WHO calls for enhanced vigilance and community cooperation
THE World Health Organization (WHO) has confirmed that the diarrhoea outbreak spreading through the country since November 2015 is caused by rotavirus, a highly infectious virus that can cause an outbreak which is difficult to control.
Symptoms of rotavirus infection include severe watery diarrhoea, often with vomiting, fever, and stomach pain.
Infants and young children under 5 years of age are most likely to get rotavirus disease, especially infants from 6 months to 2 years.
They can become severely dehydrated and need to see a health care worker quickly to prevent severe illness and even death.
The WHO Country Office for the Solomon Islands is working very closely with Ministry of Health and Medical Services Health Emergency Operations Committee and with the United Nations Children’s Fund (UNICEF) to step up the response to the outbreak.
According to the WHO Representative for the Solomon Islands, Dr Audrey Aumua, WHO is supporting the Ministry of Health and Medical Services to monitor the outbreak and implementing response measures as diarrhoea cases are increasing in Central, Choiseul, Isabel, Malaita and Temotu Provinces, even as cases in Honiara and Guadalcanal Province has stabilized.
Enhanced surveillance for diarrhoea cases
Today’s surveillance figures show that the number of diarrhoea cases are increasing in Central, Choiseul, Isabel, Malaita, Temotu and Western provinces while the number of new cases in the last few weeks in Guadalcanal Province has stabilized.
New cases are declining in Honiara Province but it will take a few more weeks of monitoring before the outbreak comes to an end in Honiara.
A number of deaths have been reported since the outbreak began, which may be due to rotavirus.
It is likely that four children died from the complications of rotavirus diarrhoea.
Two adult deaths are also being investigated but adults are much less likely to get severely ill from rotavirus. They may have died from other causes.
Dr Aumua said that WHO is providing epidemiologists to support the Ministry’s surveillance unit which coordinates data collection and analyzes the weekly data received from hospitals that are part of the National Sentinel Surveillance System and the clinics that are also reporting diarrhoea cases as part of national efforts to monitor this outbreak.
WHO also works closely with the National Referral Hospital (NRH) clinicians, providing guidelines and educational materials for health care workers to ensure that sick children receive the best possible care.
“We are monitoring what is happening throughout the country. While we are not seeing as many cases in the other provinces as we saw in Honiara and Guadalcanal at the moment, anyone can easily get infected by rotavirus.
“It can also spread very quickly so all provinces must remain vigilant.”
Laboratory testing and confirmation for rotavirus
WHO is supporting laboratory diagnosis by connecting the NRH laboratory with international reference laboratories in Australia and Fiji.
Specimens were tested at the beginning of the outbreak to find the cause.
In this outbreak, rotavirus was confirmed as the cause of diarrhoea from testing 28 samples of which eight have been confirmed using a method that determines the actual presence of rotavirus in stool samples and another seven are considered preliminary positive because they have only been tested using a screening test.
Once the cause of the outbreak has been determined, it’s not necessary to test every single case.
Community engagement in outbreak response
WHO works with UNICEF to provide extensive support on health promotion and social mobilization activities to make sure that that the general public is aware of preventive measures.
Messages on basic hygiene practices, recognition of signs and symptoms of infection, water and food safety practices and seeking immediate medical care have been disseminated to parents and community leaders.
“What we see with rotavirus is that young children under 5 years of age are the ones getting infected.
“Young babies in particular can easily lose fluid and important salts when they experience diarrhoea and vomiting,” said Dr Dadari of UNICEF.
“It is very important that parents follow the basic instructions provided by health care workers and complete the course of oral rehydration fluids and give 14 days of zinc tablets to their children.
“Breastfeeding mothers must continue to breastfeed. Parents must know how to identify when their child has diarrhoea and how to give oral rehydration salts and zinc to prevent dehydration. Boiled water that has been allowed to cool, coconut water and lemon juice are also good for treating diarrhoea.”
The Ministry of Health and Medical Services has distributed medical supplies, soap and water and health promotion materials to clinics and communities to stop the spread of rotavirus and ensure that sick children get the best health care.
Dr Aumua reinforced the messages put out by the Ministry.
“Rotavirus is easily spread by the vomit or faeces of an infected person directly from one person to another, for example, when touching the hands of someone who is sick, when changing nappies of babies with diarrhoea, from touching surfaces or objects that have been contaminated with diarrhoea or vomit and sometimes from contaminated water or food.”
She said good hygiene is the best way to prevent catching rotavirus and other causes of diarrhoea.
Basic measures that people can take to prevent the spread of diarrhoea include:
* always washing hands thoroughly with soap and water after using the toilet after changing nappies, and before eating or preparing food and drying them with a clean towel;
* drinking only water that has been boiled or disinfected with chlorine, iodine or water purification tablets;
* using proper toilets such as pit latrines, pour flush and flush toilets and ensuring faeces is covered or buried well away from water sources to prevent contamination of drinking water and to stop flies from spreading disease; and
* practicing the 5 keys to safer food, which are: keeping clean; separating raw and cooked food; cooking food thoroughly; keeping food at safe temperatures and using safe water and raw materials at all times.