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Oct 9, 2014

Healthy Living looks at the ChikV threat to Belize

On Tuesday, officials from the Ministry of Health hosted a press conference to discuss Belize’s preparedness for Ebola and Chikungunya. Belizeans have been preoccupied about the country’s level of readiness to handle the lethal virus, Ebola. Currently, the Ministry of Health maintains that the threat level for Belize when it comes to Ebola is low – nonetheless they have initiated surveillance at all ports of entry and have prepared medical staff.  As it relates to Chikungunya, health officials say, it’s not if Chikungunya will affect Belize, it is when. Currently, ChikV has been spreading across the Caribbean and Central, South and even North America. El Salvador’s outbreak alone has reached almost thirty thousand cases. Tonight on Healthy Living, we find out more about Chikungunya.


Marleni Cuellar, Reporting

It’s in India; it’s in China, In Italy, In South Africa, Venezuela, Jamaica, United States….and as you can see from this map. In many more countries all over the world, Chikungunya (or ChikV) is a viral disease transmitted by mosquitoes. It was not common to the Americas; in fact it was in December 2013 that ChikV was reported in this region in the Caribbean.


Dr. Marvin Manzanero, Interim Head, Epidemiology Unit, Ministry of Health

Dr. Marvin Manzanero

“Primarily documented in African continents, but there had been sporadic imported cases to the Americas including the U.S., but there had not been any sustained transmission so that countries would have called it a national epidemic. I now believe you can classify it as an endemic disease.”


Doctor Marvin Manzanero is currently the epidemiology unit of the Ministry of Health, who has been closely monitoring the situation of ChikV.


Dr. Marvin Manzanero

“It is transmitted by two mosquitoes—the aedes aegypti and aedes alboquitos—same transmitters of the dengue virus. So with globalization, urbanization, it is expected the Chikungunya along with other viral diseases will start to come about. So this is something of what we call re-emerging & emerging infections affecting most countries.”


Marleni Cuellar

“Is it possible that there are cases in Belize that perhaps have not been confirmed?”


Dr. Marvin Manzanero

“It is possible. Chikungunya may not exactly take everyone to the health care facility. So there could have been a case and the patient didn’t make it to the health facility. That is a possibility. We are trying to establish epidemiological links. We have had six suspect cases reported to us by both public and private sector. We haven’t had any confirmed case. Yesterday, the ministry got a call about a potential imported case from El Salvador and we are doing case investigation yesterday and today. And that could be our index case, our first case that is not locally transmitted, but it is important and that can give rise to a local transmission.”


The symptoms of Chikungunya are very similar to dengue with a sudden onset of fever, rash, and joint pain. This is described as the main difference between ChikV & Dengue. The name Chikungunya traces back to Africa and it means “that which bends.”


Dr. Marvin Manzanero

“The pain might be so severe so that people walk with a bend or kind of crunching position associated with the joint pain. How long the joint pain lasts could be two to three weeks.  It’s not necessarily going to kill you, but it can make you very sick. For example we are looking at cases in El Salvador where they are reporting a lot of economic losses associated to people not going to work as a result of Chikungunya, in some instances up to three weeks. So when you start doing the math, that is where it perhaps could affect not just the Ministry of Health in terms of resources—because there is no treatment—but in terms of days loss. And I think that would be of concern for employers, for social security board if it hits Belize the way it has hit other countries. So that is why it hasn’t fallen off the radar and because of the chronicity it can have in terms of the joint pain, it can be much more prolonged than dengue so that the person might be unable to work for a longer time than a person who has had dengue.”


No specific treatment or cure for ChikV. Symptoms would be treated individually. The joint pain, though, can last for a few weeks, a few months or for years.
There are rapid test available in the private sector, however, these tests are simply not sensitive enough for a proper diagnosis; therefore a follow up testing has to be conducted. This is done by sending the samples out of country for confirmation.


Dr. Marvin Manzanero

“The more important thing is establishing an epidemiological link. If you have been to an area where there has been ongoing transmission of Chikungunya, then that’s an area of concern for us. If you have not moved, let’s say outside of Belize….outside of south side Belize City and there are hotspots in Belize City for dengue, then the first thing we have to think of is dengue and not Chikungunya. But if you have been to El Salvador or Guatemala and on the western portion of Guatemala primarily, Caribbean countries, then you should be considered for Chikungunya. And you should be able to pass that information on to your physician so that you establish the link.”


But even with the proper vector control. Belizeans should be a bit more cautious of their environments and if you do develop symptoms, report to your nearest health care facility. Although it is only a matter before we confirm our first case, given the time of year, Belize may fare of well…at least for 2014.


Dr. Marvin Manzanero

“I don’t think we’ll have that many. We are almost at the end of the rainy season, we are almost at the end of where dengue usually peaks in the year so I think we could follow the same pattern. We might have a bigger problem in the years to come, but I don’t think we will have a problem this year. Try to avoid mosquitoes as much as you can. Keep using insect repellants, long sleeves; try to be in an area where you are not exposed to mosquitoes which are usually more active in the morning, break of dawn and at dusk or the early hours of the evening. And I think primarily having a clean yard.”

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Viewers please note: This Internet newscast is a verbatim transcript of our evening television newscast. Where speakers use Kriol, we attempt to faithfully reproduce the quotes using a standard spelling system.

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