Chikungunya not confirmed

The Director General of Health, Leausa Dr. Take Naseri, has stated there are no confirmed cases of the mosquito borne chikungunya virus in Samoa.

At a press conference held yesterday, the Leausa said while no laboratory tests had come back as yet to categorically confirm cases of the virus, there were 19 suspected, or clinically diagnosed, cases on island.

“So I think we need to clear that up,” he said.

According to Mosby's Medical Dictionary a clinical diagnosis is one made on the basis of knowledge obtained by medical history and physical examination alone, without benefit of laboratory tests or x-ray films.

Leausa said blood samples had been taken from the suspected cases and were sent overseas - to New Zealand, Tahiti and Noumea - for testing.

He said only once the results come back his Ministry could either confirm or deny a chikungunya outbreak.

If and when it is confirmed, Leausa said it would be the first time this virus has ever presented here. In saying this though, Leausa said his sector was highly suspicious of it being the chikungunya, with physicians making their clinical diagnoses based on a patients travel history and the symptoms they present with - such as a rash, fever and joint pain.

“But so far we are waiting for the lab to confirm and once we get a confirmation of that then we will get back to you,” he said.

“We have sent out specimens and we are still waiting on them. The turn around time for a specimen may take two to three weeks.”

He said his Ministry had screened all 19 suspected cases for all strains of dengue, all of which came back with a negative result.

Leausa said in the meantime the sector is doing all it can to prevent an outbreak.

“We started (preventative measures) before we were alerted to this case,” he said.

“We have done a lot of things. We have started our boarder control. We started our clean up at the ports of entry – especially Faleolo and Fagali’i airports.”

He said the main preventative measure was to spray to prevent the vectors, in this case mosquitoes, from spreading the virus.

The D.G. said his Ministry had advised the airlines that the spraying of planes would begin.

“In the event we feel that there is something going on or that we don’t then we will have to spray,” he said.

“So since last week we have started spraying all the flights from Pago on arrival.”

Leausa said the ports had also been sprayed, as had the area within the vicinity of the wharf.

“Even the boats we have done (sprayed),” he said.

“Today the team is going to the Satitoa Wharf because for the S.I.D.S. (conference) the boat trips form Pago will go to Aleipata so we sent a team there on Friday last week."

“And they have a campaign going on."

“Most of the school compounds in the town area we have sprayed and we have also looked at the areas where there are suspected cases."

“(Areas) like Vaimauga area we sprayed there because that was our index case from there and Vaimea area where we have four suspected cases.”

He said other preventative measures were to advise the public to help with the destruction of mosquito breeding grounds, especially rubbish.

“Those water retaining containers and debris that could encourage the breeding of these mosquitoes,” he said.

Looking now at hospital protocols, he said as the chikunguna virus was not as virulent as dengue fever, it is being treated depending on the severity of the case presented.

“As I said the chikungunya itself is not as fatal as the dengue and most people go there (to the hospital) because they are sick,” he said.

“Not very severely sick so what happens is that they get triaged depending on the severity of the presentation."

“So that is the protocol of it mind you it is not contagious in the sense that it can spread from person to person it is the mosquito that transmits it from person to person.”

He added that in a bid to prevent it from spreading, the Ministry had sprayed around the hospital twice now.

When asked if this potential outbreak worried him so close to S.I.D.S., the D.G. said his sector was taking a lot of extra precautions

“Before S.I.D.S. we are planning a mass events surveillance so with this case we have already started mobilising and are in the process of doing that so SPC and World Health Organisation are helping us do the mass gathering surveillance,” he said.

“So it is just not for chikungunya but for any other disease like diarrhoea and other bugs that causes diarrhoea."

“So we are doing the monitoring pre-S.I.D.S. and post- S.I.D.S.

“So we have that in place and we have people coming down to help us.”

Looking now to American Samoa, the D.G. said four samples had been tested in a laboratory and three out of the four cases had tested positive for the virus.

In an alert issued by Leausa’s counterpart, Director Motusa Tuileama Nua, he reports that the American Samoa Department of Health and the LBJ Hospital have confirmed Public Health chikungunya “chik” fever as the cause of the fever, rash and joint pains outbreak on Tutuila. There have been 343 recorded cases, with six patients hospitalized and no deaths, since July 1,2014. The American Samoa Director General also provides information for patients.

“If you develop fever, body aches with or without rash, check with a nurse or doctor,” the alert reads. ”Apply ice packs to your painful joints and rest them as much as possible Stay indoors in aircon, behind screens or under bednets while you are ill (if you get bit by mosquitos while you are ill, they will spread the disease to your family and neighbors).”

For people who are travelling the A.S.D.H. says: “Do not travel off-island if you are ill with fever and body aches. ”If you travel and become ill after you arrive, tell the doctor who sees you that you may have been exposed to chikungunya.”

In a bid to prevent the spread of illness the A.S.D.H. reports only the aedes mosquito spreads chikungunya.

“Almost all aedes mosquitos come from the following items that collect rain water,” the alert reads.

“Uncovered rain barrels, buckets, junk tires, junk appliances (such as refrigerators, washing machines), boats, equipment (and) plastic tarps. Prevent your family from getting chikungunya by covering rain barrels with a screen or cloth and eliminating these other items near your home, within 100 yards (about 30 metres) where mosquitos breed. ”Protect your family from getting mosquito bites by wearing long pants, socks and long sleeve shirts when you go outside (and) using mosquito repellent (with DEET) when you go outside.”