Today's Trinidad Guardian Editorial rightly says "Far more effective than treatment is prevention and efforts at managing dengue outbreaks have been pathetic in 2008." Yet our loser Health Minister Narace gets to stay on the payroll! I think the PNM's new slogan should be something like:
PNM: Ministers Guaranteed Payroll no matter how spectacularly we fail! The best job security in T&T! Absolutely no accountability!
Dengue demands aggressive action
Efforts at managing dengue outbreaks have been pathetic in 2008. The crucial vector for dengue transmission is the aedes aegypti mosquito, and efforts at controlling this insect have been poorly implemented even in areas known to be at risk.
The viruses that cause dengue haemorrhagic fever are notorious for their subtle diversity and the complexities of diagnosis and treatment.
For that reason, the precise identification of dengue has proven to be a challenging matter and misdiagnosis is one of the issues that make identification of an outbreak challenging. It is also possible for multiple variations of the virus family responsible for dengue to be active in a single outbreak, each of which responds differently to treatment.
The fugitive nature of these flavivirus serotypes has made it possible for successive Ministers of Health to argue with passion that dengue is not a problem in T&T.
Health Minister Jerry Narace argued for long weeks that eight-year-old Sasha Bickram did not die of dengue fever until a blood report showed unequivocally that she had tested positive for dengue antibodies.
The residents of Frederick Settlement, Caroni, were certainly furious after the recent death of UWI student Camille Ramcharan and the positive diagnosis of Ramcharan’s parents and two other residents of the area. Camille’s father, Freddy Ramcharan, claims that 50 other people have been diagnosed with dengue in the area for the year. The community was finally sprayed to suppress mosquitoes last week.
It is one of the curiosities of the disease that it cannot be positively identified until the suspected victim’s body responds to the flavivirus with antibodies, which takes time and sometimes repeated testing to confirm.
There is no vaccine for the variations on flavivirus and long before formal confirmation through blood testing can confirm its presence, patients are put through a physical wringer, suffering fevers, bladder problems, potentially fatal loss of blood platelets, bleeding and plasma leakage. Dengue attacks human blood to devastating effect and early, decisive treatment is critical.
Far more effective than treatment is prevention and efforts at managing dengue outbreaks have been pathetic in 2008.
There have been reports that the Insect Vector Control Division has been poorly supplied with insecticides and has been unable to respond to the need to suppress mosquito breeding.
In place of decisive action on the part of the Government, the nation has, instead, been treated to an ancient television advertisement encouraging citizens to clean up their environment. While the sentiment and advice are legitimate, the ad itself is so weather-beaten and overused that it is, to all intents and purposes, invisible.
Surely, the Government’s information services can find the time to update this useful bit of information when it isn’t working on public relations newscasts.
The Ministry of Health should further be mindful that even one death attributable to the spread of dengue fever is one fatality too many in a nation that hopes to deliver on its goals for 2020.
Decisive action on insect vector suppression, refreshed public information and more open acknowledgement of the real status of dengue infection in T&T are long overdue.
Editorial
The Trinidad Guardian
Tuesday 23rd December, 2008
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