Extreme vigilance and measures to combat mosquitoes are defining recent efforts by Cuban health authorities in the campaign to prevent the spread of viruses transmitted by the Aedes aegypti mosquito (including Zika, dengue, chikungunya and yellow fever).
On March 2, the Cuban Ministry of Public Health reported that the first imported case of Zika virus had been detected in a 28 year old Venezuelan doctor, who remains quarantined with a further 37 high risk individuals. Given this situation, health authorities are increasing vigilance efforts and examining all individuals suffering from non-specific fever. Controls have also been strengthened at entry and exit points to the country as well as airports.
28 imported cases of chikungunya were detected in 2015, while reports of dengue were registered in 55 municipalities, predominantly in the most densely populated zones across the island’s 15 provinces, demonstrating the high risk of infection to the population.
Although Cuba has been working intensely over the last month to eradicate the aedes aegypti mosquito, unsatisfactory fumigation efforts, adverse environmental and weather conditions and a lack of cooperation by the population, have contributed to continuing high levels of infestation.
In the call made by President Raúl Castro, February 22, 2016, to prevent the spread of Zika, he highlighted that the Party and government leadership has adopted an action plan – carried out by MINSAP – to combat the vectors.
Tasks include extreme vigilance to reduce environmental risks; the strengthening of sanitary controls at entrance and exit points to the country; guaranteeing medical and hygienic-epidemiological attention; progressively training public health workers in control and prevention measures; as well as conducting a comprehensive public awareness campaign, instructing the population in timely control and further prevention measures.
Dr. Roberto Morales Ojeda, minister of Public Health, highlighted the importance of applying biolarvacides to water containers in all homes and communal areas; carrying out various cycles of aerial and home-to-home fumigation; keeping roof terraces, basements, elevator shafts, areas of rust deposits, glens, rivers and water areas clean; keeping potable water tanks covered; repairing leaks in health facilities; as well as providing the population with products to eradicate mosquitoes.
Such efforts are being supported by an additional 9,000 Revolutionary Armed Forces (FAR) personnel, and over 200 National Revolutionary Police (PNR) officials, all equipped with the technical means to advance anti-mosquito and sanitization efforts.
“The participation of the armed forces,” noted the minister “will be decisive in this intensive stage given their discipline and organization. Their efforts also demonstrate to the population that effective efforts to eliminate mosquitoes and their breeding sites are being carried out.”
Morales Ojeda stressed the importance of community participation to tackle environmental hazards, with an emphasis on personal vigilance noting that those who fail to cooperate with sanitation efforts will be heavily penalized.
Tourists and visitors arriving to Cuba are being requested to submit a Health Statement at entry and exit points to the country, while stringent vigilance measures are also being applied in order to identify individuals with symptoms of the aforementioned diseases, and ensure their admittance to medical institutions for treatment. Cuban collaborators serving abroad are also being closely monitored and undergoing regular temperature checks, while those working in African countries are required to present up-to-date vaccination certificates.
Although there is no proven link between the Zika virus and microcephaly in newborns, Dr. Roberto Álvarez Fumero, head of MINSAP’s Maternal-Infant Program, has advised pregnant women to visit their family doctor as soon as possible in order to start the pregnancy checks and maternity-infant monitoring processes, which will “enable them to benefit from pre-natal controls,” he stated.
In order to improve immune defense, the pediatric specialist recommends women of child-bearing age take folic acid, whether they are trying for a baby or not. He also explains that Cuban medical services are extending precautions to pregnant women presenting with fever or who live in areas with high levels of the Aedes aegypti mosquito.
One such measure includes performing the third trimester ultrasound at 28 weeks (in Cuba the first ultrasound is performed in the first 12 weeks and the second between 18 and 22 weeks) as well as a 15 day check-up performed by specialists.
The doctor also advised intermittent consultations by generic specialists to be carried out on newborns identified as suspected cases, in order to rule out other possible causes, as well as virological studies. The information obtained from these investigations is available to international organizations, noted the MINSAP official.
Álvarez Fumero states that the Cuban healthcare system, and in particular its Maternal-Infant Program, are ready and able to detect infection in a timely manner and thus reduce the risk of microcephaly.
The region is facing a complex epidemiological situation given the spread of the Zika virus, and as such Cuba is carrying out efforts to prevent infection and reduce infestation rates, an immense task for this first half of the year.