By Henry S. Fraser From Caribbean360

BRIDGETOWN, Barbados.  In 429 BC a plague similar to typhoid killed a quarter of the population of Athens in Ancient Greece. Around 170 AD a plague similar to small pox killed 30 % of the population of Europe, Western Asia and North Africa. The first bubonic plague in the sixth century killed 40 % of the population of Europe, and in the 14th century the second “plague”, spreading with disastrous consequences across Asia to Europe, and known as the Black Death, killed up to 70 % of the people in some countries in Europe.

The great plague of London in 1665 killed 20 % of the population in 1665. Plagues of small pox and cholera have decimated populations across the world, and from the sixteenth century yellow fever began its rampage in the Americas. Barbados had a major epidemic of yellow fever in 1647 and again in 1852. The cholera epidemic of 1854 claimed almost 21,000 lives or one seventh of the island’s population. (It finally led to efforts to provide a water supply across the island.) And the so-called Spanish ’flu pandemic of 1918 – 19 killed somewhere between 20 and 40 million people across the world.

And then there was Asian ’flu and SARS, and dengue. The major Caribbean dengue epidemics of 1969 and 1977 began in Cuba, Haiti and Puerto Rico, spread to Jamaica and then to the Eastern Caribbean. In fact after studying and writing two papers on the 1977 epidemic in Jamaica in the summer of 1977, my wife and I returned to Barbados on September 18th. The following week my mother became the first laboratory confirmed victim of dengue in Barbados. I must have brought a “dengue mosquito” in my pocket! And now we have endemic dengue and frequent outbreaks.

It’s useful to bear these chilling facts in mind today when we consider the Ebola epidemic in West Africa and the Chikungunya epidemic of the Caribbean and Americas, which has spread from South Asia, India and East Africa (where it was first described) to the Caribbean and Americas. The irony, and for those suffering the more severe symptoms the tragedy, is that in the days of the great plagues nothing could be done; in the yellow fever epidemics the mosquito as carrier was unknown. But today a great deal CAN be done, but it’s human nature to ignore information and advice, and assume “It will never happen to me”; and “Why should I bother”; and “I can’t do anything about the mosquitoes”. And of course the same can be said about the prevention of obesity, diabetes, hypertension and heart attacks.

Chikungunya was recognised in the Caribbean almost a year ago. The first case was identified in St. Martin last December. The Director of the Caribbean Public Health Agency (CARPHA), Dr. James Hospedales, issued a major public announcement on May 1st that there was a Caribbean epidemic of Chikungunya across the Caribbean (in five countries by then). The Caribbean response should have been an IMMEDIATE public health campaign in May / June. By September Jamaica was “under heavy manners”, to invoke their famous 1970s phrase, and by October Prime Minister Portia Simpson-Miller announced a National Emergency.

The epidemic hit Barbados by September, although the first reported case (imported) was in June . A “quick and dirty” telephone survey of a dozen family practitioners in 9 different locations have provided some evidence that the epidemic peaked in October and is now past its peak. The mean “guesstimate” for October was 37 % of patients seen, and for November 21 % – a drop by nearly half.

The Ministry of Health’s Public Service Announcements have been emphasising the importance of eliminating the breeding sites of mosquitoes, by removing stagnant water and all possible places for it to accumulate. This includes the following advice:

Dispose of all outdoor containers, including coconut shells and styrofoam dishes that people simply throw around. Store tyres in the garage or dispose of them. Clean water bowls for pets frequently. Discard water from plant saucers. Keep roof gutters and drains clean. Stock any ornamental pools with fish. Spread a film of kerosene on any pool of water after heavy rains. Seal wells and water storage tanks, and place mosquito “dunks” in large bodies of water. De-bush empty lots, which conceal rubbish and stagnant water and in which mosquitoes hide in the day. AND CHECK YOUR PROPERTY CONSTANTLY!

There has been confusion over the importance of de-bushing. Mosquitoes breed in water contained in all kinds of detritus on abandoned lots and in gutters and pools after rains. The eggs will survive and hatch into larvae when the water accumulates again. Bush delays evaporation – large pools of water remain, even in open fields after two inch rains, and can remain in gutters for days, so de-bushing IS important. And obviously we should ALL use mosquito repellent every day and every time we go out. We can and we MUST control mosquitoes and stop this epidemic by Christmas when people gather together – we don’t want to provide left over mosquitoes with a banquet at every Christmas party!

The epidemic is past its peak, but we MUST stop it completely. We must ALL play our part.

Brickbat: FIFA claims “Exonerated.” “No major problematic conduct.” No doubt FIFA will soon announce that the sun will rise in the West.

Professor Fraser is past Dean of Medical Sciences, UWI and Professor Emeritus of Medicine. Website: www.profhenryfraser.com

For more on this story go to: http://www.caribbean360.com/opinion/henry-s-fraser-chikungunya-and-the-great-plagues-in-context#ixzz3K2qaNRW2