The Caribbean Epidemiology Centre has confirmed another locally transmitted case of dengue fever in the Cayman islands.
This brings to five the confirmed number of local cases. There have also been three confirmed imported cases of the mosquito-borne disease so far this year.
Head of the Cayman Islands’ Public Health Department Dr. Kiran Kumar said that, as of Wednesday this week, 37 suspected cases from Cayman were being or had been investigated by the Caribbean Epidemiology Centre, known as CAREC, in Trinidad. Of the suspected cases, 11 have been submitted to CAREC for testing since 12 October.
“We got back results for 17, of which nine were negative, eight were confirmed dengue – three imported and five local transmissions,” Dr. Kumar said.
Six of the confirmed cases have been in West Bay, one in George Town and one in Bodden Town. Dr. Kumar said those cases were no longer infectious.
Results are pending for a remaining 20 cases. It usually takes about seven to 10 days for tests to be completed.
Dr. Kumar said the Public Health Department expects to see more local cases emerge due to rains and the subsequent presence of standing water, in which the dengue-spreading Aedes aegypti mosquito breeds.
“The CAREC lab does different types of testing, depending on the time the blood sample was collected after [the patient] getting sick. Also, they batch the samples coming from various Caribbean countries — hence, sometimes the delay.
“While it is good to know the results immediately, it is not critical to have the lab results for the management of a case,” Dr. Kumar said.
Of the 37 suspected cases, seven were admitted to hospital, including two of the confirmed cases, one of the negative cases and four of the cases that are still pending results. Dr. Kumar said all of those who had been hospitalised, either for observation or because of their age, had been released and none had been in critical condition.
He added that in severe cases where a patient has been hospitalised, the Public Health Department can request CAREC to do the test as a matter of urgency, but this still requires a minimum of five days for shipping the samples to Trinidad and for the testing to be completed.
However, the Public Health Department does not wait for the CAREC results to be returned before contacting the Mosquito Research and Control Unit about a suspected case.
“Instead of waiting for results, we immediately report to MRCU of the address of the suspected case for them to take anti-mosquito measures.
“The good thing about this is the Aedes mosquito has to bite the sick patient in the first week of illness and has to survive for about 8 to 10 days before it can transmit – so if they are destroyed during this period, we are OK. The patients are infectious to mosquitoes only during the first week of illness only; afterwards, [they’re] non-infectious,” Dr. Kumar said.
From this week, the Cayman Islands Public Health Department plans to issue weekly or bi-weekly updates on the dengue outbreak.
Symptoms of dengue fever includes fever, headache, joint pain, nausea, eye pain and rash. There is no vaccine for dengue and no specific treatment for the disease itself, as the doctors treat the symptoms, keeping patients hydrated and managing pain.
The US Centres for Disease Control and Prevention recommends that patients with suspected dengue go immediately to an emergency room or doctor if they are suffering from severe abdominal pain or persistent vomiting; red spots or patches on the skin; bleeding from the nose or gums; vomiting blood; black, tarry stools; drowsiness or irritability; pale, cold, or clammy skin; or difficulty breathing.
The best method to help avoid being bitten by a dengue-carrying Aedes aegypti mosquito is to ensure there is no standing water around the home or workplace, as the female mosquito, which spreads the disease, breeds in water.
“I urge the public to eliminate stagnant water in their yards in coconut shells, cans, wheelbarrows and saucers in plant pots, etc,” Dr. Kumar said.
The mosquito control unit advises the public to dispose of trash correctly as bottles, cans and fast food containers provide a breeding ground if thrown in the bush, and to turn over larger yard items that can hold water, including children’s portable sandboxes and plastic toys.
The unit also advises the public to remove tarps, as if those stretched over firewood piles, boats, sports equipment and grills are not taut, they can also hold water.