue haemorrhagic fever.

      Camille's cousin, Ronny Khan, told the Express yesterday that they were saddened that "it took the death of someone" in order to get the authorities to spray the area. He said their initial request to have the area sprayed all but fell on deaf ears.

      Chaguanas Mayor, Dr Surujrattan Rambachan, yesterday confirmed that the area had been sprayed.

      Camille's parents Freddy Ramcharan and Shakera Mohammed also tested positive for dengue and were treated at the Eric Williams Medical Sciences Complex, Mt Hope. Ronny said his parents Vilma and Habib Khan also tested positive earlier this week and received treatment at the said hospital. He said both his mom and aunt have since been discharged from the hospital but up to late yesterday evening his dad remained at the hospital where doctors were monitoring him.

      In another statement issued from the constituency office of the Chaguanas West MP Jack Warner, media officer Ann Dookie said that in addition to the area being sprayed with ULV machines yesterday morning "a gang from the Tunapuna Corporation began cleaning the drains".

      The statement also indicated that the United National Congress Alliance (UNC-A) Chief Whip, Ramesh Lawrence Maharaj, councillor for the area, Sharma Deonarine, and other executives of the Chaguanas West Executive would meet with the residents today to discuss the mosquito problem and other issues affecting them.The meeting is to be held at the Caroni Community Centre at 2 p.m


      • #18
        Re: Trinidad: Dengue outbreak


        110 more workers hired to spray killer mosquitoes
        Aabida Allaham

        Tuesday, December 23rd 2008


        A new squad aimed at eradicating the deadly aedes aegypti mosquito, which has been wreaking havoc across the country, killing some and leaving many fighting for their lives, is now armed and ready to hit the streets.

        The new squad of 110 Insect Vector Control Division (IVCD) inspectors, who have been trained on how to use the various machines and the uses and mixing of chemicals, will be prowling your neighbourhood in search of the enemy. The new inspectors took the total number of sprayers and perifocal operators in the IVCD to 580.

        Decked off in their new uniforms, gas masks and spraying cans, the members were paraded before the media yesterday, even as more and more residents across the country pleaded for help.

        Dr Clive Tilluckdharry, specialist medical officer attached to the IVCD, told members of the media gathered at the unit's St Joseph headquarters that the mosquito invasion at Frederick Settlement, Caroni, was now under control.

        Tilluckdharry said: "Currently the aedes index in the area (Frederick Settlement) is 1.1, compared to 7.3 in late November, and I would like to remind you, that the acceptable level is under five per cent, which means that currently the area is safe in terms of aedes infestation."

        He said members of the IVCD had sprayed the area twice before and intend to return today to complete their mission.

        However, residents there intend to highlight their problem this morning along with their Member of Parliament, Jack Warner, and Opposition Chief Whip, Ramesh Lawrence Maharaj. Their action follows the recent death of a promising University of the West Indies engineering student, Camille Ramcharan, 22, from dengue.

        Residents claimed that Health Minister Jerry Narace was not telling the truth when he said there was no dengue outbreak, because scores of persons in the village and other communities around the country were being admitted to the hospitals for treatment for the disease almost on a daily basis.

        Yesterday, Tilluckdharry said that out of 778 houses in Frederick Settlement, they had visited 520 homes, of which 23 were found to be positive for dengue. All of those homes were treated, he said.

        He said the unit builds an aedes index by calculating the number of mosquito breeding sites on people's properties. He said in some areas, people may have a very low mosquito population or even a low risk of infection, but because of the constant movement of people within the country, dengue could be contracted elsewhere because the aedes aegypti can travel with the disease.

        Tilluckdharry said because they could not cater to the travel of the mosquito, the IVCD had developed a special blitz programme that consisted of consecutive perifocal inspections, treatment of premises, thermal fogging and residual spraying. He added that they had been engaged in this since October, despite claims from the residents that they have not been to their area.

        Ministry of Health adviser Dr Rohit Doon, who was also present, said the Chief Medical Officer will present a full report on the dengue situation in January 2009. Doon also urged people to ensure proper household hygiene in order to eradicate the aedes aegypti mosquito and dengue.


        • #19
          Re: Trinidad: Dengue outbreak


          Mr Narace's dengue challenge
          Wednesday, December 24th 2008

          The new squad set up by the Ministry of Health to assist in the eradication of the deadly dengue-bearing aedes aegypti mosquito is a welcome development even if it is a case of being better late than never. Earlier this month Dr John Agard, Professor of Marine and Environmental Sciences at the University of the West Indies at St Augustine, confirmed that there is an increase in dengue fever throughout the region.

          Speaking during a forum at Sir Arthur Lewis Institute of Social and Economic Studies on "Climate Change and the Caribbean: a clear and present danger?" Dr Agard noted that "it is an insect vector with consequent dengue epidemics no matter what anybody says. It is happening throughout the region" since the "mosquito life cycle now is going faster because of the slightly increased temperature, their breeding faster. The sporadic rain into the dry season has allowed them to breed through the year, rather than just through the wet season and they travel."

          We do not know whether that "no matter what anybody says" was a direct reference to Health Minister Jerry Narace's repeated denials of any such outbreak as he sought refuge in the exact dictionary meaning of "epidemic" even as throughout the country doctors were confirming the living experiences of citizens who claimed that, on the evidence of their eyes, the number of mosquitoes - and, as a consequence, potentially-deadly dengue fevers - had increased.

          It is difficult to understand why Mr Narace was so consistently evasive unless, of course, any admission of the truth would give credence to the widespread view in the population that the Ministry had allowed its spraying capacity to decrease, if not degenerate, over the years - a view now confirmed by the belated decision to increase by more than 100 the number of Insect Vector Control Division inspectors and train them in the use of the requisite machines and chemicals.

          Mr Narace came into the Government on the heels of Prime Minister Patrick Manning's assertion that he is a man who "delivers" but this must count as having been his lowest political hour and we must hope that the rest of his tenure bears out Mr Manning's faith in him since he is in charge of, literally, a life and death Ministry that ranks high in the electorate's continuing estimate of the effectiveness of the Government that it elected a little more than a year ago


          • #20
            Re: Trinidad: Dengue outbreak

            Friday, 12.26.08

            Official: Trinidad should ask Cuba for medical aid


            SAN JUAN, Puerto Rico -- Trinidad's former health minister says the island should ask Cuba for help against an increase in dengue cases.

            Hamza Rafeeq says the mosquito-borne virus is threatening the lives of hundreds of people in Trinidad's rural communities.

            Cuba this month gave Trinidad's prime minister a free surgery to remove a cancerous tumor from his kidney.

            Rafeeq notes that the Pan American Health Organization sent Cuban experts to Trinidad to battle dengue in 1997.

            The Trinidad & Tobago Express newspaper stated Friday that more than 2,500 dengue cases and 35 deaths have been reported this year.

            “Addressing chronic disease is an issue of human rights – that must be our call to arms"
            Richard Horton, Editor-in-Chief The Lancet

            ~~~~ Twitter:@GertvanderHoek ~~~ ~~~


            • #21
              Re: Trinidad: Dengue outbreak


              Year of dengue outbreaks
              By LARA PICKFORD-GORDON Monday, December 29 2008

              THE YEAR started with Health Minister Jerry Narace signalling his intention to make improvements in the sector. The Minister announced that the Regional Health Authorities and his Ministry would embark on 100-day plans which would tackle areas for priority action.

              However, throughout the year members of the public and health workers had cause to show their anger with the failings of the service and system. This month there were vociferous calls from the Opposition benches for the Minister’s resignation.

              There was some progress in health this year, but disease and death again stole the spotlight. People will remember 2008 as the year of the “dengue outbreak”.


              From early January reports of persons contracting dengue fever began surfacing and continued consistently throughout the following months. To date the number of people who have contracted dengue is not known but there were many. Westmoorings, St Augustine, St Joseph, Caroni, Sangre Grande, Tabaquite and Freeport were among the areas hardest hit.

              In January, 12 Chinese construction workers employed at the site of the multi-million dollar National Centre for the Performing Arts on Keate Street, Port-of-Spain, contracted dengue and there were fears that the disease would pose a threat for the Carnival season.

              The workers were housed at Keate Street compound occupied by SCG International TT Ltd, contractor for the project. Six of them were hospitalised at St Clair Medical for treatment and the Keate Street area was subsequently sprayed a few times. The Port-of-Spain Corporation Public Health Department visited the site and made recommendations for cleaning.

              On January 27, Mayor of Chaguanas Suruj Rambachan criticised the Health Ministry for failing to provide personnel to spray homes in the Borough to prevent dengue. He said there were ten confirmed cases and his office had to spend $13,000 to purchase chemicals to spray affected areas.

              Reports of dengue deaths also made news throughout the year, with several cases receiving media attention. The death of eight-year-old Sasha Bickram on August 9 sparked outrage and Narace was severely criticised for saying her death was not due to dengue.

              His view was reinforced at a media briefing chaired by Chief Medical Officer Dr Anton Cumberbatch who said “a confirmed established cause of death can only be certified by a post mortem performed by a qualified pathologist and in this case blood investigation and report from that investigation must also be supporting the pathologist report with respect to dengue”. An autopsy was not done on Bickram.

              There was more anger heaped on the Ministry when 11-month-old Josh Moonilal died at SFGH after being warded for dengue haemorrhagic fever.

              At a post-cabinet media briefing on August 14, Narace said there was no dengue outbreak in the country. He said up to the middle of this year there were 120 cases and this figure was well below the mid-year national average 228 for the past three years. Narace also said there were no deaths this year from dengue and from 2003 to the present there were no confirmed deaths due to dengue haemorrhagic fever.

              The Medical Professionals Association of TT subsequently responded to the Ministry’s data by stating that two deaths occurred in March and July this year.

              In August the Ministry hosted an Inter-sectoral forum on dengue at Crowne Plaza in which Narace said two deaths did occur this year but provided no details. At the forum Narace said the Ministry was expecting an increase in dengue cases and had provided a $6 million allocation for goods and services to deal with dengue.

              The CMO said there were 1,000 suspected dengue cases in the country and the last major outbreak was in 2002 when TT had 6,308 cases. Cumberbatch said the Ministry’s objective in 2008 was to prevent an increasing number of reported cases. However, the perceived dengue situation caused the UK Foreign and Commonwealth office to warn British citizens about “increased activity” with dengue.

              A team of experts from the Pan American Health Organisation (PAHO) came to TT in October to provide advice on dealing with dengue. The visit was at the request of Narace and the findings of their report are yet to be made known.

              The death of 22-year-old UWI student Camille Ramcharan of Frederick Settlement, Caroni on December 9 prompted a series of protests against the Health Ministry and its Insect Vector Control Division (IVCD). Residents led by Ramcharan’s father Freddy have demanded action to deal with the conditions in the area (overgrown bush, dirty drains) which they believed were contributing to the mosquito infestation problem which caused approximately 50 residents to get dengue fever. The IVCD held a media briefing on December 22 to provide an update on the work done in Frederick Settlement outlining a series of spraying activities. But this has not placated the residents.

              The Ministry has said a full update on the dengue situation will be given in January 2009 by the Chief Medical Officer. ...


              • #22
                Re: Trinidad: Dengue outbreak


                Grande woman loses dengue battle
                Aabida Allaham

                Wednesday, January 7th 2009

                A 76-year-old woman became the first dengue victim for the year.

                Camille Greenaway, of Coronation Road, Sangre Grande, died on Sunday after battling with dengue haemorrhagic fever at the Sangre Grande Hospital for several days.

                One of her daughters, Patricia George, said while the hospital staff on ward five did everything they could to save her mother, they claimed that the staff in the emergency department "acted as if they could care less".

                "For three consecutive days we took her to casualty (department), but the doctors there ignored her and refused to admit her, even though she was in pain," she said.

                Already unable to walk, Greenaway's family pleaded with several different doctors on the third day to admit their mother, whose health was already failing.

                "They finally admitted her, but she did not last long after that," George added.

                However, it was not the fact that she died of the fever that bothered her 11 children; it is simply because they have been unable to get the Insect Vector Control Division (IVCD) to spray the area in which Greenaway lived.

                "Since she died on Sunday we have been calling on the Ministry of Health's Dammarie Hill office, in Sangre Grande to come and spray the area, but they said they need to investigate. Meanwhile, it have a whole set of mosquitoes making more people sick," George alleged.

                Officials at the Sangre Grande Regional Corporation said they working on the mosquito problem. Meanwhile, an official from the IVCD has promised this newspaper that they will spray the area today in light of the circumstances.


                • #23
                  Re: Trinidad: Dengue outbreak


                  No Dengue Outbreak Says Health Report.

                  January 20th 2009.

                  Only six dengue deaths last year say the Ministry of Health.

                  The Ministry yesterday issued a report saying that only six persons died from the disease.

                  This conflicts with some reports which have put the number of deaths as high as fifteen.

                  According to the report on dengue in Trinidad and Tobago there were 3,832 reported cases last year.

                  However, the Ministry says only 100 were confirmed by the public health lab with six deaths in total.

                  According to the report the majority of cases occurred in the under 18 age group.

                  The report did not classify the situation as an outbreak but noted that the rate of infection was similar to other paho member countries.

                  According to the Ministry barrels were responsible for 70 percent of the breeding areas found for the aedes egypti mosquito which carries the disease.

                  It says water tanks, buckets, tubs and basins, tyres, guttering and bottles account for the other breeding grounds.


                  • #24
                    Re: Trinidad: Dengue outbreak


                    Puzzling dengue statistics

                    By LARA PICKFORD-GORDON Thursday, January 22 2009

                    Although the Health Ministry’s 2008 end of year dengue report stated that there were 100 cases of dengue confirmed by the Trinidad Public Health Laboratory (PHL), the Pan American Health Organisation data on dengue for 2008 lists 206 “lab confirmed” cases up to week 37–September.

                    The data at the site was updated October 26, 2008.

                    According to the “Number of Reported Cases of Dengue and Dengue Haemorrhagic Fever in the Americas by Country: Figures for 2008 (to week noted by each country)” on PAHO’s website TT had 2,366 clinical cases of dengue, eight cases of Dengue Haemorrhagic Fever and Dengue Shock Syndrome and three deaths. The incidence rate on the PAHO site was the same figure provided by the Ministry of 182/100,000 population. Dengue Type II and III were circulating last year.

                    The figures for the English speaking Caribbean were provided to PAHO by the Caribbean Epidemiology Centre (CAREC).

                    Health Minister Jerry Narace was asked to comment on the discrepancy yesterday after the formal opening of the La Romaine Health Centre.

                    He said whatever information was given in the report was compiled by the Chief Medical Officer Dr Anton Cumberbatch. Narace directed Newsday to Cumberbatch for comment.

                    However, on Wednesday Newsday sent an e-mail to the Health Ministry via its communications department with questions on the issue but comment was not immediately available and there was no response yesterday.

                    The Ministry’s statistics have raised questions from some quarters and one medical practitioner questioned how the Ministry could rely only on confirmatory testing from the PHL.

                    “Only 100 samples reached the PHL?”

                    The doctor said the Ministry provided test kits for dengue and hospital laboratories verified the tests.

                    He said a positive IGM indicated antibodies against dengue and was used for diagnosis and treatment while the positive IGG test indicated exposure to dengue in the past.

                    “For the positive cases we only count the positive IGM, regardless of the IGG.”

                    The doctor said the PHL took between six and eight weeks to send back the results from tests.

                    Another doctor who saw the report described it as “superficial” and lacking analysis.

                    He referred to the Health Minister Jerry Narace’s statement last year that there were no deaths and this view was later revised.

                    The doctor noted that the Ministry’s comparison of six-year cycle periods provided a percentage for confirmed reports but not a percentage for the deaths.

                    He said if the Ministry had provided percentage of deaths it would indicate that for 1997-2002 of the reported deaths –95 or 23 percent (22) were confirmed while for 2003-2008 of the 11 reported deaths, 54 percent (6) were confirmed.

                    The report stated that for 1997-2002 there were 17,233 reported dengue fever cases and 1,308 or 7.59 percent confirmed.

                    Between 2003-2008 there were 8,534 reported dengue fever cases and 333 or 3.90 percent were confirmed.


                    • #25
                      Re: Trinidad: Dengue outbreak


                      Gopeesingh: Ministry's dengue figures bogus
                      Louis B Homer South Bureau

                      Thursday, January 22nd 2009

                      Recent figures supplied by the Ministry of Health on dengue fever and dengue haemorrhagic fever (DHF) are bogus and misleading, Caroni East Member of Parliament Dr Tim Gopeesingh has alleged.

                      Gopeesingh yesterday called on the Ministry to "investigate the figures produced by the Chief Medical Officer, because... a report submitted by the Pan American Health Organisation shows 100 per cent increase in confirmed dengue fever cases up to October 2008".

                      Gopeesingh said "the report submitted by the Ministry was clearly an attempt to cover up the real position".

                      When Health Minister, Jerry Narace was approached yesterday at the opening of the La Romaine Health Centre for an explanation on the difference in the figures, he said, "Check with the Chief Medical Officer. He is the one who provided the figures."

                      Efforts to reach Dr Cumberbatch, the Chief Medical Officer, were, however, fruitless. The Express was told that he was engaged in meetings.

                      Two weeks ago, the Express asked the Minister to provide up-to-date statistics on the dengue outbreak, and last week the Ministry submitted statistics for 2008.

                      PAHO's figures were updated to October 26, 2008. Gopeesingh said the figures submitted by the Ministry do not include the hundreds who received treatment in the ten nursing homes around the country.

                      Gopeesingh said "dengue related illnesses are not reportable to the Ministry, so that the figures supplied by the Ministry would obviously be less than the number of cases recorded at the health institutions".

                      The Ministry reported that the number of reported cases for 2008 was 3832, while the PAHO report stated for 37 weeks the number reported was 2366. There was a high incidence of dengue from October to December which is not recorded by PAHO.

                      PAHO reported 206 confirmed cases up to October while the Ministry stated that the figure was 100 for 2008.

                      The Ministry reported six deaths, while PAHO up to the end of October reported three deaths. In November and December 2008, over ten deaths were reported through death certificates issued to patients who had died of DHF.


                      • #26
                        Re: Trinidad: Dengue outbreak


                        Call for dengue fever cases to be reported by law

                        Louis B Homer South Bureau
                        Saturday, January 24th 2009

                        Pressure is mounting from medical practitioners to make dengue and dengue-related illnesses a notifiable disease in view of the number of deaths that are reportedly occurring in various parts of the country.

                        At present there is no obligation on the part of medical practitioners to report those illnesses to the Ministry of Health.

                        Dr Neil Singh, Secretary of the Medical Board, said yesterday that it is time to include dengue and dengue-related illness as notifiable diseases.

                        Singh said under the Medical Board Act, "certain diseases like tuberculosis, leptospirosis, yellow fever, and malaria are included in the list of illnesses that medical practitioners are legally bound to report to the Ministry, but this is not so in the case of dengue".

                        He said "with the increase in dengue and other related illnesses that cannot be contracted from person to person the population needs to know the extent of these illnesses."

                        Singh said "there is a need to amend the act in light of new diseases that hitherto was not in the schedule."

                        Singh's comments came in the wake of conflicting data regarding dengue illnesses.

                        The Ministry of Health figures and those given by the Pan American Health Organisation differ.

                        Dr Tim Gopeesingh, MP for Caroni East, said recently, "The Ministry of Health and its surveillance section reports illnesses that occur at public institutions, while many people die at private institutions and those are not reported to the Ministry, and therein lies the difference in the figures."

                        He said the public is not interested in the semantics or systems. "What they want is the truth", said Gopeesingh.

                        Singh agreed that the reporting system by hospitals is poor. He said "the reporting system is poor, and the surveillance system needs to be revamped or improved."

                        Singh said the Private Hospital Board has a legal responsibility to meet regularly to ensure that all aspects of the Act are adhered to.

                        He said he has been a member of the board for the last four years "and we have met only once".

                        He explained that according to the law "post mortems have to be carried out on patients who died within 24-hours after entering a hospital".

                        In the case of private health institutions doctors can issue a death certificate "without a post mortem so long as they are satisfied with the cause of death."

                        At present the Ministry of Health does not have a system in place to track down all deaths occurring in private institutions. The only time the information becomes available to them is when the Registrar of Births and Deaths submit their annual reports."


                        • #27
                          Re: Trinidad: Dengue outbreak


                          Teen died from dengue
                          South Bureau

                          Saturday, September 12th 2009

                          The teenager who was found dead in his bed after being treated for gastroenteritis died from dengue haemorrhagic fever, an autopsy revealed yesterday.

                          Moonilal Toolsie Singh, 15, was found dead by his parents when they went to check on him on Thursday morning.

                          Relatives said the Penal Secondary School pupil was examined by a private doctor and sent home for bed rest. They said Singh went to bed with a fever and could not understand how it could have led to his death.

                          A post-mortem was performed on his body yesterday.

                          Singh lived at SS Erin Road, Penal.

                          The number of suspected dengue fever cases so far for 2009, according to the Ministry of Health, was 880. The statistics do not give the number of people who were confirmed as having the disease or how many people died from the illness.

                          The Express has reported on the deaths of two people this year whose death certificates gave the cause of death as dengue haemorrhagic fever -Barrackpore taxi-driver, Persad Backarally, who died in March, and 12-year-old Sydney Boodhan of Princes Town in June. -CK