Chikungunya virus confirmed

Health expects situation to get worse before it gets better noting 77 new suspected cases

The Ministry of Health (M.O.H.) yesterday confirmed Chickungunya as the virus that has been plaguing Samoa for the past few weeks.

During a press conference, Health’s Director General (D.G.), Leausa Dr. Take Naseri, said his department was bracing for an even bigger outbreak.

He said the situation is likely get worse before it will get better.

“I think we are building up to that level where we are going to see more cases,” he said. “And we are hoping with what we are doing now, in trying to control and contain, we hope we are heading in the right direction to combat this so that we wont see many (more) cases.

“But like with any outbreak, we expect to see more cases now."

“And the fact that we are not immune to the virus so we are expecting more cases.”

Leausa said 96 people had so far presented with symptoms congruent with chikungunya.

“Gender-wise I think they are about the same number of females to males – 52 females and 44 males (have presented),” he said.

“(With) age groups involved are usually the younger age groups.”

He said the first case presented to the health sector late last month.

“On the 24th that was the first suspicious case on the 24th of July,” he said.

“And slowly we are seeing at the beginning of August an increase in the number of cases (see graph below)."

“So we are bracing for an outbreak.”

He said the M.O.H. received confirmation that it was chikungunya last Saturday with lab results coming through from the 20 specimens that were sent off with the Secretariat of the Pacific Community (S.P.C.).

“Of the 20 specimens we sent off island they came back eight of those specimens were positive for chikungunya and 12 were presumed negative,” he said.

“Now know this is chikungunya for definite. We now have a viral infectious outbreak in our country.”

Leausa said while 12 of the tests returned a negative result, he believes further testing beyond the Rapid Tests conducted by the S.P.C., which according to the World Health Organisation are used for preliminary for where screening test results are required, will yield more positives to be returned on the specimens.

He said the S.P.C. also tested for dengue fever, the zika virus and leptospirosis, all of which came back negative.

What this confirmation means however, is that the Acute Fever and Rash (A.F.R.) that people were being clinically diagnosed now has a laboratory confirmed causality – the chikungunya virus.

Looking now to the two deaths that were reported by the Ministry recently, the D.G. said one was a 45-year-old male who was admitted to the Intensive Care Unit (I.C.U.) at the national hospital, and the other was a 14-year-old female.

He said while the M.O.H. thought that the deaths could be related to current outbreak, he said the laboratory tests could link neither death directly to chikungunya, with the 45-year-old male suffering from other medical conditions.

“The 45-year-old’s test was negative (for chikungunya) and the 14-year-old’s was inconclusive,” he said. “We cannot say for sure that the cause of (his) death is chikungunya due to the other pre conditions (he suffered)."

“With The 14-year-old we cannot link (her death) to the (test) results yet."

“So we are looking at it again. We expect the results of the further tests soon.”

He said he knew of no other patients that had been admitted to the I.C.U. with similar symptoms.

Leausa said in a bid to contain the outbreak the M.O.H. had moved into contain and control mode.

“We are expecting more and more people will be sick so what we are doing now is containment and control,” he said.

“We are trying as much (as possible) to contain the disease in certain areas and also control."

“In the sense to control the number of people who will be infected and also control the process of the infection when people come to the hospital."

“We are also looking at source reduction (of the mosquito breeding grounds) so the reduction of the mosquito population is really important now.”

He said the Ministry was also working with the Ministry of Natural Resources and the Environment (M.N.R.E.) and the Ministry of Women, Community and Social Development (M.W.C.S.D.) in conducting a mass clean up campaign around the town area.

“Especially around schools, if you go around the school compounds there is a lot of rubbish a lot of plastics…where all the mosquitos can breed,” he said.

Leausa said before the laboratory confirmation of chikungunya, the Ministry was focussing on targeted areas in regards to preventing the spread of the virus.

Now, with this confirmation he said they are casting a much wider preventative net, especially in the more densely populated areas.

“We are (also) doing the spraying,” said the D.G.

“We are also hoping that we can train some people to help with the spraying because we don’t have enough workers to do the spraying so we can teach them and then we can give them the chemicals."

“The W.H.O. has also offered their help with the chemicals and everything they have also offered some mosquito nets so we will look at that.”

He said in addition to this the M.O.H. was enforcing its surveillance and reporting so they can keep abreast of what is happening.

“So this is also good for our preparations (for the Small Island Developing States – S.I.D.S. conference),” he said.

In regards to S.I.D.S., when asked if it was being considered whether or not to restrict people coming to Samoa from the neighbouring American Samoa, Leausa said it would be very difficult to restrict such travel.

“We have given travel advice that if they are sick then please don't come here,” he said.

“We cannot force them to stop coming here, maybe that (can be) done at another level of government.”

“But we are trying to restrict the movement from Upolu to Savai’i.”

“So that it does not spread to Savai’i because there is no international port in Savai’i. where you can’t get a direct flight from Pago or direct boat from Pago to Savai’i.”

He added several parents had approached the Ministry for travel advice regarding their children who were due to compete in a tennis tournament in the territory.

Upon receiving the advice, the parents decided not to let their children attend the competition.

Finally, Leausa said he wants to reassure the public that the Ministry with the support of the government is doing everything they can.

“We are soliciting help from our development partners especially from the W.H.O. and the S.P.C.,” he said.

“And we are also asking the public to help us with source reduction to clean up and minimise the breeding sites for mosquitoes.”

He urges the public not to panic.

“This is why we wanted to update you we also want to reassure the public of what we are doing and also educate the public with the knowledge of what is happening,” he said.

“That we can all work together to help (prevent the further spread of) this disease.”