Wednesday , July 6 2022

Dr. Koot downplays mosquito threat

The Daily Herald writes that the head of the public health department Dr. Gijs Koot downplayed threat and pledged active prevention measures to address the dengue and chikungunya threat pointed to by Cuban Medical Entomologist Sandra Moreno Reyes in public reports.
Dr. Koot issued a correction of the recent Island Government press release which stated that Randall Johnson is the Head of Public Health Department stressing that Johnson oversees the Mosquito Control Department.

Dr. Koot downplays the mosquito threat stating that “dengue fever is relatively innocent and so is chikungunya, but we still need to try to prevent them.” As Head of the Public Health Department he pledged to be more active in creating awareness about dengue and chikungunya prevention measures via radio shows.

Regarding the report issued by Moreno Reyes, Dr. Koot noted the association of the researcher with Labiofam and the product promotion aspect of the work being conducted. While the promotion of the Cuban biological product is not an issue, he believes the product needs to be tested and compared with other alternatives. He would have liked Moreno’s presentation to include information about when the mosquitos are most active and to have publicly stressed the need to install nets. He argued that the island’s residents don’t use or maintain mosquito nets, something that is necessary especially when there are children in the household. Dr. Koot noted that there is a scarcity of mosquito nets on Saba.

Regarding the elimination of mosquito breeding sites Dr. Koot said that the community must “get rid of the water collection places and this need to be told over and over.” He would like to promote a programme in which participating households that comply with inspection would receive a “mosquito-free home” sticker. Such a programme he believes would “put some community pressure on all individuals.” He also proposed focusing the allocation of resources, arguing that when looking at mosquito breeding sites “80 per cent or more of the locations are fine” and do not need to be visited frequently, while others need closer supervision.

Dr. Koot noted the survey interviews conducted by Moreno Reyes in her research but he would have liked the survey to explore why certain people find it so difficult to clear up their household, if they need help or if they are “just ignorant.” To address these alleged behavioural challenges, Dr. Koot would like to commence a procedure in which auxiliary police officers would give penalties to those who do not comply.

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4 comments

  1. I am so pleased that we have such a proactive Public Health Department on Saba.

    It is good to learn that, on Saba, “the dengue fever is relatively innocent and so is chikungunya”. I actually was getting a bit nervous about these diseases as on most other islands of the Caribbean, the people are alerted by their Health Departments. The Daily Herald writes that French government is even sending experts to St. Martin and St. Barths. It is good to know now that this is a wasted effort.

    Therefore, it is high time that he informs the US Center for Disease Control about his knowledge, as they recently released statistics which indicate that in the past year, there were 3,095 confirmed cases of dengue on St. Maarten/St. Martin, some 11,169 cases in just one province of Colombia and some 110 deaths registered in the Dominican Republic attributed to dengue.

    We have observed that he, being the Head of the Public Health Department, was not yet convinced that a public awareness program was needed, else he certainly would have initiated this. It is probably more appropriate to wait until we have confirmed deaths on Saba. So it makes sense to criticize the proactive action of the Agriculture Station.

    It is also good to learn that the Public Health Department is of the opinion that we need to use mosquito nets. Fortunately, they also have detected that there is insufficient supply of such nets on Saba. Given the confirmed need for these nets by the Public Health Department, I expect that there soon will be an ample supply of mosquito nets on Saba that will be available at a price that we can afford.

    Or will this just be the next failure of the governmental services after the recent police and fire brigade dramas?

  2. I hope that the irony of Eddie’s words is well understood. To give an example of the concerns I copied here an article published in Th eDaily Herald today. My comment would be: who are we to be downplaying the risks that are recognised everywhere around us.

    Today in The Daily Herald!!!

    French officials are supervising Chikungunya operations on St Martin

    Two State offi cials from Paris, Director of Direction Générale for Overseas Territories Thomas Degos and Assistant Director of the Ministry of Health’s Crisis Centre, Olivier Brahic, are currently on the island to oversee the chikungunya prevention operation in St. Martin and St. Barths. They met with President Aline Hanson before attending a press conference with Préfet Philippe Chopin on Wednesday together with representatives of Agence Regional de la Santé (ARS) from St. Martin and Guadeloupe. Their mission, which includes the islands of Guadeloupe and Martinique, is to supervise the chikungunya operation by ascertaining needs and difficulties, facilitate working relationships between the relevant services, determine how the epidemic is evolving, and respond to the crisis in the most effective manner possible.
    The situation in St. Martin is described as a “generalised epidemic” with more than 1,000 suspected cases and currently 601 confirmed cases. Among the assistance provided to ARS are two epidemiologists and a specialised nurse of ARS in Provence, France, to reinforce the teams in place.
    Also present at the meeting was Délégué Territorial for ARS on St. Martin Pascal Godefroy, Director of Pole Veille Sanitaire in Guadeloupe Patrick Saint-Martin and an ARS nurse Chantale Thibaut. Thomas Degos said the approach to tackling chikungunya is a little different to dengue, as its pathology is still relatively unknown, therefore there is more emphasis on the basics; protecting oneself and destroying breeding grounds.
    The priorities are to intensify actions in the schools in Concordia, in Sandy Ground, which is the area most affected, and with the district councils. St. Barths does not have district councils but public meetings have been planned.
    The participation of the public in helping to destroy breeding grounds (throwing out stagnant water etc.) is crucial to fighting the epidemic, and as Chantale Thibaut pointed out, chikungunya is “now everybody’s business.”
    Pascal Godefroy noted that although the epidemic is serious, it is under control. “There are many new actions we are embarking on now and I hope little by little we will see the numbers drop and fewer cases at the hospital,” he said. Asked about the disparity of figures with the Dutch side, Godefroy said that was probably due to persons who preferred to be tested on the French side instead of the Dutch side and therefore become included in the French-side figures.

  3. Canada expands chikungunya travel health warning for the Caribbean

    Canada’s Public Health Agency has expanded its list of countries in the Caribbean with confirmed cases of chickungunya and warns visitors to take precautions against the mosquito-borne virus. (File photo)
    TORONTO, Canada, Friday February 14, 2014 – The Public Health Agency in Canada has issued an updated travel health notice following a reported increase in the number of cases of chikungunya disease in the Caribbean.

    According to the latest advisory from the agency, “there have been confirmed cases of chikungunya on the Caribbean islands of Saint Martin/St. Maarten, Dominica, Guadeloupe, Martinique, Saint-Barthélemy and the British Virgin Islands. These cases mark the first time that locally acquired transmission of chikungunya has been detected in the Region of the Americas.”

    Symptoms include a sudden high fever, severe pain in the wrists, ankles or knuckles, muscle pain, headache, nausea, and rash. Joint pain and stiffness are more common with chikungunya than with dengue. The symptoms appear between four to seven days after the bite of an infected mosquito. The majority of clinical signs and symptoms last three to 10 days, but joint pain may persist longer. Severe cases requiring hospitalisation are rare.

    There is no vaccine or treatment for chikungunya, which has infected millions of people in Africa and Asia since the disease was first recorded in 1952.

    The Canadian health agency recommends that travellers protect themsleves from mosquito bites, “particularly during peak mosquito biting times around sunrise and sunset” and to see a health care provider if symptoms similar to chikungunya develop after returning to Canada.

  4. The Chikungunya virus, which is spread by the Aedes aegypti mosquito specie, has infected people on 5 Caribbean islands. According to the Daily Herald there have been close to 500 cases of the virus reported on St. Martin alone.
    Sandra Moreno Reyes, the Cuban medical entomologist who came to Saba stated in her report that the Aedes aegypti specie is the most common mosquito specie found on Saba.
    It seems obvious that on Saba vector control planning efforts should focus on the suppression of the Aedes aegypti specie in order to avoid an outbreak of the disease and that the public health sector should lay the foundation for emergency interventions in the event of an outbreak. However there are many things, as Dr. Koot suggests, that individuals can and should do on their own.
    The Aedes aegypti specie unlike other mosquito species breeds inside of a household, not outdoors. Its breeding grounds are inside household containers, under beds in bedrooms, in closets and clothes and in hampers, in stagnant water in vases etc. The majority of homes on Saba do not have screens or air-conditioning, so the suggestion of using bed nets and especially IT (insecticide treated) bed nets is a very good one. These not only keep mosquitos away from their prey, but will also kill the mosquito after contact with the treated net, thus reducing the chance of infection. Insect repellent products should also be used in order to keep the mosquitos at bay and insecticide treated clothing should be considered.
    There should be a coordinated effort on the part of the public health sector and the public at large working together to eradicate the possible threat of an outbreak. As Sandra Moreno Reyes’ article states, mosquitos know no frontiers!