Trinidad

Originally published on August 17, 2008

Update 4 on August 30

Anecdotal reports gathered by Trinidad and Tobago’s Newsday from residents of Biche, Poole Village and Plum Mitan in East Trinidad have painted a disturbing picture of Classic Dengue, Dengue Hemorrhagic Fever and even DHF induced coma in that part of the country.  And the commenters are not satisfied with either the treatment offered at the Regional Corporation’s Sangre Grande hospital or the level of attention given to the situation by the health authorities.

“My mother was warded at hospital since Thursday (August 14) with high fever and bleeding from the mouth,” lamented Rajendra Rampaul.  He told Newsday that he too had been to hospital several times only to be sent home each time with nothing more than an “injection.”  In the end he and his mother resorted to a private laboratory that confirmed that they both had Dengue.

“People are bleeding through their mouths,” echoed Gulcharan Mahadeo.

Shafira Mowlah claimed that her daughter was in a coma for three out of the ten days she spent in hospital.

Another complaint was that patients were being made to wait for hours in some instances for medical assistance.

But Health Minister Jerry Narace would not go so far as to declare a Dengue Outbreak in Trinidad.  The fact though is that Sangre Grande Hospital could Confirm six (6) Cases of Dengue (August 21).  No particular mention was made of the number of DHF Cases.

In addition, there were 120 officially recorded cases in Trinidad and Tobago for the period January to June.

The current trending of the disease has since become clearer in the last few days.  Caribbean Net News, on Saturday, August 23, referencedthe Sangre Grande Hospital Laboratory’sClinical Director Anthony Lokai, to up the number of Confirmed Dengue Cases at Sangre Grande for August to 25.  10 of them had to be hospitalised.

Lokai also reportedly told the Trinidad Express that the Dengue Outbreak had spread to some new communities, Moka Heights, Maraval and Mafeking Village in Mayaro among them.

The comparative data presented by Minister Narace at a press conference on Thursday, August 14 refuting media reports of an outbreak is, however, dated (1990 – 528 Cases; 1996 – 395 Cases; 2002 – 447 Cases) and thus lacks validity for comfort sake.

More revealing are the official Carec (Caribbean Epidemiology Center) numbers.  The number of Reported Cases of Dengue and Dengue Hemorrhagic Fever (DHF) for all 52 weeks of 2002, last updated in June 2003, was 6,246 cases Classic Dengue, 273 Dengue Hemorrhagic Fever.  Deductively, there were another 5,799 Cases of Dengue between July and December of that year.

The Dengue situation in Trinidad was worse still in 2003 when 6,289 DF and 80 DHF cases were logged.

For the next four years ending in 2007, there was a dramatic downturn in all round Dengue cases in the twin-island republic.  Classic Dengue tanked to 546 Cases in 2004.  The Cases then flattened to an average of 42 per annum over the three-year period from 2005 to 2007.

In that context, therefore, 120 Cases of Dengue and Dengue Hemorrhagic Fever in the first six months of 2008 is tantamount to an appreciable jump that cannot be denied, let alone ignored.

Chief Medical Officer Dr Anton Cumberbatch.

Dr. Anton Cumberbatch

Based on this indisputable evidence, we at the Coalition would call this a major Dengue Outbreak in Trinidad.  No question!  It is left to be seen whether this will be borne out by the data when released to the media.  Chief Medical Officer Dr. Anton Cumberbatch gave the assurance that the data would be made available while speaking at a press conference held on Wednesday, August 20 at the Ministry of Health, Park Plaza, Port of Spain.

Doctors at the San Fernando General Hospital (SFGH) voiced their agreement, indirectly of course, with this position in a statement refuting the pronouncement of Minister Narace that there was no Dengue.  Going by the definition of ‘Outbreak’ as “two or more persons diagnosed with a particular disease from the same household or village,” and the fact that there were Confirmed Dengue Cases in Freeport, Sangre Grande and Princes Town in East Trinidad, the medical practitioners have satisfied themselves that these linked cases constituted an Outbreak.

They were nevertheless careful to add that Trinidad was not in an epidemic state, which is when an entire region in a country is affected by a given disease, in this case Dengue Fever.

In an apparent response to the reality of the situation and the news that an eight-year old from Freeport had died just recently after a bout with Dengue, Narace announced his ministry’s intention to launch a nationwide campaign against the Aedes aegypti mosquito, the carrier of Dengue Fever.  Surveillance reporting by health institutions has already been increased from weekly to a daily basis.  Public education too has been stepped up.

Further, the Trinidad Health Ministry has re-issued clinical protocols for the management of Dengue to clinical and emergency staff.

Additional resource: Dengue diagnosis