Published On: Wed, Aug 17th, 2016

Time to stop visitors from Venezuela from entering the Caribbean without a treatment certificate

A child walks past a mural depicting Venezuela's President Chavez in CaracasIn 2001, Venezuela was so affected by dengue that it trickled down through the Caribbean and the Americas, which reached a crescendo by 2014. Almost every citizen throughout the Caribbean suffered from the disease; it proved unstoppable.

Dengue is still hampering Venezuela, according to official figures; over 12,000 cases of dengue have been reported in Venezuela in 2014 – compared to around 600 cases of chikungunya in 2012.

Followed then by chikungunya, which again reached its peak in Venezuela in 2015 and since has again spread through the Americas and Caribbean.

The Venezuelan government vowed to redouble efforts to combat the mosquito-borne diseases dengue fever and chikungunya virus. In 2014, President Nicolas Maduro announced Bs 416 million (US$66 million) would be invested in a national plan to tackle the two diseases. According to Maduro, the plan was to focus on providing “high-level preventive measures”, including fumigation. Maduro said the initiative will be a “fight for the health of the homeland”.

But the measures did not happen in most of Venezuela, the promises were simply not kept.

Maduro stated the government plans to spend over Bolivars 4 billion (US$600 million) on new medical equipment nationwide. That is also nonsense; he just does not have any money at all to invest in the health of the people. Clinics and hospitals are without drugs and dressings and equipment that does not work and outside contractors refuse to visit the country fearing for their physical safety and also catching serious diseases. Children and old folk are dying in droves, the health system unable to cope with them.
Neither dengue nor chikungunya are generally fatal, but both can pose serious health risks to those that catch them.

What is much more worrying is that malaria was eliminated in Venezuela 55 years ago but now it is gathering momentum again and soon all of Venezuela and surrounding countries will be ultra infested with it once again. Malaria can in many cases be fatal, once contracted it is a disease that affects the patient for the rest of their lives.

Venezuela was the first nation in the world to be certified by the World Health Organization for eradicating malaria in its most populated areas, beating the United States and other developed countries to that milestone in 1961.

Venezuela had the most human malaria cases in Latin America before 1936. During 1891–1920, malaria was endemic to >600,000 km2 of Venezuela; deaths from malaria substantially reduced the population during 1891–1920 (1). No pathogen, including influenza virus (1918 pandemic), caused more deaths than malaria during 1905–1945. Early malaria epidemics had mortality rates of 60–70 deaths/1,000 persons; rates were as high as 531 and 1,125 deaths/100,000 persons in Carabobo and Cojedes States in 194.

It was DDT that eliminated malaria, but that is now a banned substance and we have nothing today as effective.

In the Caribbean we must make urgent provision for what we must certainly expect to be a major Venezuelan export to all the Caribbean islands and the Americas. It all goes back to failing to get control of the mosquito problem and quite simply having no money to do that.

One thing we can be sure of if malaria comes to the Caribbean as a pandemic we can say goodbye to the tourism industry as we know it.

One thing we can be even more than sure of, it’s on the way.

The risks to health whilst travelling in Venezuela will vary between individuals and many issues need to be taken into account, e.g. activities abroad, length of stay and general health of the traveler. It is recommended that you consult with your General Practitioner or Practice Nurse 6-8 weeks in advance of travel. They will assess your particular health risks before recommending vaccines and /or antimalarial tablets. Some of the problems experienced by travelers cannot be prevented by vaccinations and other preventive measures need to be taken.

• Courses or boosters advised for Venezuela: Hepatitis A; Tetanus.
• Other vaccines to seriously consider: Diphtheria; Rabies; Typhoid; Yellow Fever.

Malaria is a serious and sometimes fatal disease transmitted by mosquitoes. You cannot be vaccinated against malaria.

Malaria precautions

Malaria risk is present throughout the year in all areas. Risk is highest in Amazonas, and Bolivar states (including Angel Falls). Variable risk is found in Anzoategui, Delta Amacur, Apure, Monagas, Sucre and Zulia states. There is a lower risk in other areas including Caracus and Margarita Island.

Malaria precautions are essential. Avoid mosquito bites by covering up with clothing such as long sleeves and long trousers especially after sunset, using insect repellents on exposed skin and, when necessary, sleeping under a mosquito net.

Check with your doctor or nurse about suitable antimalarial tablets.

High risk areas: atovaquone/proguanil OR doxycycline OR mefloquine is usually advised. Antimalarials are not normally advised for day trips to Angel Falls but would be advised for longer stays.

Variable risk areas: chloroquine and/or Proguanil is advised.

Low risk: antimalarial tablets are not usually advised.

If you have been travelling in a malarious area and develop a fever seek medical attention promptly. Remember malaria can develop even up to one year after exposure.

If travelling to high risk malarious areas, remote from medical facilities, carrying emergency malaria standby medication may be considered.

By Peter Binose

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