They are not calling it an outbreak, but health officials in Dominica have confirmed a number of cases of tuberculosis (TB), with some five cases recorded to date.
Dominica’s Chief Medical Officer (CMO) Dr. David Johnson has confirmed to DNO that a number of people have been hospitalised at the Imary ward of the Princess Margaret Hospital (PMH) suffering from TB.
“I can confirm to you that presently we have five cases at the PMH with TB and they are isolated and I want to tell the public that we are taking all the necessary measures to safe guard the public,” Dr. Johnson said.
According to him, all the cases are that of drug addicts and alcoholics.
The CMO said the ministry of health in collaboration with the PMH are taking all the necessary steps to safeguard health care workers.
“We do not have an outbreak of TB and there is no cause for alarm by the general public. The ministry of health is in control of the situation and we just want the public to be aware of what is happening and take the necessary steps to safeguard themselves,” he said.
Dr. Johnson stated that of the current five cases, three are new while the others are reoccurrences.
He said that the Ministry of health has also been doing follow up work after persons affected with TB are released hence they are able to follow their life pattern.
“We follow them into the community and ensure they take the necessary medications…so we are very much on top of the matter,” he said.
At present, a third of the world’s population (more than 2 billion people) are infected with the bacteria that cause tuberculosis.
However, only one in 10 infected people will show signs of the disease.
This is known as active tuberculosis.
In the UK in 2009, over 9,000 people were reported to have active tuberculosis.
Although the number of people getting tuberculosis had been dropping since the 1950s, this number has been increasing again each year since the late 1980s.
Tuberculosis occurs most often in major cities.
This is because there are more risk factors in cities, such as overcrowded housing and more people arriving from countries where there is a higher rate of tuberculosis.
Greetings! Very helpful advice within this post! It is
the little changes that make the biggest changes. Many thanks for sharing!
It was about time that they addressed the issue. I am tired of walking up and down hospital corridor holding my breath. Thanks Dr. Johnson
Is all them man that messing around with not only Haitians but also spanish women that spreading that thing around loke that!
The hospital employees/nurses should be screened for the disease and must receive screenings each year.
Your doctor may monitor you during treatment with blood tests to check your liver, sputum tests to see if the bacteria are susceptible to the antibiotics you are taking, and chest X-rays to look for signs of disease.
A person with a positive skin test, a normal chest X-ray, and no symptoms most likely has only a few TB germs in an inactive state and is not contagious. Nevertheless, treatment with an antibiotic may be recommended for this person to prevent the TB from turning into an active infection. A person with a positive skin test along with an abnormal chest X-ray and sputum evidencing TB bacteria has active TB and is contagious. As already mentioned, active TB usually is accompanied by symptoms, such as a cough, fever, weight loss, and fatigue.
The most common medications used to treat tuberculosis include:
Isoniazid
Rifampin (Rifadin, Rimactane)
Ethambutol (Myambutol)
Pyrazinamide
Many of us fail to understand why nurses who are paid to do their jobs do not see it their responsibility to maintain order in their wards.
These are the same nurses who fail to function effectively and for not wanting to take responsibility for the mal supervision of people in their care, turn around and play politics.
Many of us in the private sector wish we could fool around, mess up people’s businesses,then turn around politicize the matter and blame the government.
Current TB cases do not record the highest figures over the last decade (4 new patients plus 1 old) so what has gone wrong, and whose fault is it that the patients are roaming hospital grounds? Skerrit?
i went to the male ward a few weeks ago, and there were several haitians with TB. WHY dont they test the haitians before letting them enter the country.
Someone should explain why lies like these are propagated. To be politically content? lol
Management of TB
This is the reference
Caribbean Guidelines for the Prevention, treatment, care and Control of Tuberculosis and TB/HIV (2010).
For further reading please goggle
(Caribbean Guidelines for the Prevention, treatment, care and Control of Tuberculosis and TB/HIV (2010).
Management of TB
I must commend the nurses and doctors at the medical wards for their dedication and hard work they are doing. We must rise above the blame game and address this problem as we are faced with it this very second. With globalization comes movement of people from one country to the other and with this come benefits and disadvantages. Yes some countries are plagued with diseases unlike others but this is no reason why we should not allow them into our country. Hence the reason for the health sector to put strategies in place to stop the spread of TB.
The primary mode of transmission for TB disease is through inhalation of infectious particles. When that individual coughs, sneezes or signs the droplets nuclei containing the TB bacilli are expelled into the air and these droplets nuclei can remain for several hours in the air depending on the environment. Isolation of these patients on the ward is also critical. When out of the room they should use their face mask at all times, if in hospital I am assuming that they are still contagious, if sent home then they have to continue treatment for 6-9 month as per doctor’s orders with Direct Observation Therapy by the district nurses and the involvement of family. Face mask will not be necessary after 2/12 of treatment and a clear of bacilli in sputum are indicated. If bacilli are still present then transmission is still possible. All these should be considered in the patient care.
TB Infection: This means that the tubercle bacilli are in the body but the intact immune system is keeping then under control. In our body we have what is called the macrophages which act as scavengers and they engulf the bacilli. If the immune system is compromised then the bacilli multiples and spread to other sites in the body. Therefore one may have latent TB infection with no symptoms which also mean that they cannot pass it on to others and they do not have the TB disease. That’s why people living with HIV are a vulnerable population.
TB Disease: TB disease can develop very soon after an infection (primary TB) or many years after the infection (reactivation or post – primary TB). 5% of people who have been recently infected with Tb will develop TB disease in the first year or two after infection. Another 5 % will develop disease in their lives. The remaining 90% will stay infected but free of disease for the rest of their lives.
Management of TB
There is so much to talk about when one speaks of TB. But I seek to address the concerns of the TB patients on the wards.
1. If there continues to be an increase then the powers that be must consider an area to nurse these patients.
2. Continue to pursue high- quality of Direct Observes Therapy (DOT) this entails the patient being watch when anti TB drugs are administered. The other aspect of this should take into consideration political commitment with adequate and sustained financing and so far I am aware that all TB drugs are free. Early detection is critical, the PMH Lab I must say has competent staff and it’s up to the public to know the signs of TB do not be afraid and visit the doctor it may well be some other sickness (Some of the main signs and symptoms of TB are: night sweat, bloody sputum, weight loss, dry cough which continues for weeks into months) you may or may not have all these symptoms.
3. Addressing TB- HIV, Multiple Drug Resistance and the needs of poor and vulnerable populations is a must. This can be achieved by collaborative TB/HIV activities, addressing the needs of TB contacts and poor and vulnerable populations. The HIV unit is doing a great job. All HIV patients should be tested for TB. Well then there should be some form of dialogue with representative of the immigrants from epidemic areas with TB not to discrimination against them but to work with them on how and where they can seek assistance. Whether it’s for treatment or information.
4. Primary health care strengthening contributes to the health system by the continuity of education, human resource and financing, supplies is also a must. The nurses in the community go above and beyond by ensuring DOT is done for TB patients “WELL DONE”.
5. All care providers should be involve and the need to have standards and make use of these standards must continue
6. People with TB must be empowered , proper communication with TB clients/patients, having advocacy , community participation in TB care is vital in prevention and health promotion
7. Learn from our mishaps what could be done earlier, better, ensure monitoring and evaluation is ongoing.
What next Dominica what next?? These people have to be quarantined asap!
by the 1980,s TB was completely erradicated from dominica….
i have been always making the same comment. hatians should be allowed to present a medical document before coming to dominica.. and imagine the immigration and customs officers have to interview these people..
Where did you get the information that by the 1980’s TB was completely eradicated from Dominica? I am a health care worker who started working with the Ministry of Health in 1986 and every year we always had one or two cases occurring. TB is almost endemic in Dominica. Most likely those cases are persons who did not seek medical attention or did not follow their treatment regime.
to all of u about the highest rate of tb cases here in the usa comes from the spanish speaking people and countries, stop putting/ looking down at the Haitians people they are people like me and u trying to seek a better life for themselves and their families, what would the American’s say about us who flocked to there shores for a better point of our lives everyday
Just because they come for a better life, if they nasty, doh say they nasty then.
That’s why I maintain Dominica should enforce a strict ‘No haitians allowed’policy. I would build a special bench for them in Melville Hall. As they ‘deborday’, “sit here plz” next flight out of DA they onboard. TB is too prevalent in Haiti to be allowing the influx of these ppl down here!
@ Henry!
The meaning of HYPOTHESIS is: a tentative explanation for a phenomenon, used as a basis for further investigation
A hypothesis is a precise testable statement a prediction of what researchers expect to find and prove. So my guess is you meant hepatitis, is it?
Learn to think before you start pounding qwerty
Five (5 cases of tuberculosis is an extremely high figure considering the mode of transmission is airborne, that is, coughing,sneezing, etc.
Control and eradication should be very high on Ministry of Health’s agenda, and that is required urgently!
Systems and process should be put in place for visitors be screened. BCG vaccine should be offered to all health care professionals at hospital and community settings. PLEASE PROTECT OUR HARD WORKING HEALTH PROFESSIONALS!
Concerned
i suspect that came from the east
man this nonsense come here by them Haitians spreading all their diseases and nonsense all over the place
Discriminatory statement! Please give sreaders your reason for such statement.
Have you got evidence to support your claim?
TB IS A GERM CALLED TUBERCLE BACTERIUM. IT IS A BACTERIAL INFECTION WHICH IS AFFECTS THE LUNGS.IT CAN BE SPREAD BY AIR DROPS ,SPITTING ,SNEEZING ,COUGHING AND BREATHING.ONLY PEOPLE WITH TB IN THE LUNGS CAN SPREAD THE IT.
IT IS VERY VERY IMPORTANT THAT IF ANY ONE FEEL A CHANGE IN THE WAY THEY BREATH AND SUDDENLY STARTS COUGHING THEY SHOULD CONSULT A DOCTOR AS SO AS POSSIBLE BECAUSE IF IT IS CAUSED BY TB IT CAN BE CONTAGIOUS . IF YOU ARE DIAGNOSED WITH TB YOU SHOULD TAKE PROPER PRECAUTIONS SUCH AS HAVE YOUR OWN ROOM ,EATING ,DRINKING IN YOUR OWN BELONGS AND COVERING YOUTH MOUTH TO PREVENT OTHERS FROM BEING CONTAMINATED WHILE YOU TAKE YOUR TREATMENT SERIOUSLY.
ADMIN: Please people cut down on the all caps. Please read our disclaimer on all caps.
Isaiah 53: verses 4-5
Surely He has borne our griefs and carried our sorrows; yet we esteemed Him stricken, smitten by God, and afflicted.
But He was wounded for our transgressions, He was bruised for our iniquities; the chastisement for our peace was upon Him, and “by His stripes we are healed”
The prophet Isaiah, in the message above, speaks about God’s Person of Love–His only begotten Son in the flesh, the Man whom we read about in the Holy Bible–His name is Emmanuel, Jesus, Christ– who is Eternal Spirit, God Almighty with us.
When we have understood and to accept what Jesus did on the cross on our behalf; to see with our eyes of Spirit–His humiliation, suffering, and dying, which sent Him to the grave; when by faith and through spiritual wisdom, we can fathom the Power by which Jesus was raised from the dead; it is only then that we can come know the Power of Love–the Spiritual blood of God in Jesus Christ–the nature of Light in our souls–when this soul is revived, quickened by our faith.
For “in Him there was Life and the Life was the Light of men. The apostle John speaks here about Jesus Christ at John 1:4
This Life which is “spiritual Light” in us, enters by our channel of faith, through our conscience, where God’s Holy Spirit indwells us–bringing us alive to our Holy God and His traits of Love in Spirit and in Truth.
And Love is perfect, just as God is perfect. Hence in Love there is no sickness and no death. In Love there is no darkness and no night. In Love there is no sorrow and no crying.
But in Love there is the kinetic energy –the essence of peace and joy–which dwells in the mind. That energy keeps us floating over the vile and discord, the toil and strife, and the wickedness and evil of this worldly existence. Faith in God is the channel by which we attain His grace of peace and joy.
Our sickness and disease are the thorns of our flesh–the messenger of Satan, who comes like a thief, to steal, kill, and destroy us. They cannot have any effect on our spirit self–if we are alive in Jesus Christ. I am saying that, as our conscience trains, disciplines, and feeds our mind, we learn to overcome or have control over the ailments of the flesh, which comes with the intentions to destroy us.
People of God, in our Dominica, we should not deny that we are sick or that we may be coming down with a serious illness. We should not deny that a doctor or certain medication can heal us–for we do not know how or through whom God can do His work in us.
What we should do is to call on the strength and authority of our God, through faith, trust, obedience, and humility, as we fight for victory against our difficult circumstances.
But we should not simply accept whatever the ailment that attacks us and to give it the win, because we would be giving Satan the win–his victory is our death and destruction–as we return to the dust of our physical formation forevermore.
BY THE STRIPES OF JESUS CHRIST WE ARE HEALED–first and foremost–as long as we can maintain that Truth by faith. In other words Love–the Spiritual Blood of Jesus Christ, which is the Lifeline of our soul–does everything to continue our thriving in Life, those of us who are alive–meaning that we are born of Love, which the nature of God Almighty.
Love, when it is our Life, represents the greatest and perfect anointing–the primary medicine–which lubricates our soul, mind, and physical body; keeping us cleansed, sanctified, and or consecrated.
Sickness, disease, and death has already been defeated–as the apostle repeated the words of the prophet Hosea, when he says: “O death where is your victory? O grave, where is your sting”
1st Corinthians 15: 55
Remember Jesus words as well: “In this world you will have tribulation, but be of good cheer, I have overcome the world”. John 16: 33
Therefore let us practice by faith to speak against the fears of this world–like the many kinds of sickness and disease which comes to buffet us–practice makes perfect.
In Jesus Christ we have the victory we desire. Just abide in His Love; and to God be the glory!
Seriously, check this website. Very helpful
http://www.cdc.gov/tb/
I think there is a great need for T.B screening at the airport for Haitians especially
How are you going to do that at the airport? Test results for TB are not instantaneous. Are you going to detain people at the airport until they clear your discriminatory test? Why do you single out Haitians for your discriminatory policy?
let’s not discriminate but T.B screenings should be done at ports of entry
One of the requirements for obtaining a residence permit in Dominica is the submission of a chest x-ray (as well as an HIV test) amongst others. I wonder if this is strictly ahered to.
Who brought that into Dominica? MoH, please investigate!
I am really not sure when last Dr.Johnson went to the ward. I went to the ward 2 days ago and the TB patients are NOT ISOLATED. One gentleman was actually sitting on the bench outside the ward with only the top of his mask tied. The bottom of the mask was not tied and he was talking to several other people there with him. The other patients are also walking up and down the ward and the fans are oscillating overhead. There is one particular patient who is actually there for the last year. It is ridiculous for them to be on the same ward with other patients and wearing the wrong type of mask for TB patients. This puts healthcare workers, other patients and their families at risk. It is not an outbreak now but it will be if proper action is not taken
Thats probably the real reason for the increase. Not Haitians but slackness. Dominicans hate the english, hate the chinese and hate themselves.
eh! eh! I forget, and they hate the haitians!
Ladies and gentlemen, a closer look at Haiti and China where immigrants are coming from have a high rate of Tuberculosis. http://upload.wikimedia.org/wikipedia/commons/b/b6/Tuberculosis_world_map_-_DALY_-_WHO2004.svg
If one looks at the map closely we will see that both Haiti and Dominican Republic are the highest in the Caribbean.
what is tb and is it dangerious?
TB is a contagious disease, closely associated with poverty through overcrowding and, particularly malnutrition. HIV sufferers are particularly vulnerable.
It would be important for Dr. Johnson to state what is the prevalence of Active TB in Dominica (baseline) so that we can decide whether this is a real epidemic. Considering the tiny population of Dominica this could be read as an outbreak.
Dr. Johnson should clarify what is meant by “we follow them” as this is a bit ambiguous. Does he mean that “we will follow” or “we have been following”? It is quite perplexing that there should be ‘reoccurences’ (which should be read as re-activation) of TB cases if there is an established DOTS program that is monitored for its effeciency. I am also concerned about the type of TB cases (especially with re-activation) presenting. Are they drug resistant TB or extra drug resistant TB. Are they pulmonary TB or otherwise? It is important that we do not try to pacify the public with mis-information or half truths.
P.S I don’t think that the blame should be laid on “immigrants” or “drug addicts” or “HIV infected individuals”. Rather TB is a marker of social inequity that we as Dominicans should be working at eliminating.
-with Love from Wesley.
Wesley living in Brooklyn New york and at the DOH TB department?Your verse lyrics sold you out Wesley/dept of health New york.
Yeah, you know…back in like 1997 in Nashville, this dude had TB at the TGIFridays…they closed it…we stopped going, it is what it is….
what or how is TB spread. This is missing in the information. Can anyone help?
google it..did that and got lots more info
http://www.cdc.gov/tb/ Peep….
The bacteria are spread when an infected person with the disease coughs, sneezes, talks, spits and someone in close proximity inhales the bacteria. That person may or may not get sick.
Couching without covering your mouth while in the midst of others,eating and drinking from the same utensils as the infected patient, being in close confinement,(breathing in the same air that the patient breathed out. In other words the patient should cover their mouth with a mask at all time and be isolated.
i am fed up with these people that lying so much there r the infected people all over the place without mask and coughing even talkn to people without mask ask the nurses and other health workers they will tell u or ask people visiting the wards man all outside walking
please anonymous, just don’t run y mouth if u have not facts in that area of healthcare field because u comment is so whah, get y fact before u write, such awful thing and where did u get y MD license from. ignorance is bad thing
Too many immigrants on our small island… no name no warrant.
As people move from one part of the world to the next, more and deadlier strains of diseases are bound to follow.Did you study history at school?
What we need now is a major education campaign as well as new screening requirements for would-be immigrants.Lets’ stop pointing fingers and instead take the necessary steps to protect ourselves, our families, communities and our country.
Dude, like the world is REALLY SMALL (Small as Dominica)…seriously….I mean if there were no immigrants, at some point everyone on the island would need to stop getting married, because soon, you would ALL BE RELATED…get it?
what if i just say haitians
What if I just say Dominicans? How you like them apples?
This is the important statement here. “overcrowded housing and more people arriving from countries where there is a higher rate of tuberculosis.”
The world’s second largest tuberculosis epidemic – where is it found?
China
Haiti
China I work for Dept of health and from wesley.I deal with all nationalities here and they are in numbers a 1500,000 fold case here from everywhere haiti is low China is the culprit.
Ask me i can come to DA and put Dr.Johnson in the shade on TB and epidermic markers.
Too many foreigners/Haitians in DA coming with all them diseases, wonder how many of them have hypothesis
China is second only to India
This will spread like wild fire in DA, cause all them DA men and women sleeping with Haitian will eventually catch all them diseases from Haitians
I meet a beautiful Haitian woman, nice body and face out of Dominica, no one would ever think that she have AIDS, i was informed by another Haitian that this woman is an AIDS carrier, all those saying that Dominicans are against Haitians this is not true, all i have to say is later will be greater, just the beginning of things to come since they landed in Dominica all sought of negative things are taking place on the island
most time ppl with TB are HIV postive
very true my dear!
why do you have to say that before HIV was TB,you can get tb by walking on somebody dry spit but you can’t get HIV like that .the only thing i can say we inport so many haitions and they have a large amount of TB over there in haiti so i expect that . in the to come to the us you need the TB test to come da all you need is a ticket and a passport
ok doctor anonymous…. all you always no better
Wrong. People with HIV are more prone to obtain TB due to compromised immune system. Having TB does not necessarily mean you have HIV.
Your analysis is spot on! HIV sufferers are more prone to infections, and TB is just one of them, because of their impaired immune system.
Did yu pull that info out of your magic dumb hat ?
Mabouche’ that’s an establish fact.
Thats is a not a scientific fact!!!! get your facts straight