Diario Libre spoke with the gastroenterologist Carmen Cabral, who affirmed that salmonella is one of the main bacteria causing food poisoning, together with Clostridium perfringens, Escherichia Coli (E. Coli), and Campylobacter.

The specialist acknowledged that, lately, in her professional practice at Centro Medico Moderno, she has seen an increase in positive diagnoses for salmonella and Escherichia coli.

“Could it be that they are in the water, in the vegetables? Could it be that people are eating more in the street? Something is happening!” the specialist commented.

According to Cabral, “before there was a lot of amoeba, but now you do a gastrointestinal panel on patients, and you find Campylobacter, Escherichia coli and salmonella like nothing else. I’m not even surprised anymore.”

“Where there is no good food handling, that’s where you get infected,” she said.

The gastro listed the symptoms: nausea, vomiting, abdominal pain, fever, headache, and sometimes bloody diarrhea.

“When the patient goes to the emergency room it is because he is dehydrated most of the time because he has vomited a lot. Then come the complications where the patient can go into sepsis or septic shock,” she said.

The physician emphasized washing vegetables for salads, washing hands after going to the bathroom, covering food to avoid flies, and not reheating food more than once.

“A lot of pesticides are used and the handling from the field to the final consumption destination is too much. Some people think that vinegar is enough,” he commented.

Cabral recommends using chlorinated water with 20 drops of chlorine per gallon and leaving the products to soak for half an hour.

“They should be washed with bottled water, because if you use tap water, we are not at all,” she specified.

The doctor pointed out that the effects of food poisoning would depend on the organism of each individual but that there is an incubation period depending on the pathogen in the food.

Salmonella, frequent in poultry, eggs, and dairy products, usually lasts between six hours to six days in its incubation period.

Escherichia coli typically lasts three to four days; sometimes, it can take up to 10 days. It is found in raw or undercooked meat, unpasteurized juice or milk, soft cheeses made with unpasteurized milk, fresh fruits and vegetables, and contaminated water and feces of people carrying the bacteria.

In seafood poisoning, the reaction usually takes 30 to 60 minutes and up to 24 hours.

Cabral recommends seeking medical advice since these bacteria can cause intestinal perforation and affect the liver and gall bladder if not adequately treated.

Treatment usually includes antibiotics, usually with metronidazole, and sufficient hydration.

Santo Domingo.- The Technological Institute of Santo Domingo (INTEC) and Macrotech, a specialized company in comprehensive health services, have signed a collaboration agreement to promote educational and scientific initiatives that improve the quality of life and contribute to the sustained development of the Dominican Republic.

Dr. Julio Sánchez Mariñez, the rector of INTEC, and Joaquín Toribio, the founder and general director of Macrotech, signed the agreement. The collaboration aims to support educational and scientific activities for students in the Biomedical Engineering program, including internships for students from various fields of study at the university.

Dr. Sánchez Mariñez expressed his appreciation for Macrotech’s support and highlighted the importance of developing technical capacities to design solutions for complex health issues. He emphasized the positive impact of the collaboration on society and sustainability.

Joaquín Toribio, the general director of Macrotech, expressed satisfaction in contributing to the development of technical skills and offering the company’s laboratory practical training in the Biomedical Engineering program. This commitment reinforces their dedication to societal contributions.

The signing ceremony, held at the university, was attended by Macrotech representatives Melissa Bisonó, the commercial director; Esteban Rodríguez, the regional senior marketing manager; and Norelyn Ramírez, the regional communications manager. INTEC was represented by Alliet Ortega, the Vice Chancellor of Administration and Finance; Arturo del Villar, the academic vice-rector; and several deans and faculty members from various areas of study.

The collaboration between INTEC and Macrotech will foster innovation, research, and the development of skills in the healthcare sector, contributing to the advancement of the country’s healthcare system and the well-being of its population.

According to official data, so far this year, there have been 1,837 cases of dengue fever, a disease transmitted by the bite of the Aedes aegypti mosquito that breeds in clean water, especially in the water that accumulates in or around homes.

The highest number of cases reported up to epidemiological week 20, when 1,341 cases had been registered, was in Greater Santo Domingo, with 523 cases, followed by Santiago with 290 and Monte Cristi with 112 reports in the surveillance system. In the province of Puerto Plata, 83 cases of dengue had been reported up to that date; in Barahona, 65; in La Altagracia and Maria Trinidad Sanchez, 61, respectively; in San Cristobal, 60 cases; in La Romana, 58 and Sanchez Ramirez, 58 cases of dengue. Luis Rosario, director of the Regional and Provincial Health Directorates, assured that dengue, malaria, and other epidemiological surveillance diseases had registered a decrease so far this year.

Humans cannot deny the importance of water as a resource for life, which serves for hydration, daily hygiene, cooking food, and other uses such as irrigation, recreational purposes, and even energy production.

However, when water is contaminated by parasites, it can cause various diseases, especially in the digestive tract.

In the Dominican Republic, it is not uncommon for diarrhea to be caused by parasitic agents detected through stool culture.

“We live with parasites. It is very common in our country that a patient who comes with diarrhea and fever turns out to have a parasitic infection,” said gastroenterologist María Alonzo.

This is due, to a great extent, to four fundamental reasons: impurities that were not eliminated in the source at the moment of drinking water; lack of chlorine; deficient systems of storage of the liquid, and bad hygiene habits on the part of the citizens.

“Many of the pictures we see in the gastro consultation have to do with water that has not been properly processed and transmit parasites, bacteria and viruses,” she added.

According to the specialist at the Center for Advanced Gastroenterology, the most common parasite reports she sees in her practice are from patients infected with amoeba and giardia.

Dr. Maria Alonzo (EXTERNAL SOURCE).

These microscopic agents can cause acute gastroenteritis, consisting of diarrhea with nausea, vomiting, fever, and general malaise.

Alonzo clarifies that it is important to identify which parasitic agent is causing diarrhea, since “each one has a specific type of treatment.” Self-medication is ruled out.

“We cook or clean with non-potable water, thus contaminating the food and then we ingest it. Also, people who do not wash their hands properly, when interacting with food, in the end it is transmitted orally,” the doctor explained about the transmission cycle.

The gastro pointed out that children and elderly people are the most at-risk population, reminding that in case of diarrhea, the main thing is to keep the patient hydrated until he/she receives the corresponding treatment, otherwise, it could lead to renal failure.

More hand washing
Although it may seem a reiterative measure, Alonzo called for more emphasis on hand washing education, a simple action with proven results for the benefit of health.

“The Covid pandemic reminded us of this, but we are becoming increasingly lax. People no longer last the 20 seconds they should be soaping each hand. Only good hygiene prevents these cases (of parasitosis),” she said.

Water crisis
At present, the country is experiencing a water shortage as a consequence of the drought, aggravating the factors that lead to a lack of sanitation, which may cause, in addition to gastroenteritis, an increase of dengue, malaria, and chikungunya due to the storage of water in tanks and gallons that end up becoming mosquito breeding places if they are not hermetically sealed.

Another disease that spreads rapidly due to lack of water is cholera since its transmission is entirely linked to poor hygiene and sanitation habits. It is important to note that cholera cases have decreased and in the last few weeks, Public Health has not reported any new infections.

A direct consequence of the low rainfall is that the Santo Domingo Aqueduct and Sewerage Corporation (Caasd) has stopped producing about 25% less water than it used to, for a deficit of 139 million gallons per day in Greater Santo Domingo.

According to epidemiological surveillance records of notifiable diseases, as of March 25, the system had captured 1,331 cases of dengue, 31% more than last year; 66 of malaria, 24% more and 100 of leptospirosis, 107% more (including 10 deaths).

Also, they report 14 cases of diphtheria, with one death; 12 cases of tetanus in non-neonatal ages, with seven deaths, and two cases of pertussis, including one death from that cause.

While the records for the year 2022 up to the same period, reported 1,007 cases of dengue fever captured by the system; 53 cases of malaria, 48 of leptospirosis and eight deaths; six cases of diphtheria and one death; eight cases of tetanus in non-neonatal age with one death and one case of pertussis.

The data are contained in epidemiological bulletin number 12 of the General Directorate of Epidemiology of the Ministry of Public Health.

The report details that in epidemiological week 12, which ended last March 25, 62 probable cases of dengue were reported, 21% of the cases are distributed in the province of Santo Domingo, and 303 cases were reported during the last four weeks of registration.

In relation to malaria, the accumulated cases as of that date were 66, of which 50% came from the outbreak in the province of Azua.

During week 12, the report indicates that five suspected cases of leptospirosis were reported, in three men residing in María Trinidad Sánchez, Peravia, and Santiago Rodríguez provinces, and one woman in Hermanas Mirabal province.

The provinces with the highest cumulative incidence of this disease, transmitted to humans through contact with the urine of infected animals, especially rats, are Santiago Rodriguez, Peravia, Azua, La Romana, and Monseñor Nouel.

SANITARY PANORAMA
On 10 April, Listín Diario reported that the first three months of this year, between medical protests, cholera outbreak, dengue cases, Covid-19 surveillance, and epidemiological alert for the presence of chikungunya in the region, were the topics that occupied the most attention in the sanitary field in the country. While the health system maintains important challenges aimed at maintaining a low incidence of other diseases.

The doctors leading the associations believe that many specialists feel impotent when they realize that the drugs required to manage and avoid the complications of diabetes are not affordable for the Dominican population.

To address the issue, SODENN and SODODIAN have deposited the scientific evidence, adjusted to the latest knowledge on diabetes mellitus treatment, to the General Directorate of Medicines, Food and Sanitary Products. They hope that the country will update the medicines used for treating diabetes based on the latest recommendations from international organizations. The associations believe that the changes can improve diabetes management in the country and change the history of pain caused by the chronic and acute complications of the condition.

In another initiative, the country is set to host the First International Diabetic Foot Congress, “With Feet on Earth” – ALAPID 2023, in Punta Cana from May 18 to 21. The congress will bring together researchers from Latin America, the Caribbean, and other parts of the world to discuss innovations in the field of diabetic foot complications. The congress aims to unify international clinical, medical-scientific, and surgical concepts and efforts on diabetes, and address topics related to clinical endocrinology and nutrition in patients suffering from diabetes mellitus.

However, the Onamet explained that the effects of a trough to the north over the Atlantic Ocean associated with a weak frontal system will originate in the afternoon until early evening cloudy increases with isolated downpours, thunderstorms, and possible wind gusts in the northwestern portion and the Central Cordillera, with greater frequency in the provinces: Dajabón, Elías Piña, Puerto Plata, Valverde, Espaillat, Santiago Rodríguez, Santiago, among other nearby areas.

Temperatures will continue to be quite hot during the day due to the combination of the dust coming from the Sahara and the wind blowing from the southeast. Therefore, the recommendation to the entire population to drink enough liquids (water), wear light clothes (preferably light colors), and not expose themselves directly to the sun, especially from 11:00 a.m. to 4:00 p.m. without sunscreen, is maintained.

For tomorrow Sunday, in the morning hours, there will be isolated showers on the Caribbean coast and the northeast of the country. However, in the afternoon, the trough will bring more moisture and instability to our forecast area, generating cloudy conditions with locally moderate to heavy downpours, thunderstorms, and wind gusts over the northwest, northeast, Central, Central Cordillera, and the border area until the early hours of the night. Cloudy skies and scarce precipitation will continue to prevail for the rest of the country.

The hospital building has an area of 748 square meters and has an imaging center, sonography, physiotherapy, laboratory, gynecology, internal medicine, dentistry, pediatrics and pharmacy, 6 general specialty clinics, among other services.

The president was accompanied by the vice-minister of construction of Mived Danny Santos and other representatives of the entity. Santos explained that the health care center had an investment of 121 million pesos in construction and equipment.

He highlighted that the construction of this project was stopped since 2018 (with only 20% of execution) and was resumed in this management to finish its materialization.

Aerial view of the Diagnostic Center in Ciudad Juan BoschMIVED.

He added that the residents of this housing complex “will no longer have to move to another place to receive a quality hospital service” and that “the Dominican government is committed to health, because you, our people, come first.”

On his departure, the first head of state was seen off by community members carrying banners with the phrase “four more.”

The sectors that will mainly benefit from the opening of this Health Center are Las Aguas, La Ureña, Jerusalén, Nuevo Amanecer, Residencial Las Américas, Ciudad Satélite II, Los Paredones, and Paraíso III.

The head of state, together with Mived, delivered around 7 kilometers of asphalted streets and 3.5 kilometers of sidewalks and curbs.

Other activities

Abinader also presided over the inauguration of the new emergency room of the Robert Reid Cabral Children’s Hospital, where he gave instructions for the remodeling of the burn unit of the hospital and the intensive care and pediatric area.

The burn unit will be put out to tender and would be ready between April and May 2024, said the director of the National Health Service (SNS), Mario Lama, who added that the areas currently being refurbished had been abandoned for a decade.

He detailed that the expansion and refurbishment carried out in the Emergency Room is valued at RD$76,523,581.80, which was completely equipped with an amount of RD$13,280,590.29.

In addition, he indicated that the readjustment of the spaces comprising the areas of the emergency office, suit with two cubicles, cure, plaster, nebulization with six stations, pharmacy, observation with 23 compartments (two isolated), waiting room, emergency area with 12 pieces, trauma shock with four cubicles and doctors and nurses station.

Robert Reid Cabral Children’s Hospital Emergency Department

The Robert Reid Cabral emergency room also saw the construction of a front gate, a new ambulance canopy, a perimeter sidewalk, asphalt tarpaulin, exterior painting, and the construction of a gas control booth.

He also inaugurated in Brisas del Este, Los Frailes, 7 kilometers of asphalted streets and 3.5 kilometers of sidewalks and sidewalk repair, construction of scuppers and speed bumps, and painting of streets in this community for a value of RD$220 million.

Luis Abinader greets the students during the event.

The last activity in this area was the delivery of the Basic School Tomas Taveras Educational Center (Mandinga) with a capacity of 980 students and built with an investment of more than RD03 million.

The Minister of Education, Angel Hernandez, spoke of the importance of artificial intelligence in education today and explained that the Ministry of Education would soon launch the Decennial Education Plan which should take into account the changes in technology.

After various complaints were presented, including one about altering the gestational age of deceased newborns to modify statistics, a vote was taken to create a collegiate department in the Perinatology area of the hospital to audit the records of births and neonatal mortality.

The proposed interim collegiate management would be made up of a representative of the CMD, the maternity hospital management, and the National Health Service (SNS). Senén Caba, the president of the Dominican Medical College (CMD), along with several other medical professionals, led the meeting and declared that the situation had to be addressed immediately for the benefit of the patients.

The activity was attended by Yocasta Lara, the director of the SNS Hospital Centers, Dr. Martin Ortiz, and the director of the Los Mina Maternity Hospital, Leonardo Aquino.

Barahona, DR
The emergency area of the Jaime Mota Regional University Hospital (HRUJM) was busy this Good Friday due to the number of patients who arrived for various reasons, mainly due to traffic accidents involving motorcycles.

Injured in motor vehicle accidents were Eleodoro Medina Matos, 66, Nashla Ramirez, 6, Elias Cuevas Rubio, 26, Brayelin Peña, 14, Luis David Rodriguez, 26, Nelson Daniel Peña Segura, 37, and Luciano Jimenez, 28.

Ramón Urbáez, 32 years old, a resident of the La Peñuela sector of Cabral, was taken to the local hospital’s emergency room because of a fishing spear stuck in his back, accidentally caused by a companion when they were both fishing on the “El Curro” hill.

The cases are from Batey VIII, belonging to Cristóbal and others from the provinces of Independencia, Bahoruco, and Barahona, as well as from the municipality of Tamayo. Many of them were admitted to this health center.

So far, in Barahona province, there are no records of deaths within the Easter Week: Conscience for Life, 2023 operation, except for the death of a man from Azua de Compostela who hit the motor he was driving with a vehicle near the Vicente Noble intersection.

Dozens of people moved toward the different communities of the coastal area, many of them to visit beaches, rivers, and mountains. However, despite the large number of vehicles that moved towards that part of the province, there are no reports of traffic accidents.

In addition, the different neighborhoods have remained calm during this Good Friday. In the early hours in other sectors, citizens took out their swimming pools for children and adults to bathe, despite the prohibition due to the drought affecting the country.