High on Ebola, low on chikungunya
By DERRICK MILLER
Since the recent outbreak of chikungunya in the Caribbean, four individuals with close connections who arrived back to the U.S. from the Caribbean region were hospitalized immediately and diagnosed with the virus. In addition, a few medical center employees communicated that they have seen an increase of patients from the region admitted to their medical facilities.
I am not a medical doctor, nor I do I play one on the television; however, based on the recent reports, chikungunya has seen a significant up-tick. On the other hand, an impression is being portrayed that it is under control on these shores.
The leaders must address this issue openly and develop a solid plan before this potential storm, where soon U.S. and other countries well-traveled by Caribbean people will begin to put the medical drone on the region. The drone concept is geared to destroy anything in its path when launched. However, could you blame the U.S. if they cut travel, and begin to set high alerts and screening of passengers from the region?
The recent death of Thomas Duncan from Ebola at age 42, after arriving in the U.S., has created an intensive focus on foreign travelers from many poor and developing countries. Although many believed Thomas Duncan’s death while in U.S. care would inevitably send a statement to others to not come, many people are now wondering what the color of medicine is after two dedicated Caucasian doctors who worked in Liberia contracted the virus and recovered. One of the silent tones in the Caribbean addressing chikungunya, I believe, is not the politics of the virus, which is often seen elsewhere – for this region, it is all economics.
Here is why: in most of the region, the economic engine is tourism, and if what has taken place in Liberia is any indication, the fallout could be worse than the economic collapse in 2008 which has left many still sneezing. I begin to wonder if the reason reports of this increasing tide seem a bit hushed up is to protect the tourism industry while many locals are suffering silently. The appropriate business model during a turbulent time is not only to be prepared, but also willing to inform about structural problems. This approach not only builds credibility, but also shows a level of leadership that is lacking today on several fronts.
This is not a call for a reduction of travel to and from the region, or high-level screening at airports; that would be premature at this point. On the other hand, when the local government is slow to educate people, it could be the beginning of a tornado building. Therefore, questions must be asked. Along these blue waters, there lies an undercurrent that can overflow the banks at anytime, and the long-term impact could cripple many lives, both medically and economically.
Managing these issues takes compassion and resources. Recently I saw a Facebook picture post of what appeared to be a sick person from the region who became more victimized as he was scorned because of the appearance of what was believed to be the symptoms of the Ebola virus. Furthermore, when it is reported that a few local doctors are contemplating refusing to report to work in the event of an outbreak due to the lack of medical supplies and other resources, it is troubling.
In today’s society, where billions are being spent on wars and politicians’ re-elections, it is hard to fathom that lack of resources and awareness, combined with scorn, can leave many more suffering. I hope elected officials, medical personnel and CARICOM step up to educate people and seek help through awareness, because potential problems such as what is occurring in Liberia and other West African countries, where perception is more dangerous than the actual virus, can happen here too.
These islands are unique and sometimes that can be their own downfall because the uniqueness creates a form of isolation. It further limits collaboration, as all seem to be competing for a piece of the visitors’ pie. Therefore, competition mutes concerns, while marketing becomes a “them and not us” mentality.
This virus is not just an island thing, and nor is it found only in third world countries. One of my less-informed friends stated that he is going to stop eating chicken and stop going to places where lots of chicken is found.
Education is key: no, you cannot get it from eating chicken or visiting places where chicken is in abundance. The name chikungunya derives from a word in the Makonde language, roughly meaning “that which bends up,” reflecting the physical contortions of a person disabled by the disease. Many reports have noted that it was first identified in Tanganyika (now Tanzania) in 1952.
According to the Pan American Health Organization (PAHO), the first known autochthonous chikungunya cases in the Western Hemisphere occurred in October 2013 on the island of Saint Martin. By March 2014, travelers to other Caribbean islands carried it to: Dominica; the British territories Anguilla and British Virgin Islands; overseas territories of France like Guadeloupe and Martinique; and the constituent countries of the Netherlands Antilles, as well as other areas such as St Kitts and Nevis; the Dominican Republic; and St Vincent and the Grenadines.
An estimated 3.6 billion people in 124 countries are at risk worldwide, such as the many who are exposed to dengue fever. Large outbreaks have also been seen on Indian Ocean islands, in India and South-East Asia, according to the Infection, Genetic, and Evolution Journal. It has also reached Asia and Europe, and North America has seen a few cases recently in Florida.
The National Institute of Health, the World Health Organization, public health departments and infectious disease authorities have noted that chikungunya is a viral disease that is rarely fatal. It is transmitted to humans by infected mosquitoes.
The symptoms include high fever and headache with debilitating joint pains, swelling and stiffness of joints, muscular pain, headache, fatigue, nausea, vomiting, and a rash that can last for several weeks. Normally within four to seven days after been bitten, the symptoms appear.
The mosquitoes become infected when they feed on an infected person during the viraemic period. Today, there are no specific antiviral treatments or vaccines available. However, it also has been reported that commonly used medications include ibuprofen, naproxen, acetaminophen, paracetamol, and aspirin. Although there have been reported deaths, the numbers are extremely low compared to Ebola; however, one should not discount it as a storm that will pass soon.
These regions have to debunk the notion that only certain medicines can cure this outbreak, while many studies have been reporting there are no known cures at this time for the symptoms. It is extremely important that people take serious preventive measures such as wearing bite-proof long sleeves and trousers. More information has been published by many health organizations.
It can be extremely difficult to track down all mosquitoes and apply chemical spray on an entire region to reduce concerns.
Today many travelers are still waiting on a concrete government plan on how they are handling the issue in a coordinated effort. If there is one, please post.
Although some awareness has been registered, and governments seem now to be taking steps to mitigate the potential problem, more needs to be done. Nevertheless, can we all be stratified?
As the region continues to attract visitors, it is also important that these visitors receive a disclaimer of this undercurrent taking place. The leaders must make sure that all proactive measures are taken, seek help and resources as needed and stop putting on a good face on such issues with a relaxed attitude. I am still optimistic that all can come together and weather this storm. Moms and I have a ticket ready to land soon to take a break from this upcoming winter.
• Derrick Miller is a trained U.S. Federal law enforcement officer that has been in the criminal justice field for more than 14 years.
October 22, 2014