Saturday , April 1 2023

St. Maarten can now test for chikungunya

The Daily Herald reports that the St. Maarten Laboratory Services (SLS) is now testing for the mosquito-borne illness chikungunya virus CHIKV. The test is done using a fluorescent microscope.

Since the first CHIKV case surfaced on the island in January of this year, St. Maarten has been sending its chikungunya tests abroad. However, about a month ago, the local SLS lab began testing in-house, which means that
samples are no longer sent abroad and savings will be accrued as a result.

Chikungunya is transmitted to humans similarly to dengue fever, by virus-carrying Aedes mosquitoes. Two species
of mosquitoes transmit the virus: Aedes albopictus and Aedes aegypti. Infection with the virus typically is not fatal, but can cause debilitating symptoms including fever, headache and severe joint pain lasting weeks, months or even years in some cases.

The symptoms can start with an acute febrile phase lasting two to five days, followed by a longer period of joint pain in the extremities. It is this pain that may persist, in some cases, for years.

Read about an account of an Chikungunya infection here.

SLS Director Dr. Nasser Ajubi said before he took up his post at the helm of the facility in July, the lab had invested in the necessary equipment to be able to perform the chikungunya testing. Two SLS staffers were subsequently trained by the Dutch National Institute for Public Health and Environment RIVM on how to perform the testing. The trainingwas done in August.

“Because this is a very specialised test, we started with two employees and once those two employees have mastered the testing, because the more you do it, the better you get, the idea is for one or two more persons to be trained,” Ajubi said. At the moment, testing for chikungunya is done once weekly – on Fridays. Ajubi estimates that by the end of the year, SLS will have tested around 500-600 patients since testing started a month ago.

Being able to test for chikungunya  in St. Maarten has multiple benefits for the island. Local testing means that
the country’s surveillance on the virus will be enhanced and St. Maarten will be able to gauge more efficiently whether the confirmed cases of the virus are increasing or decreasing and whether there is an epidemic.

SLS provides the statistics on the virus to the Ministry of Health’s Collective Prevention Services (CPS). “Part of our task to provide surveillance data to CPS; it is also necessary for the doctor to know the status of the test, not to necessarily treat the patient, but to know that the patient has the chikungunya or dengue or some other viruses because some of the symptoms of dengue and CHIKV look alike so the doc will still need the results.”

Ajubi estimates that the country will also be saving about 20 per cent in expenses as a result of doing the tests locally. “Since we are doing the test locally, we will be charging the insurance companies fees lower than the Netherlands. There is also a big difference in savings because if we have to send samples to Holland, we have to use a courier service – there will also be savings on that as well.”

In explaining how the testing is done, Ajubi said the body of someone infected with CHIKV produces antibodies, which begin to circulate in the person’s blood stream. The test that is done is to identify the presence of those antibodies in the bloodstream. “We look at two types of antibodies because the way our body works is that it produces two types of antibodies – one is a rapid response and the other is a delayed response. Based on the response of both tests, we will be able to say if the person has had a recent infection or if they have been exposed in the past. We match the samples – in general, do about 20 samples a week.”

In the meantime, the best means of prevention against chikungunya is overall mosquito control and the avoidance of bites by any infected mosquitoes. No specific treatment is known, but medications can be used to reduce symptoms. Rest and fluids may also be useful. To test for chikungunya, persons need to visit their house doctor, who will recommend testing or not.


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