Public statement by CMO on Zika Virus threat to Dominica

1. Background

Zika has been identified in several countries in Central and South America including Venezuela, Mexico and Panama
More recently in Suriname, Puerto Rico and Martinique.

Zika was first isolated in 1947 in the Zika forest in Uganda.

The first documented outbreak outside of Africa and Asia was in 2007 on the Pacific island of Yap.

There is an ongoing outbreak in Brazil since May 2015.

2. Incubation Period and Transmission

Zika virus belongs to the same family of viruses as dengue and chikungunya and is predominantly transmitted via the bite of the Aedes aegypti mosquito but may also be transmitted via blood transfusion, from mother to unborn baby and also through sexual intercourse.
It takes 3 to 12 days from exposure to onset of signs and symptoms.

3. Signs and Symptoms
As many as 3 out of 4 infected persons may not have any signs and symptoms. Those who feel ill present with fever, rash, muscle pain, joint pain, headache, pain behind the eyes and sometimes red eyes. This is very similar to dengue or chikungunya.

4. Complications of Zika Virus Infection

While the majority of cases of Zika virus infections will resolve without difficulty in 2 to 7 days, some patients my go on to develop a problem with the nervous system called Guillain-Barre Syndrome. These patients present with worsening weakness in the body and require hospitalization. If the muscles of respiration are affected they would need management in the Intensive Care Unit.

The other major complication being reported by Brazil and French Polynesia is babies being born with poor brain development identified by their smaller than normal heads or microcephaly.

The Ministry of The Ministry of Health and Environment has been in close communication with the PAHO/WHO and CARPHA in monitoring the situation in the region and is on full alert and has put together a Plan of Action for the prevention and control of Zika.

The Plan of Action focuses:
• Surveillance and laboratory detection
• Source reduction of the mosquitoes
• An aggressive public education campaign to reduce the presence of the mosquito that transmits this disease and empowers persons to protect themselves against bites from mosquitoes.
• clinical management

5. Surveillance and Laboratory Detection

The fact that so many people can have the illness without feeling ill makes it very likely that Zika will enter Dominica undetected. Blood samples of suspected cases will be sent to CARPHA for testing.

6. Prevention and Control of Zika Virus Infection

The focus of prevention and controlling Zika must focus
1. Source reduction of Aedes aegypti mosquitoes( vector control and prevention)
2. Empowers the public to prevent themselves from being bitten( Public Education Campaign)
6.1. Aggressively reducing the population of Aedes aegypti Mosquitoes in Dominica

An intense and sustained campaign aimed at reducing the breeding Aedes aegypti mosquito is required to minimize the risk to Dominicans posed by Zika.

There are lessons to be learnt from the 2014-2015 Chikungunya epidemic. This means:
• Mobilizing the community for source reduction (removal of potential breeding materials such as tires, old refrigerators etc.)
• Treating breeding sites with biological measures (e.g. fish) or chemical means (e.g. oil on stagnant water)
• Fogging of areas where indices are high in populated areas or where cases are found

6.2. Empowering the Public to Protect Themselves

Persons must take all necessary actions to minimize the risk of being bitten by infected Aedes aegypti mosquitoes. This is particularly important for women who may in the first trimester (first three months) of pregnancy. This includes
• wearing of long sleeve shirts and long pants and
• the use of mosquito nets
• the use of mosquito repellants
• ‘Mosquito proofing’ homes and other buildings by installation of mosquito screens
7. Significance for Dominica
• Epidemics similar to dengue and possibly Chikungunya can be expected
• Potential for large outbreaks since mosquito indices are high and the population is naïve to Zika infection
• Possible increased burden on existing health-care system and social services
• Neurological complications esp. in pediatric population
• Could potentially affect economy including tourism

The Ministry of Health and Environment will continue to keep the public informed about Zika and urges everyone to pay close attention to the messages that will be disseminated in the coming days and weeks.

A hotline number is available to receive further information or advice. The hotline number is 1 767 448 2151.