Home' Trinidad and Tobago Guardian : August 11th 2014 Contents "It (polio) came, we studied it, figured out how it
spread, educated people...along came the vaccine
and I think the last case of polio in the Caribbean
might have been in 1982 in Jamaica."
He said the region was accustomed to responding
to high public health alerts, citing the 2009 H1N1
influenza (swine flu) pandemic and the 2007 cricket
world cup as the most recent events that caused a
high level of awareness and preparedness in the
"I would say that we are accustomed. The region
has a high level of travel from different parts of the
world, and I would say the public health officials are
used to being faced with threats and there are systems
in place to deal with that."
However, Hospedales admitted the Caribbean was
struggling to deal with the Chikungunya virus, saying
Carpha planned to go back to the drawing board on
He said: "Our record is not so proud with Chikun-
gunya. We predicted that we would not do too well
because of the abundance of the mosquito vector.
"Over the years the vector, the aedes aegypti, has
become much more adapted. It is everywhere and
solid waste has gone up everywhere."
He added: "Many years ago people had screens
on their houses, but nobody does that anymore.
"ChikV has revealed to us that where vector-borne
diseases involving the aedes aegypti are concerned,
we are not well prepared. We need some new inno-
He said Carpha planned to have an expert meeting
in October to devise new strategies to tackle ChikV.
At the moment, according to the Ministry of Health,
there are 14 confirmed cases and 27 suspected cases
of ChikV in T&T.
Monday, August 11, 2014 www.guardian.co.tt Guardian
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Although the region is not yet fully pre-
pared, Hospedales is confident, based on
the Caribbean s track record for controlling
the spread of infectious diseases, that the
Caribbean is capable of containing Ebola
if it enters the region.
"If heaven forbid a case of Ebola arrives
here, I think we will do quite well in detect-
ing, investigating, and managing it. It may
be that a few people will get it but after, it
would be shut down and we ll be able to
"We are fairly confident, knowing our
member states, that widespread Ebola in
our community is not going to happen."
Saying the Caribbean had a proud track
record in controlling infectious diseases, he
recalled when cholera---a disease caused by
the water-borne bacterium Vibrio choler-
ae---emerged in South America in the early
1990s. "The region was on high alert, very
similar to what we are seeing now. Cholera
had spread from Ecuador, to Colombia then
to Venezuela and reached north-west
"I was part of the investigative team at
the time. We were able to rapidly do a study
to determine what the local risks and sources
of transmission were. There was intensive
education of the population on the impor-
tance of hand washing and boiling water
and chlorinating water with bleach.
"There were emergency meetings, sharing
of information among all the chief medical
officers and epidemiologists. As a result, it
never spread into the islands and it disap-
peared because we were able to control it."
He added the Caribbean was among the
world leaders in controlling vaccine-pre-
ventable infectious diseases like polio,
measles, smallpox, and German measles.
"In 1991, we became the first region in the
world to eliminate measles. We had the
Americans, the British, and the French com-
ing and saying How did you do that? So
we have punched above our weight in that
In the first half of the 20th century, he
said, poliomyelitis, a deadly and crippling
virus, was a major health concern in the
region, claiming the lives of many children.
Track record proven during Cholera threat
In this image taken on Saturday, a large billboard promoting the washing of hands to
prevent the spread of the deadly Ebola virus in Monrovia, Liberia. AP PHOTO
The Ministry of Health says it is currently review-
ing and updating its public health emergency plans
in light of the of the Ebola outbreak in West Africa.
In an e-mail to T&T Guardian, the ministry said:
"Over the years there have been many threats from
diseases such as cholera, H1N1 and Sars and contin-
gency plans have been developed for our health in-
"Should a case of Ebola be suspected in T&T, we
would execute these plans and procedures to ensure
that patients are appropriately cared for in a way
that minimises the potential for spread to other per-
sons. These plans include provisions for personal
protective equipment for health care workers, desig-
nated facilities for isolation of patients and other lo-
"Our public health emergency plans are being re-
viewed and updated in light of this new public health
The ministry said it continued to work with all
stakeholders to ensure international best practices
were followed at ports of entry, adding that there
was heightened vigilance for travellers arriving from
countries where Ebola was endemic.
The Ministry advised citizens to avoid non-essen-
tial travel to Sierra Leone, Guinea, and Liberia.
MINISTRY EBOLA PLANS:
The term Public Health Emergency of Interna-
tional Concern (PHEIC) is defined in the Interna-
tional Health Regulations (2005) as "an
extraordinary event" that is serious, unusual or un-
expected; carries implications for public health be-
yond the affected State's national border; and
requires immediate international action.
According to the WHO, under the PHEIC, all states
• Be prepared to detect, investigate, and manage
Ebola cases. This should include assured access to
a qualified diagnostic laboratory for Ebola.
• Provide travellers to Ebola-affected and at-risk
areas with relevant information on risks.
• Have the capacity to manage travellers from
known Ebola-infected areas, arriving at interna-
Continued from Page A6
He said although the risk was low, it
was important at this stage for authorities
to raise public awareness about the deadly
virus through public education campaigns.
Asked if the region had a laboratory to
test for Ebola, he said no, saying that type
of laboratory had a biosafety level of four,
the highest. "The Carpha laboratory is
biosafety level three. For a biosafety level
four pathogen like Ebola, the facilities used
would be in the US and Canada. So we
will work with those countries."
He added: "During the cricket world
cup there was a temporary biosafety level
four because thousands of people came
and it was necessary. Right now the assess-
ment of the risk of Ebola arriving here is
low, so the rationale for establishing a
biosafety level four diagnostic facility is
not so strong."
However, he said Carpha was in ongoing
discussions with health authorities in
Canada on the feasibility of establishing
a biosafety level four laboratory in the
Hospedales said Carpha, whose mission
was to provide strategic direction, in
analysing, defining and responding to pub-
lic health priorities of Caricom, held meet-
ings with all the chief medical officers in
the region, as well as epidemiology and
laboratory directors, aimed at strengthening
the region s preparedness for Ebola.
Hospedales: Ebola risk in region is low
Executive director of the Caribbean Public
Health Agency, Dr C James Hospedales.
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