There will be an increase in fogging with focus where dengue is most prevalent

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The folowing is a statement to Parliament yesterday on the dengue oubreak in Jamaica by Health Minister Dr Christopher Tufton.


Mr Speaker, on January 3 (2019), the Ministry of Health confirmed that Jamaica had surpassed the epidemic threshold for dengue, based on the number of reported cases in December.

In line with section 16 (1) of the Public Health Act, a press conference was called and the nation immediately notified, based on available and verified data.

In line with our international obligations, January 3 also saw notification to the International Health Regulations Unit of the Pan American Health Organization/World Health Organization. The chair of the National Disaster Council was also notified. This, in order to coordinate and report on activities to respond to the increased number of dengue cases.

The Health Emergency Operations Centre began partial activation at 11:22 am on December 27, 2018 and full activation on January 3, 2019, triggered by the increase in dengue cases across the island.

It was the first time that Jamaica exceeded the outbreak threshold of 96 cases, with 123 dengue case reports received.

Up to January 3, we had some 830 cases classified as suspected, presumed or confirmed.

There has been 23 confirmed cases of dengue for the period. All 23 cases were confirmed by PCR (confirmatory test for the virus). Of these, 22 were identified as DENV Type 3 (dengue strain seen in this outbreak) while one (1) case had low viral titre and the dengue type was not identified.

Of note, Mr Speaker, is that while the number of suspected and confirmed cases of dengue — as so far reported — are more than for 2017, they are significantly less than for 2016. As at January 3, up to December 2018, there were 830 suspected dengue cases compared to 215 in 2017 and 2,297 for 2016.


Geographic distribution

The largest numbers of suspected/presumed/confirmed cases for the period (2018) were reported from Kingston and St Andrew (207), Westmoreland (90), and St Catherine (84), respectively.

The largest number of suspected/presumed/confirmed cases for December 2018 were reported from Kingston and St Andrew (32), St Ann (30) and St Thomas (13).

The greatest rates per 100,000 population, however, were reported from St Ann (17), St Thomas (14), and St Mary (11), respectively.


Ministry response

Mr Speaker, the Ministry of Health intensified its activities for dengue as far back as July 2018 when we launched the Enhanced Vector Control Programme with the start of recruitment and training for 1,000 temporary workers to conduct mosquito search and destroy efforts, and public education at the community level.

Strategies for the prevention and control of dengue include heightened surveillance through the integrated surveillance programme (sentinel sites, laboratory, vector-breeding hot spots).

Dengue case definitions were recirculated to all parishes and regions on January 2 (2019) and presentations made at the January 4 meeting of the medical officers of health to update them on the response to reinforce surveillance and clinical management. Daily updates on the cases of dengue are also now being provided.


Community engagement

As noted, Mr Speaker, enhanced vector control activities began in July 2018, and have now been extended to March (2019), to include the employment of an additional 500 temporary workers, who will join the effort to identify and eliminate mosquito breeding sites. This is in addition to retraining of Ministry of Health vector control works done earlier in the year.

With partnerships established with private pest control operators to increase services in all parishes, the public can expect, in the coming weeks, to see an increase in fogging, with a focus on those areas where dengue has been seen to be most prevalent. This will build on efforts from 2018, when, between January and November, some 2,584 communities were inspected and 343,237 premises visited.

Of the premises visited, 55,795 were found to be positive for the Aedes aegypti mosquito — one of the vectors for dengue. We inspected 960,023 containers and of this number, 124,433 were found to be positive. In response, we conducted 843 fogging sessions in 2,081 communities.

We have also extended the USAID-ZAP programme, which should have ended in July last year to July this year. Their team has so far worked with the ministry’s vector control staff in more than 71 communities to eliminate mosquito breeding sites.

There is also ongoing collaboration with The University of the West Indies, Mona, at the Mosquito Control and Research Unit to reduce the spread of vector-borne diseases.


Clinical management

We have also enhanced our clinical management efforts. Already:

• Clinical staff have been re-sensitised to the management of dengue.

• Emergency departments at hospital have been bolstered by increased clinical and administrative staff; and

• Sensitisation of all doctors, private and public, have been conducted.

The ministry is also increasing available hospital beds by providing the support to open unused wards at St Joseph’s and National Chest hospitals and we now have extended opening hours at various health facilities in anticipation of increased demand on the system.

The following health facilities have, since November, extended their opening hours:

Kingston & St Andrew — The Stony Hill Health Centre, Olympic Gardens Health Centre, Glen Vincent Health Centre and Slipe Pen Road Comprehensive Health Centre

St Thomas — Morant Bay Health Centre

St Catherine — St Jago Park Health Centre, and Greater Portmore Health Centre.

St Ann — St Ann’s Bay

St Mary — Annotto Bay, Highgate, Oracabessa and Gayle

Manchester — Mandeville Regional, Spalding

Clarendon — May Pen Health Centre

St James — Montego Bay Type V

Westmoreland — Savanna-la-Mar.

Blood inventory at the National Blood Transfusion Services has been conducted and adequate measures increased as at January 3, 2019.

Laboratory capacity has been improved through support from the Caribbean Public Health Agency (CARPHA) and the University Hospital of the West Indies to expedite the testing for dengue. The Ministry of Health is also finalising framework agreements with four private laboratories to further enhance testing capacity.


Public education

Mr Speaker, an extended public education campaign — launched in May with the observation of Mosquito Awareness Week — has also commenced and will continue in the coming weeks. Public service announcements regarding mosquito breeding sites, symptoms of dengue and personal protection tips, which have been aired since August last year, continue to be shared and are being ramped up in the print and electronic media, inclusive of social media.

This builds on work started earlier in the year, with the production and distribution of press releases on dengue and the hosting of press conferences to keep the public abreast of developments with the virus.

We are also reaching our people face-to-face. Dengue information flyers and brochures continue to be procured, with close to 100,000 already distributed to homes, health centres and hospitals across the island. Members of this House may have, as recently as last Sunday, been in receipt of a number of those flyers and brochures.

These, of course, add to public education content that would have already been in circulation from our health promotion and education teams, as part of their routine dengue education efforts.


• Parish councils and the Ministry of Local Government are being engaged as it relates to the removal of domestic waste/garbage from communities.

• A Dear Doctor Letter has been distributed to the field to sensitise physicians and parents regarding the dengue alert.

• A Dear Parent Letter has also been sent to the Ministry of Education for dissemination.

• The Health Alert Card is also being utilised to inform travellers to the island of dengue fever and the actions to take in the event symptoms develop.

Mr Speaker, the public can feel sure that the team at the Ministry of Health is doing all that they can to ensure the best possible health outcomes for those currently affected by dengue and to prevent the spread of the virus to other members of the population.

Of course, our success at the end of the day, will be determined in no small measure by the responsiveness of the public to our efforts. And so we urge Jamaicans to themselves search for and destroy mosquito breeding sites around their homes; visit their doctors if they experience symptoms and follow the prescribed course of treatment.

Thank you.


Dr Christopher Tufton

Minister of Health

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