…in light of outbreak in Venezuela
HEALTH Minister, Dr. Leslie Ramsammy, said the health sector workers have stepped up efforts to improve vigilance, in light of an outbreak of cholera in neighbouring Venezuela. “We have been monitoring the situation in Venezuela… we have no confirmation of deaths…all of our health care facilities have the medical supplies to respond to this,” he said.
Ramsammy stressed that Guyana is not on the ‘alert’, as was reported in some sections of the media.
In public health language, the word alert translates into a more serious situation, and would mean that Guyana would have to report to the World Health Organisation (WHO) that the country is on ‘alert’.
“We are being cautious and are monitoring the situation carefully,” the minister said.
To date, reports are that there is confirmation of 111 imported cases from the Dominican Republic.
“Our major focus before was on the ports of entry such as the airports; but now that it is closer to home, we have to look more closely at our borders…it means that we have to pay closer attention to health centres in Region One (Barima/ Waini),” he said.
Currently, he noted that there is daily reporting, as well as checking.
Ramsammy said, “We will be in direct contact with the major health centres and hospitals in Region One…we are not just waiting for them to report. It is a two-way contact to ensure the best surveillance.”
Together with cases in Haiti, starting in the 41st epidemiological week in 2010, these are the first large-scale cases in the Americas since 1994.
In the Region of the Americas during 2009, 17 cases of cholera (all imported) were reported from Canada and the USA (12 cases), and Paraguay, with a small cluster of five cases with no deaths.
No significant activity with regard to cholera was reported for 2010 until the situation in earthquake-ravaged Haiti developed.
In the 41st epidemiological week of 2010, Haiti reported an increase of acute diarrhoeal diseases in the Department of Artibonite and in the Central Department.
In week 42, the isolation of Vibro cholera O-1 serotype Ogawa was confirmed in a sample of hospitalized patients. Artibonite is traditionally a rice producing district that was overwhelmed by refugees from the earthquake ravaged capital area living with relatives since January 2010.
During the 47th week,The Dominican Republic and the United States reported imported cases of cholera from Haiti, while Venezuela now reports 111 imported cases from the Dominican Republic. Other cases from the source in The Dominican Republic were reported in Mexico, Spain and the United States.

Response Started
According to Ramsammy, it was then that the Ministry of Health developed a ‘Stop Cholera’ plan for Guyana and began its implementation epidemiological week 44.  The plan consists of a number of measures, including moves to:
* strengthen port vigilance and border area surveillance for all inbound travellers;
* upgrade the national syndromic surveillance system to enhance daily reports from sentinel sites around the capital, and in strategic areas such as Regions One, Two (Pomeroon/ Supenaam), Six (East Berbice/ Corentyne) and Nine (Upper Takutu/ Upper Essequibo);
* commence the development and implementation of a revised plan to manage diarrhoeal disease nationally, with emphasis on oral rehydration therapy, and management of dehydration;
* enhance the capacity of the national laboratory system to test for and confirm cholera from stool samples;
* stock all the essential medicines and supplies needed to manage cholera at all health facilities;
* develop and implement plans, along with several stakeholders (PAHO/WHO, UNICEF and GWI), to improve sanitation and hygiene nationwide; and
* develop and implement an awareness campaign to educate the public on the risks of diarrhoea, management of cases and control measures.
According to Ramsammy, the public awareness leg of the Health Ministry’s response will be stepped-up to ensure that the Guyanese public is up to speed and is not at risk of any kind.
“I want to assure the public that the Ministry of Health is being very vigilant. There is no reason for anyone to be fearful,” he said.