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Although the Zika virus causes predominantly mild symptoms, this mosquito-borne disease has become the newest public health challenge. Meningoencephalitis, myelitis, Guillain-Barré syndrome (GBS) associated with deglutition disorders, arrhythmia, cardiac arrest, myocardial infarction, dysautonomia and microcephaly in new born babies are among the most serious recorded complications (1).
The first case of Zika in Martinique, French West Indies, was diagnosed in December 2015. To date, this country of 400 000 inhabitants has recorded over 26 600 suspected cases of Zika virus infection, with approximately 1,500 estimated cases per week, including 22 cases of GBS, with Zika present in urine in 14 of them. Among 255 pregnant women who tested positive, only two cases of microcephaly have been identified. One elderly patient died.
As with other infectious diseases that have hit us in the past such as dengue, chikungunya, leptospirosis, H1N1 influenza, cholera, measles, malaria, and the like, Zika reminds us of how connected we all are (3). The increase in international travel makes us aware that no borders are secure from the threat of diseases, especially infections ones. Health issues can become a global problem, where there are no longer strong or weak nations.
The Zika virus has become the newest public health challenge. It must be confirmed by laboratory tests (reverse-transcriptase polymerase chain-reaction assays (RT PCR) blood and urine and cerebrospinal fluid (CSF) (2). The goal is that countries with access to more advanced facilities assist others in the fight against this virus. Caribbean governments have to increase collaboration with organizations such as the Pan American Health Organization (PAHO), the Caribbean Community (CARICOM), the Caribbean Public Health Agency (CARPHA), and the Organization of Eastern Caribbean States (OECS), to reduce risks to our populations, and provide early management in affected countries. There is an urgent need for a collaborative approach through medical cooperation.
Medical cooperation has always played a major role in the improvement of healthcare in the Caribbean, particularly through increasing collaboration and promoting cooperation among nations (4). In 1984, there was collective action to promote the health of the Caribbean people, through the formation of the Caribbean Cooperation in Heath (CCH) (4). There has been improvement in important health indicators such as maternal and child health, and immunization. However, much more needs to be done in small countries with fragile economies. These countries are particularly vulnerable when hit by recurrent tropical storms, as shown by the recent devastation occurring in Dominica, where diseases such as dengue, leptospirosis, chikungunya, and Zika emerged. Governments in the Caribbean need to mobilize resources to stop this latest virus.
The University Hospital of Martinique has already initiated regional collaboration by way of assistance to Caribbean colleagues, to fight against this virus and to also share experiences and protocols to improve management techniques. In March 2016, 20 medical doctors from 15 Caribbean countries ranging from Jamaica to Trinidad & Tobago participated in a symposium on Zika management, in Martinique. This was the first time that the English-speaking medical profession had been hosted at such an event. The participants expressed their satisfaction with the programme, and agreed on the applicability of the knowledge gained to addressing the management of the outbreak in their respective territories. From the standpoint of the University Hospital, the Zika outbreak provides yet another opportunity to support neighbouring, Caribbean countries through training, teaching, and the provision of human resources (4).
We declare no competing interests.
Dabor Resiere1,2 , Ruddy Valentino1, Jean Louis Fergé1 , Keats Compton2 , Gilles Guerrier2, André Cabié 3 , and Hossein Mehdaoui1
1 Intensive Care Unit, University Hospital, Fort-de-France, Martinique, France
2 Caribbean Doctors Association
3 Infectious and Tropical diseases Unit, Universitary Hospital of Martinique, Fort de France, France
1. Cao-Lormeau V, Blake A, Mons M, Lastère S, Roche C, Vanhomwegen J, et al. Guillain-Barré syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study. The Lancet. 2016. [ePub ahead of print]. http://dx.doi.org/DOI: 10.1016/S0140-6736(16)00562-6 .
2. Rozé B, Najioullah F, Fergé J, Apetse K, Brouste Y, Cesaire R, Fagour C, Fagour L, Hochedez P, Jeannin S, Joux J, Mehdaoui H, Valentino R, Signate A, Cabié A, on behalf of the GBS Zika Working Group. Zika virus detection in urine from patients with Guillain-Barré syndrome on Martinique, January 2016. Euro Surveill. 2016;21(9):pii=30154. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.9.30154
3. Fauci AS, Morens DM. Zika virus in the Americas — yet another arbovirus threat. N Engl J Med 2016; 374: 601-4.
4. Resiere D, Valentino R, Lucron H, et al. Inter-regional medical cooperation in the Caribbean: lessons from the ongoing cooperation between Martinique, St Lucia, and Dominica. WIMJ Open 2014; 1: 26.
Competing interests:
No competing interests
15 June 2016
Dabor Resiere
Intensivist
Dabor Resiere1,2 , Ruddy Valentino1, Jean Louis Fergé1 , Keats Compton2 , Gilles Guerrier2, André Cabié 3 , and Hossein Mehdaoui1
Zika virus infection: a new challenge for ongoing French medical cooperation in the Caribbean
Although the Zika virus causes predominantly mild symptoms, this mosquito-borne disease has become the newest public health challenge. Meningoencephalitis, myelitis, Guillain-Barré syndrome (GBS) associated with deglutition disorders, arrhythmia, cardiac arrest, myocardial infarction, dysautonomia and microcephaly in new born babies are among the most serious recorded complications (1).
The first case of Zika in Martinique, French West Indies, was diagnosed in December 2015. To date, this country of 400 000 inhabitants has recorded over 26 600 suspected cases of Zika virus infection, with approximately 1,500 estimated cases per week, including 22 cases of GBS, with Zika present in urine in 14 of them. Among 255 pregnant women who tested positive, only two cases of microcephaly have been identified. One elderly patient died.
As with other infectious diseases that have hit us in the past such as dengue, chikungunya, leptospirosis, H1N1 influenza, cholera, measles, malaria, and the like, Zika reminds us of how connected we all are (3). The increase in international travel makes us aware that no borders are secure from the threat of diseases, especially infections ones. Health issues can become a global problem, where there are no longer strong or weak nations.
The Zika virus has become the newest public health challenge. It must be confirmed by laboratory tests (reverse-transcriptase polymerase chain-reaction assays (RT PCR) blood and urine and cerebrospinal fluid (CSF) (2). The goal is that countries with access to more advanced facilities assist others in the fight against this virus. Caribbean governments have to increase collaboration with organizations such as the Pan American Health Organization (PAHO), the Caribbean Community (CARICOM), the Caribbean Public Health Agency (CARPHA), and the Organization of Eastern Caribbean States (OECS), to reduce risks to our populations, and provide early management in affected countries. There is an urgent need for a collaborative approach through medical cooperation.
Medical cooperation has always played a major role in the improvement of healthcare in the Caribbean, particularly through increasing collaboration and promoting cooperation among nations (4). In 1984, there was collective action to promote the health of the Caribbean people, through the formation of the Caribbean Cooperation in Heath (CCH) (4). There has been improvement in important health indicators such as maternal and child health, and immunization. However, much more needs to be done in small countries with fragile economies. These countries are particularly vulnerable when hit by recurrent tropical storms, as shown by the recent devastation occurring in Dominica, where diseases such as dengue, leptospirosis, chikungunya, and Zika emerged. Governments in the Caribbean need to mobilize resources to stop this latest virus.
The University Hospital of Martinique has already initiated regional collaboration by way of assistance to Caribbean colleagues, to fight against this virus and to also share experiences and protocols to improve management techniques. In March 2016, 20 medical doctors from 15 Caribbean countries ranging from Jamaica to Trinidad & Tobago participated in a symposium on Zika management, in Martinique. This was the first time that the English-speaking medical profession had been hosted at such an event. The participants expressed their satisfaction with the programme, and agreed on the applicability of the knowledge gained to addressing the management of the outbreak in their respective territories. From the standpoint of the University Hospital, the Zika outbreak provides yet another opportunity to support neighbouring, Caribbean countries through training, teaching, and the provision of human resources (4).
We declare no competing interests.
Dabor Resiere1,2 , Ruddy Valentino1, Jean Louis Fergé1 , Keats Compton2 , Gilles Guerrier2, André Cabié 3 , and Hossein Mehdaoui1
1 Intensive Care Unit, University Hospital, Fort-de-France, Martinique, France
2 Caribbean Doctors Association
3 Infectious and Tropical diseases Unit, Universitary Hospital of Martinique, Fort de France, France
Corresponding author: Dabor.resiere@chu-fortdefrance.fr
1. Cao-Lormeau V, Blake A, Mons M, Lastère S, Roche C, Vanhomwegen J, et al. Guillain-Barré syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study. The Lancet. 2016. [ePub ahead of print]. http://dx.doi.org/DOI: 10.1016/S0140-6736(16)00562-6 .
2. Rozé B, Najioullah F, Fergé J, Apetse K, Brouste Y, Cesaire R, Fagour C, Fagour L, Hochedez P, Jeannin S, Joux J, Mehdaoui H, Valentino R, Signate A, Cabié A, on behalf of the GBS Zika Working Group. Zika virus detection in urine from patients with Guillain-Barré syndrome on Martinique, January 2016. Euro Surveill. 2016;21(9):pii=30154. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.9.30154
3. Fauci AS, Morens DM. Zika virus in the Americas — yet another arbovirus threat. N Engl J Med 2016; 374: 601-4.
4. Resiere D, Valentino R, Lucron H, et al. Inter-regional medical cooperation in the Caribbean: lessons from the ongoing cooperation between Martinique, St Lucia, and Dominica. WIMJ Open 2014; 1: 26.
Competing interests: No competing interests