The mosquito-borne Chikungunya virus, already rampant in Jamaica, has spread to the Cayman Islands and other parts of the Caribbean.

The Caribbean Public Health Agency’s latest report, dated October 20, states that there were 59 confirmed cases of chikungunya in Jamaica, but medical professionals are saying that the prevalence of the virus is hugely under-reported.

Chikungunya is a viral disease transmitted to humans by infected Aedes Aegypti mosquitoes. Whilst it is rarely fatal for adults, the infection can cause death in infants, people with weakened immune systems, and vulnerable older people. The virus causes fever and severe joint pain and other symptoms can include: muscle pain, headache, nausea, fatigue and rash.

Giving up alcohol for a month can change people’s drinking habits in the long term meaning people drink less and get drunk less often, according to a study.

Research shows that committing to a month off alcohol – post Christmas – was more likely to lead to people moderating their drinking during the rest of the year and to saying no to a drink on social occasions or when feeling upset or anxious.

A survey of 3,800 people who completed a questionnaire before they gave up alcohol in January 2014, found that many of those going 31 days without alcohol experienced a number of positive side-effects, such as sleeping better, losing weight and feeling more energetic. More than three-quarters of people said they had saved money and felt a sense of achievement.

Commenting on the research, Prof Wallace, chief medical adviser to the charity Drinkaware, warned that people should not be complacent.

“It’s important not to assume that having a break from alcohol for a while means it’s OK to drink to excess the rest of the year. It’s also important to recognise that just because you can stop drinking alcohol for a period of time, it doesn’t mean you don’t need to continue to moderate your drinking in the long term.”

Since the index case in Mali of a young girl who traveled from Guinea and subsequently died of Ebola, a nurse has since succumbed to the virus. Separately, another male who travelled from Guinea, has died and diagnosed as an Ebola victim, together with the nurse who treated him.

A doctor from one of the main private clinic in Bamako, is as well infected. Several dozen responders and other contacts are under quarantine and are being monitored for signs of illness. In parallel, some fever controls have been put in place on the departure of Bamako airport.

An American doctor working in Sierra Leone has also been infected by the virus and should be transferred shortly to the US.
Canada and Mauritius have decided to close their borders to travelers coming from Ebola infected countries; this measure applies even for their own citizens.

In Niger, despite none Ebola case, local authorities have developed an awareness program in schools to inform populations about Ebola risks.

A Luxemburg satellite operator SES has also launched a free TV channel “Fight Ebola” to disseminate information on Ebola, to reach 20 million people in the region.

Despite a reach of over 5000 Ebola victims, MSF has reported a drop in Ebola patients occupying hospital beds in Liberia and it is postulated this is an indicator of a downward trend in numbers of Ebola cases. As a result, the country’s president, Dr. Ellen Sirleaf Johnson, announced the lifting of the state of emergency, permitting the re- opening of public markets and other activities.

Nevertheless, the nation’s medical infrastructure remains devastated and our travel recommendations remain unchanged. It is also strongly believed that the number of cases of Ebola is substantially underreported, especially in Sierra Leone. This may partly explain any apparent dip in case reports and it is considered premature to interpret this as a definite trend.

Recent experience again reconfirms the complete lack of medical resources in the countries of Sierra Leone, Guinea and Liberia available to treat foreigners with even minor illnesses. It should be expected that should travelers, expatriates or relief workers require medical care, they will have to be self-reliant and remain in private quarters until transportation out of the country can be arranged.

Limitations is available transportation, screening and exit restrictions may delay movement of patients in need of a formal medical care.

You will find on the following pages an information update about the evolution of the epidemic
Dr. Cai Glushak
International Chief Medical Officer