Introduction
Mr. Speaker, as the new Minister of Health I and the government understand the importance of ensuring that we equip the public, including our Parliamentarians, with the information they need to protect their health. In this regard, allow me to update this Honourable House on the activities being undertaken by the Ministry of Health with respect to the Influenza A(H1N1) virus and the zika virus.
Global Situation – Influenza A(H1N1)
Mr. Speaker, as you may be aware Influenza A(H1N1) was declared a global pandemic in 2009. The virus has since been circulating in several countries across the globe. In its March 7, 2016 update the World Health Organization reported that between February 8, 2016 and February 21, 2016 their lab tested more than 158,158 specimens of which 42,727 were positive for influenza viruses. 19,269 or nearly 50% were influenza A(H1N1). The Influenza virus is usually responsible for approximately 30-35% of all seasonal influenza. The above figure therefore represents an increased proportion.
Mr. Speaker, traditionally the flu season starts in October each year. This year it has peaked late in the season because of changes in the weather pattern and is expected to end in a few weeks. This unusual pattern will be continuosly monitored in the public’s interests.
Jamaica’s Situation
Since January this year, we have confirmed 42 cases of H1N1, the subtype of influenza A virus that was the most common cause of human influenza in 2009. I want to point out that despite the increased attention to the matter we are still not at outbreak levels based on the number of cases we normally see each year. Based on our epidemiological calculations we are at “High Alert”. The WHO now reports Jamaica as having moderately higher than usual levels of H1N1 cases. The virus circulating at this time, however, seems to be causing more severe disease rather than increasing the number of cases. I assure you Mr. Speaker that we are taking this matter very seriously.
Vaccines
Mr. Speaker, influenza vaccines are usually not available to the general public. The Ministry as a matter of routine provides influenza vaccines to its frontline health workers usually from as early as October each year – at the start of the flu season – and continues to make it available to those who wish to be vaccinated against influenza. The supplies purchased are based on the average uptake as the vaccine is not mandatory but taken on a voluntary basis. The policy will be reviewed to allow availability to the public in private and public sector pharmacies at a reduced cost.
The vaccines are also used specifically for some high risk groups such as young children between 24-59 months, persons over 60 years old, persons with chronic respiratory and cardiovascular system disorders, persons with diabetes, renal failure, a compromised immune system as well as pregnant women and their household contacts.
The Ministry has already distributed to all Regional Health Authorities a total of 3,000 adult and 400 paediatric doses of influenza vaccine which were received from the Pan American Health Organization (PAHO). This to date has been inadequate.
Given the increase threat risk, the Ministry has taken steps to accelerate the procurement of additional Influenza vaccines for frontline workers and will receive an additional 5,000 doses within the next week or so. Three thousand (3,000) doses of the Influenza vaccine have been ordered through PAHO and are scheduled to arrive in the island mid-March. One thousand doses arrived from Trinidad yesterday and were distributed to remaining frontline health workers, while another thousand is expected to arrive from Belize.
H1N1 Deaths
Mr. Speaker, as at March 6, 2016, we have unfortunately reported four deaths associated with the infection. I want to express my condolences to the families of the patients. We never want any adverse outcomes for our patients and it is also a difficult for us if we lose even one.
Mr. Speaker, I want to assure the public that we continue to have adequate stock of Tamiflu in hospital pharmacies and I am encouraging the private sector to make it more available to the public. Tamiflu also has to be administered within the first two days of symptoms to be most effective. All severe cases that we have seen have received Tamiflu.
Health Promotion & Prevention Initiatives
Mr. Speaker, the Ministry has heightened its public education initiatives with respect to flu. There are ads running cautioning persons to observe proper hygiene in the electronic and print media, on billboards, on buses, on their website and on social media. The team has also provided guidelines and material to schools and other entities. We intend to contiue this programme in the coming weeks.
I have requested of the technocrats in the Ministry to continue our focus on this area and start plans to prepare for the upcoming flu season which begins in October this year.
Prevention is the best medicine for H1N1 and other flu viruses. We believe that the best course of action is to continue to put our efforts into strengthening public health practices of hand washing, cough etiquette, proper use of Personal Protective Equipment, appropriate decontamination procedures in our health facilities and public education.
For the rest of this season, I am convinced that we will have adeqaute supplies of medicines and I will personally play a role in the public awaereness programmes to support better health practices in our health care facilities as well as in the wider public.
Zika Virus
Mr. Speaker, I want to now turn our attention to the zika virus which is a disease that is spread primarily through the bite of an infected Aedes aegypti mosquito. The symptoms associated with Zika are fever, rash, joint pain, and conjunctivitis or red eyes. The United States Centers for Disease Control (CDC) says the Zika virus was first discovered in 1947 and is named after the Zika forest in Uganda.
Up to February 5, 2016, Zika viral transmission has been documented in a total of 44 countries and territories. This includes 33 countries that reported transmission in 2015 and 2016. In May 2015, the Pan American Health Organization (PAHO), issued an alert regarding the first confirmed Zika case in Brazil and on February 1, 2016 the World Health Organization (WHO) declared Zika virus a Public Health Emergency of International Concern.
Zika Virus in Jamaica
Mr. Speaker it must be reiterated that to date Jamaica has had only one confirmed case of Zika virus. On January 29, 2016, Jamaica received laboratory confirmation of a case of the Zika virus infection from the Caribbean Public Health Agency (CARPHA) laboratory. The patient, who has now fully recovered is a child from St. Catherine.
Mr. Speaker we have sent to date two hundred and fifty-four (254) samples to CARPHA for Zika testing of which we have had reports on 127. From this increase testing we have found 32 cases of Dengue, placing Dengue on high alert in Jamaica. Of note, the Aedes aegypti mosquito responsible for the transmission of the Zika virus is also responsible for that of Dengue been finding an increase in Dengue cases.
I am happy to report that the Virology lab at the University Hospital where we have our National Influenza Centre has been upgraded by the MOH ($10M equipment) and started conducting local testing for the Zika virus yesterday. They will be receiving samples from the National Public Health laboratory daily and providing results within 3 days of receipt of these samples. We thank PAHO for their assistance in the training of staff at the Virology lab to conduct this activity.
Steps being taken to reduce transmission/infection
Mr. Speaker Jamaica has achieved a breakthrough in surveillance capabilities as we are now able to test for the Zika virus at the Virology lab at the University of the West Indies. The Ministry of Health had provided the resources for this. The virology lab has been approved by the CDC which makes Jamaica the second Caribbean country, outside of Trinidad, to carry out testing of the Zika virus. This is major step in having more efficient testing of samples and will reduce the time it takes to receive results.
Mr. Speaker, we continue to be on high alert for zika and other mosquito borne illness including dengue and chikungunya and so has heightened our surveillance and vector control activities. The Ministry of Heath’s National Emergency Operations Center has remained activated since January 29 2016, to direct and coordinate the health sector activities in response to the Zika virus.
We are also a part of the National Response Mechanism coordinated by Office of Disaster Preparedness and Emergency Management (ODPEM) which is tasked to:
- Alert and inform all senior team members at the national, regional, parish and institution levels
- Ensure the provision of medical care for all affected persons
- Provide situation reports on the health sector preparedness and response
- Conduct epidemiological surveillance, data and trend analysis
Public Education
Mr. Speaker, the Ministry of Health has also developed and disseminated health education messages for rotation on television, radio and print media, press releases and public education materials and continues to strengthen community based educational programmes to increase public awareness on vector-borne disease and their control.
We have also enhanced vector surveillance and implement control interventions in selected areas, strengthen response capacity with adequate manpower to ultimately reduce the Aedes indices across the island. “Operation Mosquito Search and Destroy” was launched by the MOH in Portmore and Spanish Town and will be moving to St. Ann this Saturday in an effort to motivate Jamaicans to get involved in destroying breeding sites in and around their homes.
Mr. Speaker the Ministry of Health continues to survey the Zika situation and has launched a cleanup initiative that started in St. Catherine on Saturday February 22 and will be executed in all fourteen parishes.
The initiative is being done to mobilize and motivate residents to take responsibility by searching for and destroying mosquito breeding sites in and around their homes. Increased fogging in areas with high mosquito indices areas forms part of the Ministry’s overall heightened vector control activities.
Mr. Speaker other platforms are also being utilized to get all the necessary information on Zika prevention and control out to the public. The Ministry Health’s website and social media platforms are all sources of information that the public can access and use as well as we attempt to mitigate the impact of the Zika virus.
Conclusion
I want to stress the importance of every member of the society taking a keen interest in their health and working towards preventing themselves from getting these infections. I charge my fellow MPs to take this message to their constituents as we all work together to secure the health of our families and this nation.