Zika, Cuba travel and Miami: a reflection

 Cuban officials have a poor record on timely reporting of epidemics

According to the August 17, 2016 Department of Defense Global Zika Surveillance Summary in the Western Hemisphere (spanning January 1, 2015 through August 13, 2016) there have been 106,246 confirmed cases of Zika with 457,894 suspected cases and 1,817 microcephaly cases. 44 countries have been impacted by Zika virus.

Brazil has borne the brunt of the outbreak reporting 78,421 cases of confirmed Zika infection and 1,749 microcephaly cases. This was followed by 8,682 cases in Colombia with 22 cases of microcephaly and Puerto Rico with 8,766 cases and one microcephaly case. The Dominican Republic has 252 cases confirmed.

Meanwhile Cuba is now reporting three confirmed cases and 30 cases brought in from abroad while having mounted a propaganda campaign in February 2016 claiming to have deployed 9,000 troops in a preventive battle against Zika reported The Guardian.

Daniel Chang of The Miami Herald reported on August 17, 2016 in the article "How Cuba is fighting Zika" in the first paragraph a claim that should raise concerns:

"After Cuba was ravaged in 1981 by an epidemic of hemorrhagic dengue fever — a mosquito-borne illness — the island nation’s communist government launched an aggressive response that created the framework for its reportedly successful fight against Zika, according to an article published Wednesday in the scientific journal Nature."

Tragically, the so-called aggressive response to dengue by 1997 involved arresting at least one doctor for enemy propaganda who correctly warned of a Dengue outbreak sentenced him to eight years in prison then forced him into exile after an international outcry.  Eventually when the bodies started to pile up and it was no longer possible to cover up the epidemic the regime admitted they had a problem.

This pattern of denial and lack of transparency was repeated with a cholera outbreak in 2012. With Zika the Castro regime can fall back on a tried and true method that it has also used to reduce infant mortality rates and that is the aggressive use of abortion, even without the mother's consent. The dictatorship will be able to cover up cases of microcephaly with abortions.

 Consider that 3.5 million people visited Cuba in 2015 and tourism to the island in 2016 so far is 15 percent higher than last year. The crisis in Venezuela is impacting Cuba economically making tourism a priority source of hard income. In the past the regime has demonstrated a resistance to reporting or it has under-reported on the outbreaks of diseases in the island. The trouble is that the lack of transparency and the spread of the virus will pose a danger to tourists visiting the island who not being advised of the danger may return home as asymptomatic carriers of the virus spreading it in their country unknowingly.

According to the New York Times there are 491 cases in New York City alone, four believed to have been contracted through sex, accounting for about a quarter of all Zika cases in the United States, and the blame is being placed on the Dominican Republic and Puerto Rico, but what if Cuba is under reporting the number of infections while the number of tourists from the United States increases?

Consider for a moment that according to The Miami Herald on August 24, 2016 Florida has reported 43 local Zika infections, with almost all in Miami-Dade except for one case each in Broward and Pinellas counties and the two in Palm Beach. The entire state of Florida has reported 523 travel-related Zika cases and 70 infections involving pregnant women.

Considering all this can U.S. health officials rely on their counterparts in Havana to accurately diagnose cases of Zika and report on the Zika situation on the ground if they are caught up in a political narrative that possibly presents them with the choice of under reporting or risking prison?

Read more here: http://www.miamiherald.com/news/health-care/article97582607.html#storylink=cpy

Read more here: http://www.miamiherald.com/news/health-care/article96170442.html#storylink=cpy

Centers for Disease Control Outbreak Notice: Cholera in Cuba

Outbreak Notice
Cholera in Cuba

This information is current as of today, January 31, 2013 at 20:54 EST
Released: January 31, 2013

What Is the Current Situation?

On January 6, 2013, The Cuban Ministry of Health (MoH) confirmed an outbreak of cholera in Havana, the country’s capital. A total of 51 laboratory-confirmed cases of cholera have been reported in Havana.

In July 2012, the Cuban MoH confirmed the country’s first cholera outbreak in more than a century. That outbreak was in the city of Manzanillo, in eastern Granma province, and was declared over in late August. Cuba’s cumulative number of confirmed cholera cases since July 2012 is now more than 500.

What Is Cholera?

Cholera is a bacterial disease that can cause diarrhea and dehydration. Cholera is most often spread through eating contaminated food or drinking contaminated water. Water may be contaminated by the feces of an infected person or by untreated sewage. Food may be contaminated by water containing cholera bacteria or by being handled by a person ill with cholera.

How Can Travelers Protect Themselves?

Most travelers are not at high risk of getting cholera. However, travelers to an area with a known outbreak should take steps to avoid getting sick. (See below.) The vaccine to prevent cholera is not available in the United States.
Travelers can prevent cholera by following these 5 basic steps:

1) Drink and use safe water.*

• Bottled water with unbroken seals and canned or bottled carbonated beverages are safe to drink and use.
• Use safe water to brush your teeth, wash and prepare food, and make ice.
• Clean food preparation areas and kitchenware with soap and safe water and let dry completely before reuse.

*Piped water sources, drinks sold in cups or bags, or ice may not be safe. All drinking water and water used to make ice should be boiled or treated with chlorine.

To be sure water is safe to drink and use:

• Boil it or treat it with water purification tablets, a chlorine product, or household bleach.
• Bring your water to a complete boil for at least 1 minute.
• To treat your water, use water purification tablets—brought with you from the United States or a locally available treatment product—and follow the instructions.
• If a chlorine treatment product is not available, you can treat your water with household bleach. Add 8 drops of household bleach for every 1 gallon of water (or 2 drops of household bleach for every 1 liter of water) and wait 30 minutes before drinking.
• Always store your treated water in a clean, covered container.

2) Wash your hands often with soap and safe water.*

• Before eating or preparing food
• Before feeding your children
• After using the bathroom
• After changing diapers
• After taking care of someone ill with diarrhea

* If no soap is available, use an alcohol-based hand sanitizer containing at least 60% alcohol.

3) Use toilets; do not defecate in any body of water.

• Use toilets, latrines, or other sanitation systems, such as chemical toilets, to dispose of feces.
• Wash hands with soap and safe water after using the bathroom.
• Clean toilets and surfaces contaminated with feces by using a solution of 1 part household bleach to 9 parts water.

4) Cook food well (especially seafood), keep it covered, eat it hot, and peel fruits and vegetables.*

• Boil it, cook it, peel it, or leave it.
• Be sure to cook shellfish (such as crabs and crayfish) until they are very hot all the way through.
• Do not bring perishable seafood back to the United States.

*Avoid raw foods other than fruits and vegetables you have peeled yourself.

5) Clean up safely—in the kitchen and in places where the family bathes and washes clothes

• Wash yourself, your children, diapers, and clothes at least 30 meters away from drinking water sources.

http://wwwnc.cdc.gov/travel/notices/outbreak-notice/cholera-cuba.htm?s_cid=bb-th-twitter-001


Previous posts on cholera in Cuba:

• Totalitarianism in the Time of Cholera in Cuba January 10, 2013
• Cholera, Dengue and Totalitarianism in Cuba  August 11, 2012
• Cholera and the Cuban Health Care System July 7, 2012

Totalitarianism in the Time of Cholera in Cuba

International Media Mostly Silent on Cholera Outbreak in Cuba

Cholera

Update, January 13, 2013: BBC News bureau in Havana breaks silence: Cholera fear in Cuba as officials keep silent By Sarah Rainsford

Its a sad state of affairs that one has to learn about a Cholera epidemic by following the twitter feeds of independent activists and journalists in Cuba because the international press with bureaus there prefer to remain silent in order to avoid being expelled from the island. The Cholera outbreak has reached Havana and the reason we know it is thanks to independent journalists.

Tonight the independent journalist, Ivan Hernandez Carrillo tweeted:

The Castro Tyranny prefers Cubans dying of cholera then publish in their totalitarian communications media on the epidemic that is plaguing Cuba. They have reported to me that the regime is taking the most severe cholera cases to the Pedro Kourí Tropical Medicine Institute. Despite all the preventive measures or "band-aids" that the tyranny has underway to prevent more Cholera, it has still not made ​​it public.

Yoani Sanchez hours earlier had tweeted the following: Official sources keep silent on the subject that most of the inhabitants of several Havana neighborhoods are worried about: Cholera

First learned that there was a Cholera outbreak on June 29, 2012 thanks to reporting done by independent journalists on the island. The official media finally acknowledged the health emergency on July 3, 2012 and the international media reported on it days later in early and mid July.

Trying to investigate the epidemic has had serious consequences. Two dissidents died in what appears to have been an "accident" provoked by a state security vehicle while visiting the Bayamo province which was at the heart of the outbreak on July 22, 2012.

Another journalist, who had reported on the Cholera outbreak, is currently in prison and suffering from high fevers and denouncing the lack of medical attention.

On August 28, 2012 the regime's media announced that the outbreak was over and the international media reported it.

Despite regime claims, following Hurricane Sandy's landfall on October 25, 2012 it was evident that Cholera was still a problem in Cuba and on December 10, 2012 The Miami Herald reported on how the Cuban government was remaining silent about the deadly cholera outbreak.

There is a sad reality that many refuse to recognize. The lack of human rights in Cuba, and in particular of a free and independent press, also has consequences on the public health front.

The dictatorship has preferred to remain silent on the worsening situation with regards to Cholera in Cuba rather than confront it publicly and have it impact international tourism to the island. The regime is running the risk of another kind of outbreak in Cuba; one of rage before the half measures and official silence in the face of what appears to be evolving into an epidemic.