Port of Spain, Trinidad and Tobago.  24 November 2023.  The Caribbean Public Health Agency (CARPHA) has noted the continued increase, over the past six months, in reports of suspected and confirmed cases of Dengue in the Caribbean region, especially in CARPHA Member States that have seen increased rainfall. The associated risks and ripple effects must not be underestimated as outbreaks of Dengue and other mosquito-borne diseases like Zika and Chikungunya pose a significant threat to health, tourism, as well as social and economic development.

“Regional Health Security remains at the fore of CARPHA’s focus. In this regard, any public health threat, such as Dengue, that imperils the integrity of our regional response systems must be dealt with in a timely and effective manner and as such demands, that as the Caribbean community, we mobilize efforts to maximise efficiencies. Member States are encouraged to remain vigilant and flexible with their national work plans and available resources to maximise chances of successful responses. In 2023, four CARPHA Member States have reported Dengue outbreaks and trends are being monitored in others with subsets of all four Dengue serotypes circulating across the region,” stated Dr. Joy St. John, Executive Director at CARPHA

Dengue is known to cause outbreaks every three to five years. In the recent past, the seasonality of Dengue transmission in the Americas and the Caribbean has added to the record highs of total case numbers and complications. While 2019 was distinct for being the year with the highest number of reported Dengue cases in the Americas, it is very likely that 2023 will surpass that historic high. In 2023, up to epi-week 40, the Caribbean has noted a 15 percent increase in confirmed Dengue cases in CMS compared to a similar period in 2022.

Dr Horace Cox, Assistant Director of Surveillance, Disease Prevention and Control, and Head Vector Borne Diseases at CARPHA stated that: “The Aedes aegypti mosquito, which spreads the virus, is present in all Caribbean territories.  Vulnerable populations in small island developing states, like the Caribbean, and continental states with low lying coastal regions, need to be better prepared and resilient in addressing the prevention and control of Dengue and other arboviral diseases”.

“Around our homes and communities, we need to ensure our surroundings are clean and free of materials or containers that can accumulate water. We often overlook plant pot bases, vases, buckets and used vehicle tyres. These are typical breeding sites and should be checked frequently.  Water storage drums and tanks must be properly covered and inspected periodically to ensure that there is no breeding. Roof gutters should also be cleaned. Wire-mesh/screens on doors and windows also help in reducing the entry of mosquitoes into homes,” stated Mr. Rajesh Ragoo, Senior Technical Officer for Vector-Borne Diseases at CARPHA.

The mosquitoes that spread Dengue are active during the day. Personal preventative measures to minimise mosquito bites are also extremely important. Vulnerable groups such as infants, young children, older adults, and women who are pregnant, or trying to get pregnant, must be extra cautious. Long-sleeved clothing and repellents containing DEET, IR3535 or lemon eucalyptus, should be used to protect exposed skin or clothing, and must be used in accordance with the instructions on the product label. Confirmed cases should rest under mosquito nets.

To counter the increase in mosquitoes and potential disease transmission, greater effort should be placed on mosquito control activities in communities, and these should be intensified.  CARPHA urges its Member States to review their preparedness and response plans, as well as to continue surveillance, early diagnosis, and timely care of dengue and other arbovirus cases, to prevent severe cases and deaths associated with these diseases. CARPHA Member States (CMS) are encouraged to use available data, tools, and technologies to improve forecasting capacities, including the use of Geographical Information Systems (GIS).

CMS should also prioritise proper clinical management of suspected dengue cases by strengthening detection and management capacities at the primary health care level, thus preventing the progression of the disease to its severe forms.

CARPHA remains committed to supporting CMS in their vector control efforts, including capacity building in integrated vector control strategies.  CMS must continue to strengthen prevention and control measures such as surveillance, diagnosis, as well as timely and adequate treatment of cases, while ensuring that health care services are prepared to facilitate access and proper management of patients with these diseases.

CARPHA has launched a social media campaign to raise awareness and promote effective prevention and control measures for Dengue, a recurring threat to public health in the Caribbean region.  The campaign is a “whole of society” call to the public, healthcare practitioners and vector control officers, about their roles in this effort, and the critical need for proactive measures to reduce the spread of Dengue.

More information about Dengue and other mosquito borne diseases here:

• Facebook at carpha1
• Mission Mosquito: https://missionmosquito.carpha.org/
• Caribbean Mosquito Awareness: http://caribbeanmosquitoweek.carpha.org/

Dana Malcolm

Staff Writer 

November 24, 2023 – An inquiry has been opened into the UK’s handling of the COVID-19 Pandemic and testimony regarding the government so far is damning.

“Arguably the most fundamental misstep in the UK response was the presentation that COVID-19 would be an unstoppable flu like wave” said David Halpern, Professor on the Behavioral Insights Team, in an assessment of the COVID strategy which was read out during the hearing.

Halpern added that overconfidence and an unwillingness to learn from other countries was a downfall in the UK as well.

The inquiry is made up of five modules to investigate Resilience and preparedness (Module 1), Core UK decision-making and political governance (Module 2),  Impact of the Covid-19 pandemic on healthcare (Module 3), Vaccines and therapeutics (Module 4)and most recently Procurement (Module 5)

Right now, Module two: Core UK decision-making and political governance which called Halpern is ongoing.

Halpern says in addition the public was confused about the UKs tiered system.

“The public didn’t really understand the roles and this in some ways got worse and worse.”

Several other government aides have been called to the stand including Helen MacNamara, Former Deputy Cabinet Secretary, who painted a picture of laissez faire approach to COVID-19 rules by Boris Johnson, the then-Prime Minister asks his aides with not enough consideration given to the health of children, and perspectives of women

She recalled what she told coworkers in 2020,  during the hearing which was broadcast live: “I think we are going to kill thousands of people”.

The inquiry is ongoing, it’s a learning exercise to better prepare the country for future outbreak response and to answer taxpayers questions. No one will be charged in this inquiry.

PROVIDENCIALES, Turks and Caicos Islands, November 22, 2023 – More than 2000 students from 13 schools in Turks and Caicos Islands were given a greater chance at fighting and preventing cavities, after the Sandals Foundation, Ministry of Health and Human Services Dental Unit and Great Shape! Inc, brought their school-based oral health education preventative programme to the schools recently.

“Oral health is a very important part of overall proper health, and even more critical for children as they develop healthy habits. We must ensure that the proper dental hygiene is taught to children as early as possible, and where necessary, provide preventative services such as sealants to help prevent future damage to their teeth. Our partnership with Great Shape! Inc has, for the past decade, brought health care services to hundreds of thousands across the Caribbean, and that is something we are proud of,” said executive director of the Sandals Foundation, Heidi Clarke.

Principal of the Enid Capron Primary School, Sophia Garland while expressing gratitude for the new information being shared to her students highlighted the long term benefits for the children.

Said Garland: “Every student was able to benefit in a tangible way from the information and materials being shared on improving their oral health. The different professionals shared with them basic habits that will ensure that they can enjoy a healthier oral lifestyle. The parents have expressed their satisfaction with the new information that their children received from the volunteers with helping them improve their oral health habits.”

In addition to the oral health education, each student received toothbrush, fluoride toothpaste, dental floss and lessons on how to properly care for their teeth. Ministry of Health dental nurse Kenesha Lewis shared her satisfaction with the quality information that the students received.

“The students were also taught how eating certain unhealthy foods, improper brushing and lack of flossing could damage their teeth and affect them in the future. As a team we were able to impact students in all the government primary schools in Providenciales which we are sure will help in the better care of their oral health as they get older,” Lewis shared.

Dr. Susan Delpeche, Dental Surgeon of the Turks and Caicos Islands Government Dental Clinic noted, “This type of outreach has been phenomenal, considering that access to proper dental care is not affordable for many of our students. The volunteers are all great individuals, and our hearts swell with appreciation for the work they have done. The infusion of brighter smiles brought about by Great Shape! Inc 1000 Smiles and the Sandals Foundation has been a wonderful experience.”

Dr. Suzanne Baptista, her husband Phillip and their two sons, first-time volunteers to Great Shape! were eager to share with the students at the different schools. Though the children were missing physical school sessions, they were engaged through the virtual learning platforms and had the chance to share with children their own ages, the value of proper oral health.

“The team of volunteers here are very respectful and professional and the next generation of volunteers who came were amazing. I just love them all. Before I begin a presentation in each class I would explain why it is important to practice proper oral hygiene and how to prevent cavities. The end result is always the best. They offer the most precious hugs and smiles,” said Dr. Baptista.

Kris Ann Foster, grade 4 student at the Thelma Lightbourne Primary school shared, “The presentation from these volunteers was very informative for the children at my school. They included us in their presentations and demonstrated to us how to take care of our oral health. We have been learning this in our classes but the way that the dentists shared it, made it more fun and easier to understand.”

During the two weeks, 42 volunteers shared in the oral health education programme at the schools. The message of good oral care was shared with all classes at the schools. The Great Shape! Inc Programme was launched in Jamaica in 2003, led by Great Shape! Inc Executive Director Joseph Wright. “Our project is a preventative one. Our mission is to go into the schools to reduce or prevent cavities, and having educators and dentists sharing with the children is a proven and cost-effective way to do that,” Wright said.

The Sandals Foundation and Great Shape! Inc partnership has provided eye care and dental services to over 300,000 people in Jamaica, St Lucia, Grenada, and Turks and Caicos.