Working together to mitigate an increase of cases by M. Henry, BSc, MPH VSA-CPS-SGHC March 2015 SINT MAARTEN S CHIKUNGUNYA RESPONSE

Size: px

Start display at page:

Download "Working together to mitigate an increase of cases by M. Henry, BSc, MPH VSA-CPS-SGHC March 2015 SINT MAARTEN S CHIKUNGUNYA RESPONSE"

Corey Bishop
5 years ago
Views:

1 Working together to mitigate an increase of cases by M. Henry, BSc, MPH VSA-CPS-SGHC March 2015 SINT MAARTEN S CHIKUNGUNYA RESPONSE

2 CONTENT Background Surveillance Communication Vector management

3 VECTOR PROGRAM STATUS A program consisting presently of two field workers with 1 temp. * The knowledge of the retired experienced workers were not transferred to the present field workers Government contracts a private company to Fog the island this contract is based on the company s equipment There is corporation with the French side Vector team

4 ACTION FOR SXM AS OF 2012 Increase Awareness i.r.t. Chikungunya Improve Vector Control & surveillance Seek approval on expansion of the Vector program by at least 2 persons (1 additional team) pending Continue to emphasize the message of mosquito eradication Strengthen Partnership with the French Colleagues on mosquito control Circulated the Integrated Management Strategy to relevant stakeholders

5 1 ST FRENCH SIGNAL 2013 Reception November 16-18, an individual contacts the InVS Ars for a clinical presentation of dengue with intense arthralgia and persistent while dengue tests were negative the practitioner of infectious disease at the CH Fleming reported similar cases were reported by a general practitioner The cases resided in the Oyster Pond area

6 DUTCH SIDE CASE 2013 First case was tested on the French side diagnosed by Dutch physician was a male age 39 Was reported to CPS on December 19 th, 2013 The reported confirmed cases is 511 (470(2014) + 41 (2015)????

7 GENERAL OBJECTIVES OF THE RESPONSE the prevention, detection, and timely response to the outbreak of CHIK: through surveillance, case detection, investigation, and the launching of public health actions. Aim is to contain the number of cases To Eliminate mosquito breeding sources Promote community involvement to prevent and eliminate

8 SURVEILLANCE

9 CASE DEFINITION: Probable case: sudden onset of fever >38.5 C and joint pain in the extremities without any other explanation and CHIKV-IgM positive. Confirmed case: fever >38.5⁰C and arthralgia and detection of viral genome by RT PCR, OR recent sero-conversion or 4-fold increase of IgG on two sera taken with two weeks minimum interval. ** Total number of reporting sites: 7.

11 SURVEILLANCE 2014 reported cases requiring follow by surveillance Team

UNDIFFERENTIATED FEVER - SENTINEL 14 2014-2015 Weekly Reported Syndromes:

Undifferentiated fever (< 5 years) Undifferentiated fever (> 5 years) 4 2

12 UNDIFFERENTIATED FEVER - SENTINEL Weekly Reported Syndromes: Undifferentiated Fever <5 & 5> distributed by EPI weeks Undifferentiated fever (< 5 years) Undifferentiated fever (> 5 years)

13 COMMUNICATION Meeting outcome was communicated to the decision makers& Dart Team Physicians and community were requested to be on the alert Collective Media campaign between DS & FS with information to general population Announced and request communicated to PAHO & CARPHA Communication was established with RIVM

16 LABORATORY TESTING

17 INVOLVEMENT OF OTHER STAKEHOLDERS Solicit the assistance of GPs in surveillance Solicit lab assistance & technical guidance of RIVM )Netherlands Solicit the community in regards to monitoring the surrounding for mosquito breeding Port of Entry as it relates to dissemination of information and repellent Public Works & Garbage contractors as it relates to clean up campaign

21 PREVENTION- VECTOR MANAGEMENT Eliminating mosquito breeding sites on a large scale clean up campaign Fogging island cycle and districts at onset Placing Mosquito traps at the harbor Premise Condition Index (PCI) Insecticide Resistance Test Results

22 COST & ECONOMIC IMPACT Negative publicity by CDC even though transmission is known which is similar to Dengue. Deterring visitors to SXM Seek expert assistance for laboratory diagnosis in the Netherlands Cost Nafls Additional resources & Fogging Nafls ,- Negative travel publicity because of adherence to IHR guidelines

23 FOGGING Executed by a Private company Was carried out in collaboration with the French at the various border points District fogging where there were 5 to 10 cases reported (this was at the onset of the epidemic) Started island wide fogging in December 2013 in collaboration with French side which went over to the first quarter of 2014 Repeat island wide fogging in the last quarter of 2014

24 MOSQUITO TRAPS Placed at the harbor 5 times encountered positive mosquito breeding (resolved after informing the manager) Positive breeding was attributed to debris (which was removed) Over view of the collected information is shared with CARPHA

25 PREMISE CONDITION INDEX SURVEY Survey was proposed by CARPHA s representative Survey was carried out on the Dutch side of the island Students of the Justice Academy & the AUC assisted the staff of Section General Health with this survey

26 INSECTICIDE RESISTANCE Larval Test Insecticide: Temephos (0.02mg/l) Location No. tested % Mortality Belvedere Adult Test Insecticide: Permethrin (5%) Location No. tested % Mortality Belvedere

27 CHALLENGES Reporting from the physicians Laboratory Reporting Managing of the data time limitations and experience Effective vector program To maintain a collective approach, continuous discussion and review on vector developments/prevention Budgets or a collective budget to finance activities

28 POSITIVE OUTCOME Formalize the collaboration between the French and Dutch side as it relates to mosquito control and prevention information In collaboration with the Netherlands Public Health Authority published an article Lab screen locally CHIK IGG & IGM Opportunity for small researches Have mosquito trapping ongoing at the harbour

29 THANK YOU Q&A

6. SURVEILLANCE AND OUTRBREAK RESPONSE

6. SURVEILLANCE AND OUTRBREAK RESPONSE The main objective of surveillance is to detect, in a timely manner, cases of CHIK in the Americas. Early detection will allow for proper response and characterization