Madrid/The optimism that health authorities showed a week ago has fallen. Patients seen for febrile symptoms they grew 2.5% last weekbad news after last Tuesday the director of epidemiology Francisco Durán said, relieved, that infections had been decreasing for fifteen days.
This Monday, Vice Minister Carilda Peña García was in charge of breaking the bad news and added, bluntly, that the fundamental cause is the “very high” rates of mosquito infestation. Aedes aegypti. The official said that Pinar del Río, Sancti Spíritus, Camagüey, Santiago de Cuba, Havana and Villa Clara are the most affected provinces, although the entire country is already affected, with the exception of Isla de la Juventud, which is nevertheless considered an “alarm zone.” The rest maintain the qualification of “epidemic endemic corridor.”
Dengue is more located in the west and center of the Island, with Villa Clara, Havana, Sancti Spíritus, Las Tunas and Artemisa leading the way, but transmission is proven in 13 provinces. Chikungunya, which is more worrying because Cubans are less familiar with it, is present in all provinces, but the worst is concentrated in Havana, Matanzas, Cienfuegos and Guantánamo, which have simultaneous circulation of the two diseases.
The worst is concentrated in Havana, Matanzas, Cienfuegos and Guantánamo, which have simultaneous circulation of the two diseases
Peña García insisted on the importance of fumigation – which has arrived late and barely, due to the lack of supplies according to what specialists said on television last week – and pointed out that it is progressing irregularly, since the plan was to cover all urban areas in three weeks, but only Mayabeque, Havana, Cienfuegos, Ciego de Ávila and Santiago de Cuba reached 95%.
Given the resistance of part of the population to facilitating the passage to the fumigation brigades, Peña García recalled that when there is an epidemic it is not only mandatory, but a propagation crime can be committed if it is hindered. In addition, he recalled that it is more important than ever for citizens to participate in eliminating, each within their means, the breeding sites, cleaning the water tanks among other things. In the responses the video has receivedpublished on Canal Caribe’s social networks, reflects the discomfort of a population that insists that fumigation is not being carried out.
“In Camagüey, we live two blocks from the provincial hospital and on my block everyone is with the virus and there is no fumigation,” laments one user. There are responses from almost all provinces pointing out how alarming the situation is and how the reported cases are only the tip of the iceberg, since many do not go to the hospital. “The saddest thing, the most painful thing and what should worry our authorities the most is the loss of trust and credibility of many Cubans in our health system, once, without any chauvinism, the best in the world. Why am I going if there is nothing and many health personnel are also infected?” laments another commentator.
Yamirka Montesino Felipe, head of the National Group of Pediatric Intensive and Emergency Medicine, stressed once again that hospitalization of all children under two years of age who have febrile symptoms is essential, since they are one of the most vulnerable groups. If, in addition, there is any comorbidity, such as diabetes, oncological diseases, epilepsy and kidney problems, the alert is greater.
“When the child starts to have a fever and the family immediately goes to seek medical assistance, we manage to reach the sick patient early and avoid complications,” something that is key to “reversing developments that could be unfavorable” to the child. Fever is, he warned, more persistent in children and there may be lesions on the skin, including blisters, which cause a lot of discomfort and pain in children. However, the very painful symptoms of joint pain reported by adults are less pronounced among children.
Montesino Felipe recalled that it is key to keep children hydrated, since gastrointestinal symptoms can cause dangerous dehydration
Montesino Felipe recalled that it is key to keep children hydrated, since gastrointestinal symptoms can cause dangerous dehydration. This very basic advice would not seem like a complicated mission if it were not for the fact that the supply problems that are occurring on the Island, aggravated by the effects of Hurricane Melissa in some provinces, complicate the situation. This fact, together with problems with sanitation, makes treatment difficult and increases the danger of spread. This was recognized last week by María Guadalupe Guzmán Tirado, director of the Research, Diagnostic and Reference Center of the Pedro Kourí Institute (IPK), who warned that the proliferation of water tanks in homes – generated by the poor supply of the service – is combined with “inadequate management of solid waste and deficiencies in sanitation.”
Diana Couto Núñez, president of the Cuban Society of Gynecology and Obstetrics, also spoke of another vulnerable group: pregnant women, who also require urgent hospitalization. “You can’t make a diagnosis at home. That has to be done by the hospital,” he said, and especially if you suffer from hypertension or diabetes, since serious complications could occur.
Last week, the authorities estimated the accumulated number of chikungunya cases at 21,681, while for dengue we must consult the data from the Pan American Health Organizationwhere 9,602 are registered and a very considerable incidence, with 87.79 cases per 100,000 inhabitants. According to estimates from the Ministry of Health, the percentage of Cubans who have had one of the two diseases in this outbreak would be around 30%.
