Growing numbers of dengue cases in the U.S. Virgin Islands since November highlight the need to fight the mosquitoes that carry the illness by draining stagnant water and repairing screens, Health Commissioner Darice Plaskett told the Senate during committee hearings Thursday.
Plaskett testified to the Health, Hospital, Human Services and Veterans’ Affairs Committee on St. Thomas that there was “a noted increase” in the number of reported dengue cases in November, “in addition to verbal reports/complaints among residents and multiple schools."
Reports of suspected and confirmed dengue cases increased "despite the lack of a robust and consistent dengue surveillance system," Plaskett said. Surveillance was hampered because the Health Department was without an epidemiologist for over a year, she said.
The numbers of reported cases spiked throughout the territory in November, and have remained especially high on St. Croix, according to data Plaskett provided the committee. In October, nine cases were reported on St. Croix, six on St. John and seven on St. Thomas – higher numbers than any earlier months in 2012. Then in November, 42 cases were reported on St. Croix, 21 on St. John and 24 on St. Thomas.
St. Croix saw 43 cases reported in December, 28 in January and 47 in February, to make 180 reported cases in the last 12 months.
Reports fell on St. John and St. Thomas after November. St. John reported five cases in February and 40 cases for the 12-month span.
St. Thomas saw 15 reported cases in February, and 77 for the 12 months.
Those numbers are likely lower than the real numbers of dengue cases in the community, Plaskett said.
With no vaccine or treatment for dengue, avoiding mosquito bites is the best strategy, she said.
"The best way to reduce mosquitoes is to eliminate the places where the mosquito lays her eggs, like artificial containers that hold water in and around the home. Outdoors, clean water containers like pet and animal watering containers, flower planter dishes or cover water storage barrels. Look for standing water indoors such as in vases with fresh flowers and clean at least once a week," Plaskett said, urging residents to use repellent and make sure window and door screens are secure and without holes.
If someone is infected, take precautions to prevent mosquitoes from biting them and spreading the illness further, she said.
The committee also received an update from Schneider Regional Medical Center on its kidney dialysis unit. St. Thomas, like St. Croix, is seeing an ever growing number of dialysis patients. While Schneider is expanding its dialysis capacity, the space and funding it has right now are not enough to meet the growing need, acting Chief Executive Officer Angela Rennalls-Atkinson told the committee.
In 2010 Schneider had an average of 76 dialysis patients. In 2011 it was 87, and in 2012 it was 99, Rennalls-Atkinson said. The dialysis unit provided 12,823 treatments in 2011 and 14,848 treatments in 2012. Part of the increase is due to a decreased mortality rate, she said.
Dr. Richard Schluessel, medical director of the hemodialysis program, said the vast majority of kidney disease cases requiring dialysis stem from untreated hypertension and diabetes.
"At present, the unit is at the maximum capacity of 101 patients," Rennalls-Atkinson said. Due to constraints on money, space, equipment and personnel, "we are unable to accommodate requests for treatment from visitors or patients wishing to relocate to the Virgin Islands," she said, noting there is currently a waiting list with 51 patients requesting transient treatment and 15 patients requesting transfers from other facilities to the Schneider unit.
Right now the hospital has 23 dialysis machines, "two of which require immediate retirement," Rennalls-Atkinson said. The hospital needs over $200,000 in new equipment, she said.
Growth will be difficult, due to space constraints, she said. There is space next to the unit which would allow for enough units to treat 12 to 18 new patients, but "considering the current waiting list and approximately 25 known patients who will be requiring treatment within the next year, additional plans must be made to accommodate both residents and visitors alike."
No votes were taken at the information gathering hearing. Present were Committee Chairman Clarence Payne III, Sens. Kenneth Gittens, Nereida "Nellie" Rivera-O’Reilly, Craig Barshinger, Tregenza Roach and Judi Buckley. No committee members were absent.
