A 16-year-old of Eccles, East Bank Demerara, is the country’s second confirmed Zika virus case, while one US state has reported that a 56-year-old woman, who returned from a visit to Guyana, has also tested positive for the virus.
Minister of Public Dr George Norton and Chief Medical Officer Dr Shamdeo Persaud told reporters yesterday that the teenager, who had no history of having travelled outside of Guyana, had tested positive after a blood sample from him was sent for testing in Trinidad and Tobago.
“The person has no history of travel outside of Guyana. He did visit one of the hinterland regions more than a month prior to the occurrence of the symptoms, which started with a fever and then came down with a rash and the red eye [conjunctivitis],” Persaud said at a press conference held at the Ministry of Public Health boardroom yesterday.
The confirmation of the second Zika case was received on Friday last, which was the same day the Ohio Department of Health reported that a 56-year-old woman returning to that state from Guyana had also tested for Zika. She is the second visitor to this country who has tested positive for the virus. In January, Public Health England announced on its website that “as of 18 January 2016, three cases associated with travel to Colombia, Suriname and Guyana have been diagnosed in UK travellers.”
Persaud explained that doctors in the private and public health sector of Guyana are currently screening patients and identifying suspected cases from those who fit the “case definition” for Zika. Those patients who present with a combination fever, rashes and conjunctivitis are referred for testing at the National Reference Laboratory. This lab tests the samples for dengue and chikungunya, whose clinical presentations are similar to Zika and which are also spread by the same Aedes aegypti mosquito responsible for the transmission of Zika.
It is only those samples which are negative for these viruses that are sent for further testing at the Caribbean Public Health Agency (CARPHA) in Trinidad. CARPHA is the only agency in the Caribbean able to confirm the presence of the Zika virus.
“We had 88 persons who fell into the classification and they were tested… So far 55 results were made available; of those two are positive,” Persaud said.
The first case of Zika in Guyana was confirmed in January. That case, a 27-year-old woman from Covent Garden, East Bank Demerara, had also not travelled outside of Guyana.
Persaud explained that though the 88 suspected cases of Zika have originated from all over the country, including the outlying regions, the majority of presentations originate from the main coastal corridor of regions 2,3,4,5 and 6.
As a result, efforts are being made by the Vector Control Department to treat this main corridor, especially the area along the East Bank Demerara. There will also be fogging in the vicinity of the school attended by the teenager and the places where he attends extra lessons. This is one of the several measures being used to reduce the number of breeding areas in proximity to the infected patient who has returned to school after being treated.
Asymptomatic transfer
Persaud acknowledged yesterday that there might be seemingly healthy persons within Guyana who are unknowingly transmitting the virus.
“Unfortunately, Zika is a relatively mild disease in most persons and can even present without any symptoms, that’s the worrying part. There may be person who are relatively healthy who might be transmitting this virus,” he said.
According to the World Health Organisation (WHO), it is only one out of four people infected with Zika who may develop symptoms. Further, in those who are affected, the disease is usually mild, with symptoms that can last between two and seven days.
For this reason, the ministry is stressing the importance of members of the public assisting in the control of the population of the mosquito vector and using personal protection to prevent being bitten by mosquitoes.
Norton reminded that the Aedes aegypti mosquito is most active during daytime hours.
In January, Persaud had told Stabroek News that “Aedes is a daytime, evening and morning mosquito. It is around all the time, so you must protect yourself all the time.” He advised that persons wear light coloured long-sleeved clothes, cover their legs and wear repellent.
A significant portion of the ministry’s efforts to combat Zika continues to be focused on pregnant women, since there has been a reported correlation between mothers infected with Zika and babies born with the neurological disease microcephaly in Brazil.
Babies born with microcephaly have an unusually small head, which leads to incomplete development of the brain. The Pan-American Health Organisation (PAHO) noted that in Brazil, which has reported the largest number of Zika cases, the number of babies being born with Microcephaly has also increased. Between 2010 and 2014, the country reported a yearly average of 163 microcephaly cases but since October, 2015, there have been over 3,530 microcephaly cases recorded. These cases include 46 deaths, in 20 states and the Federal District.
In Guyana, mosquito nets treated with mosquito repellent are being distributed to all ante-natal clinics and pregnant women are being educated about Zika and the ways to prevent being bitten by the mosquito.
Persaud said yesterday the more than 5,000 nets have already been distributed and efforts are being made to have more distributed.
He explained that initially distribution was being done based on the number of mothers registered at the clinic but parameters for distribution have been extended to include young children and, therefore, more nets are being made available.
Pregnant women are also being asked to report to clinics in the early stages of pregnancy, since it is the period of the highest risk for foetal effects. “Register with your ante-natal clinic early so that they can give you the information and ensure that you are protecting yourself,” Persaud said.
Prior to last year, Zika was a relatively unknown virus existing mainly in Africa and Asia. However, since then it has been aggressively travelling through the Americas and PAHO/WHO has stated that as of January 23, 2016, it had spread to 21 countries and territories of the Americas, including Guyana.
As the disease and its effects continue to spread across the Americas, the WHO has declared a Public Health Emergency of International Concern and efforts are currently being expanded to develop a vaccine as well as to research the relationship between the virus and the diseases to which it has been linked.
The WHO has called for a coordinated and multi-sectoral response through an inter-agency Strategic Response Framework focusing on response, surveillance and research. It has also advised that travel advice for Zika-affected countries includes advice for pregnant women as well as women who are trying to become pregnant and their sexual partners. Accordingly, the United States Centers for Disease Control has issued a travel advisory on Zika-infected countries, including Guyana.
