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Ministry of Health Provides an Update on Monkeypox

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#TurksandCaicos, May 23, 2022 – The Ministry of Health and Human Services has been carefully monitoring reports of monkeypox which have been increasing and are being reported in multiple countries across Europe (Spain, Portugal, Germany, Belgium, France, the Netherlands, Italy and Sweden), the US, Canada and Australia.  12 countries which are not endemic for monkeypox, so far have reported at least 92 confirmed cases with 28 pending investigations.  More cases are likely to be reported as surveillance expands.

Although no cases have been reported in the Caribbean, it is important that persons are aware of the situation as it continues to evolve.

Monkeypox is a viral illness and is found in a number of countries in Central and West Africa.  The more recent news of spread to countries without known endemic disease is unusual.  Cases may occur in persons who have travelled from Nigeria or who have been in contact with persons with the confirmed illness.  Cases which have been reported since May 14 2022, have largely had no history of travel.

The UK Health Security Agency (UKHSA) has announced that the total number of monkeypox cases confirmed in England since 6 May is 20.  The UKHSA initially identified one case of monkeypox on 7th May 2022 in an individual with a history of recent travel to Nigeria.  Subsequently, additional infections have been identified, some of which have been linked and others which have been unrelated.  This spread as well as the occurrence of cases in Europe and other countries has suggested the possibility of community spread.   Active investigations are ongoing in countries which have identified cases including contact tracing, testing isolation etc. in order to prevent further spread.

The World Health Organization (WHO), held an emergency meeting on Friday 20th May 2022 to discuss the monkeypox outbreak.  WHO is working with affected countries in order to expand disease surveillance to find and support people who may be affected, and to provide guidance on how to manage the disease.

It is expected that more cases will be identified through surveillance with the possibility of additional countries being affected.

TCI residents returning from, or going to, countries where cases have been identified, are urged to be aware of the signs of infection and to seek medical help if they think they may be at risk.

 How the virus spreads

Monkeypox does not spread easily between people.  The virus spreads through close contact with an infected animal (rodents are believed to be the primary animal reservoir for transmission to humans), humans, or materials contaminated with the virus.  Human-to-human transmission occurs through large respiratory droplets and by direct contact with body fluids or lesion material.  Respiratory droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required.

The virus enters the body through broken skin (even if not visible), the respiratory tract, or the mucous membranes (eyes, nose, or mouth).

Person-to-person spread is uncommon, but may occur through:

  • contact with clothing or linens (such as bedding or towels) used by an infected person
  • direct contact with monkeypox skin lesions or scabs
  • coughing or sneezing of an individual with a monkeypox rash

Animal-to-human transmission may occur through a bite or scratch, preparation of wild game (in areas where the virus is present in animals such as Central and West Africa), and direct or indirect contact with body fluids or lesion material.

Individuals, particularly those who are gay, bisexual or MSM, are urged to be alert to any unusual rashes or lesions on any part of their body, especially their genitalia, and to contact a health services if they have concerns.

Monkeypox has not previously been described as a sexually transmitted infection, though it can be passed on by direct contact during sex. It can also be passed on through other close contact with a person who has monkeypox or contact with clothing or linens used by a person who has monkeypox.

 Symptoms

The incubation period is the duration/time between contact with the infected person and the time that the first symptoms appear. The incubation period for monkeypox is between 5 and 21 days.

Initial symptoms of monkeypox include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.

Within 1 to 2 days a rash can develop, often beginning on the face, then spreading to other parts of the body including the genitals.

The rash changes and goes through different stages – it can look like chickenpox or syphilis, before finally forming a scab which later falls off.

The illness tends to be mild and self-limiting within 2-4 weeks, however it can in some cases be severe particularly in persons with weakened immune systems and children. In some cases, affected persons may die.

 Treatment

Treatment for monkeypox is mainly supportive. The illness is usually mild and most of those infected will recover within a few weeks without treatment.

There is no specific vaccine for monkeypox, however, vaccines used against smallpox can be used for both pre and post exposure and is up to 85% effective in preventing monkeypox. People vaccinated against smallpox in childhood may experience a milder disease.

Anyone with unusual rashes or lesions on any part of their body, especially their genitalia, is advised to visit their health care provider, particularly anyone who; 1) traveled to countries where monkeypox cases have been reported 2) reports contact with a person who has a similar rash or received a diagnosis of confirmed or suspected monkeypox, or 3) is a man who has had close or intimate in-person contact with other men in the past month.

As the virus does not usually spread easily between people and the risk to the general public is expected to be low, however the public is advised to monitor the situation as it develops and obtain information from credible sources. The MOH should be notified of any suspected cases.

The Ministry of Health will continue to monitor developments and provide updates accordingly.

Caribbean News

Health City Surgeon Provides Hope for Critically Ill Cardiac Patients

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KINGSTON, Jamaica (August 10, 2023) – There is hope for patients suffering from critical cardiovascular issues in the Caribbean, reports one of the region’s leading cardiac specialists.

Addressing the 36th Caribbean Cardiac Society Conference last month in Kingston, Jamaica, Dr. Binoy Chattuparambil, Senior Consultant, Cardiovascular & Thoracic Surgery and Clinical Director at Health City Cayman Islands, highlighted the life-saving ECMO or extracorporeal membrane oxygenation process, a form of life support for patients, successfully and consecutively performed at the Caymanian facility.

“There is no reason for patients with reversible cardiac diseases (to) die because you can put them on ECMO and the technology is very good and our understanding (of it also) is very good,” Dr. Binoy told his peers, explaining that ECMO provides time for the body to rest and recover by doing the work of the heart and lungs.

Having saved countless lives with this technology at the Cayman Islands hospital, the respected surgeon cited a case of a child who is doing well following treatment with ECMO and transfer to the United States for a heart transplant: “Whether it is reversible pulmonary reasons or cardiac reasons, just put them on ECMO and the recovery is usually very good and we can save lives.”

In 2017, the hospital became the Caribbean’s first regional center to provide the advanced form of life support (ECMO). The hospital also installs artificial hearts or left ventricle assist devices (LVAD) for chronic or advanced heart failure patients for whom a transplant is unlikely to be readily available in the mainland United States. Health City anticipates that transplant services will be available in the Cayman Islands in the near future following the establishment of transplant laws and regulations.

The theme of the Kingston conference was “Serving and Saving the Hearts of our People Today, Tomorrow and Beyond!” and Dr. Binoy presented on “Enhancing Cardiac Surgery in the Region – Updates and Perspectives”.

The surgeon expressed his joy at seeing greater collaboration between cardiac surgeons and cardiologists throughout the region. “Now I see my cardiologists more often in our hybrid cath lab rather than outside,” said Dr. Binoy, who established the adult and pediatric cardiac programs at Health City Cayman Islands in 2014 and has overseen thousands of successful cardiac surgeries and procedures at the tertiary care hospital.

He revealed that there were no deaths or reinterventions from elective Coronary Bypass Surgery at Health City Cayman Islands and minimally invasive surgery has been successfully completed for most mitral valve defects. Additionally, aortic valve surgery has evolved over the past two decades from an open incision with a large scar to that of no incision and no scar.

Pulmonary thromboendarterectomy to treat chronic pulmonary thromboembolism is also another achievement at the Joint Commission International (JCI)-accredited institution. This procedure has been more frequently performed since the COVID-19 pandemic where patients often present with acute pulmonary embolism which can later present as chronic thromboembolic pulmonary hypertension.

In the specialized areas of pediatric and neonatal surgery, a variety of life-saving surgeries to correct defects in the heart, in collaboration with a pediatric interventional cardiologist, have been achieved at Health City Cayman Islands. Children from over 25 countries have been treated, including those families who have insufficient funds and are supported by various charities.

A broad spectrum of vascular surgery options with successful outcomes are also provided, including repair of major arteries in the chest and abdomen to treat aneurysms, and replacement of major arteries in the chest through minimally invasive or no-incision procedures.

Dr. Binoy concluded that Healthy City has “significantly contributed to the enhancement of the scope and landscape of cardiovascular surgery in the region”, and commended the Health City team for the excellent service that they have provided over the past nine years.

 

 

Photo Captions

Header: Dr. Binoy Chattuparambil addressing the cardiac conference in Jamaica.

Insert: Health City’s team at the conference included (from left): Sales and Marketing Specialist Ingrid Harris, Dr. Binoy and Rebekah Anne Brooks, Head of Marketing & Sales.

 

About Health City Cayman Islands

Health City Cayman Islands is a medically advanced tertiary hospital located near High Rock in the district of East End in Grand Cayman. The brainchild of internationally renowned heart surgeon and humanitarian Dr. Devi Shetty, it features a unique model of health care, built with a focus on the patient and rooted in innovative business models that allow the delivery of high-quality, affordable care. It is the largest hospital in the Caribbean to have earned the prestigious Gold Seal of Approval from Joint Commission International (JCI), the worldwide leader in accrediting the quality of health care. For more information visit www.healthcitycaymanislands.com.

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Caribbean News

Kidney transplant surgeries to be offered in St.Kitts and Nevis

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Rashaed Esson

Staff Writer

 

 

#St.KittsandNevis, August 5, 2023 – Kidney transplant surgeries will soon be offered in St. Kitts and Nevis as announced by Prime Minister Terrance Drew.

This development is a big one for the country’s health system and so it will provide kidney transplant services to citizens who are unable to travel overseas to acquire said services.  This was emphasized by Drew during the announcement at the Freedom FM’s Issues program held on Wednesday July 26th, 2023.

“These people are dying sooner than they should because they don’t have access to transplants.  I cannot allow our people to die when we have an opportunity to save their lives,” he highlighted.

Additionally, despite the country’s efforts to enhance health services for kidney patients, he urged residents to make better choices and take better care of their bodies adopting healthier habits such as frequent exercise, having balanced diets, maintaining blood pressure  and sugar levels etc.

But for those who fail to do so and fall victim to kidney ailments, he expressed that the aim is to have a something in place to help them.

“We want to make sure that they have an option for renal transplant and we are going to launch the renal transplant program.”

The kidney transplant surgeries will be provided at the country’s principal healthcare facility, the Joseph N France General Hospital.

In continuation, Drew further spoke to a team which will at some point in the near future, visit St. Kitts and Nevis from Canada to provide specialized training to the Haemodialysis Unit’s staff, to up the use of the recently acquired dialysis machines, further strengthening the nation’s fight against kidney diseases.

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Caribbean News

CARPHA Receives Automated Instruments to Assist in Gene Surveillance

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Port of Spain, Trinidad and Tobago, August 2, 2023 –  The Caribbean Public Health Agency (CARPHA) has received laboratory equipment to support genomic surveillance at its Medical Microbiology Laboratory for its  Member States.

The equipment was procured through the New Variant Assessment Platform, led by United Kingdom Health Security Agency (UKHSA).  This marks another milestone in CARPHA’s mission to strengthen its systems to better detect and respond to emerging diseases in the Caribbean region.

The items received are two liquid handling instruments namely, the Mosquito® HV, and the Dragonfly Discovery.

Dr. Joy St. John, Executive Director of CARPHA.  “Our overall collaboration with UKHSA has been very supportive to our work with our Member States. These devices have ensured further strengthening of CARPHA’s  gene sequencing capabilities, maintaining the cutting-edge array of laboratory services we provide to our Member States.”

“The acquisition of the instruments will serve to advance our laboratory productivity, shorten turnaround times, and reduce costs per sample.  Overall, the instruments will improve sample processing accuracy,” stated Dr. Michelle Hamilton, Head, Laboratory Services and Networks.

The Mosquito® HV is a highly accurate and precise multichannel pipetting system.  The Dragonfly Discovery enables innovative, low volume liquid dispensing that is compatible with a wide range of applications including molecular biology and genomics, and biochemical assays.

“Both devices will be used together to increase sequencing capacity by automating some of the preparation steps. These instruments will allow CARPHA to carry out multiple sample runs,  and switch between applications with minimal setup required,” explained Ms. SueMin Nathaniel, Manager of Laboratory Services at CARPHA.

The acquisition also included a supply of consumables. Laboratory staff at the CMML will receive training in the use of the instruments.

During the first half of 2023, CARPHA signed a Memorandum of Understanding with the UKHSA.  The agreement builds on a long-term collaboration to improve regional health security across the Caribbean. The MoU includes commitments to define strategies for combatting  infectious disease threats, non-communicable diseases, strengthening outbreak response, building laboratory and workforce capacity, and improving healthy safer tourism. There is specific emphasis on genomic surveillance of high priority pathogens which emerged as a new service during the COVID-19 pandemic.

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