Swine flu, round two: Caribbean outlook

The incidence of swine flu in the Caribbean shows little sign of easing overall, neither does fear of the virus. In the past week, authorities in Trinidad and Tobago have closed schools and courthouses due to the spread of the H1N1 virus. In Grenada, the government also shut schools and recalled all health workers from vacation leave as the island reported new suspected cases.

In total, there were 43 confirmed deaths in the Caribbean up to the end of last week, including 22 in the Dominican Republic, and seven in Cuba. Those figures were compiled by the Pan American Health Organisation (PAHO), which said that acute respiratory disease activity of swine flu has been variable in the region.

Some countries are reporting increasing trends while others are reporting decreasing or unchanged trends.

"Overall, the intensity and impact of acute respiratory disease on health care services is remaining low to moderate, with the exception of Belize which reported very high intensity of acute respiratory disease but a moderate impact of acute respiratory disease on health care services."

Impact

Cuba continues to report widespread influenza activity and increasing trends and high intensity of acute respiratory disease.
In Bahamas, the trend is said to be increasing; in Barbados decreasing. Cuba had the most cases in the Caribbean up to last week - 677, with the Dominican Republic reporting 424.

Others with more than 100 include Trinidad and Tobago, Jamaica, Barbados and Suriname. Overall, the intensity and impact of acute respiratory disease on health care services is remaining low to moderate according to the Pan American Health Organization.

Four deaths each have been reported in Jamaica and Trinidad and Tobago, three in Barbados, two in Suriname and one in St Kitts and Nevis.

PAHO said that health professionals in the Americas had agreed that the risk of severe or fatal illness is highest in three groups: pregnant women, especially during the third trimester of pregnancy, children younger than two years of age, and people with chronic lung disease, including asthma.

Control

It said health care providers of antenatal services should pay special attention to the signs and symptoms of respiratory infection among pregnant women.

Infection control measures at the community level, such as respiratory etiquette, hand hygiene and frequent ventilation of the households should be promoted.

"If a family member develops a respiratory infection, distancing of 1-2 metres is necessary to avoid transmission," it said.

Pregnant women should not take care of household members with by respiratory infections.

PAHO recommends national protocols for priority vaccination
When it comes to the pandemic H1N1 vaccine, PAHO recommends that countries develop national protocols for priority vaccination.

The Caribbean Community (Caricom) Secretariat has already announced that health workers, pregnant women and the elderly will get the region's first batch of vaccinations in early November.

Air and sea port workers and and front-line tourism staff could also be added to the list.

The secretariat issued a statement saying that the first shipments of doses were expected shortly from the United States, Brazil and other suppliers.

Seasonal outlook

The secretariat's programme manager for health sector development Rudolph Cummings said the H1N1 virus was expected to intensify in the cooler months of December and January, the high season for regional tourism.

Dr Cummings said the region should be "more prepared to deal" with this period than at the onset of the outbreak.

Apart from the priority groups, most Caribbean residents will have to wait as vaccine doses arrive.

Guyana's Health Minister Leslie Ramsammy has acknowledged that the region needs to do more education on both the flu and the vaccine.

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