In a document, he expressed that the operations and interventions have impacted 5,670 people, with the application of vaccines, 4,457, kit with liquid and paste chlorine to purify water, placement of oral rehydration serum, and prevention. He said that the laboratory results of the Bahoruco and La Palmita rivers showed positive results for fecal coliforms, E. coli, and pseudomonas but negative for vibrio cholera. “However, we recommend not to consume these waters given the contamination.”

He assures that the health authorities “approach this situation with the utmost seriousness. Our medical teams are on the ground, attending to each case with the objective of providing the appropriate treatment to preserve the lives of patients.”

Dr. Nelson Rodriguez Monegro
Refused to admit
Since Saturday 4, the Ministry of Health has been notified by the Provincial Directorate about the appearance of this outbreak but has insisted that it was amebao or shigelas. The population blamed Inapa for the problem due to carelessness with the collapsed aqueduct.

The doctor had already said.
What is happening is an outbreak of cholera, given that the amoeba and echerichacolis do not have those characteristics, said Nelson Rodriguez Monegro, former director of the National Health Service (SNS), before the report.

“It is worrying and calls attention to the attitude of the authorities, which is apparently their norm, in the face of an epidemic outbreak. At the time, the same thing happened with dengue,” he said.

He recalled that they began by denying the increase in the number of epidemic cases, then that “everything was under control, that the cases are decreasing, and the opposite is true. He warned that these diseases have different characteristics than cholera. He explained that the parasitosis has a fever, gas, abdominal pain, willful desire to evacuate, pain in the hypogastrium, semi-solid evacuations with mucus, and may be accompanied by blood.

People with cholera present vomiting without nausea, abundant watery evacuations similar to rice water, and there is no abdominal pain. They may have muscle cramps due to loss of electrolytes.

“They are different pictures, and the diagnosis is made with laboratory tests. Without a doubt, it is cholera.”

José Iván Encarnación, President of the Dominican Foundation for Integral Development, highlighted the measure taken by the Presidential Commission to support neighborhood development since a fortnight ago, a girl died of the disease in that area.

He thanked the President of the Republic, Luis Abinader, for instructing the director of the Commission for Neighbourhood Development, Rolfi Rojas, to intervene in the neighborhoods of Villa Duarte in alliance with civil society organizations.

“We are carrying out an unprecedented operation in terms of fumigation, cleaning of streets, avenues, alleys and gullies to eliminate the reservoirs where the larvae multiply and then become the mosquito that produces dengue fever,” he said.

He informed that, in addition to dengue, the operation prevents other diseases such as malaria, leptospirosis, chikungunya, and other illnesses that attack marginalized sectors.

In addition to the operation against dengue and other diseases, the Commission for Neighbourhood Development will impact dozens of houses in poor condition in Simonico with the replacement of roof floors paving of alleys, as well as the intervention of the gullies.

Joel La Ho of the Simonico neighborhood council highlighted the workday because it would prevent other children from dying of dengue fever, in addition to the announcement by Rolfi Rojas to start next week in the continuation of the workday with the repair of houses in poor condition.

Some health centers have been forced to suspend elective surgeries due to a lack of beds, the director of a prestigious clinic in Santo Domingo told Hoy. The reality is no different in cities like Santiago and La Vega. People go from place to place looking for a bed in the private sector, and they use primary relationships with doctors, politicians, and journalists to get a bed. In practice, there are none.

One pediatrician has up to 16 patients, another has 10, and this figure is repeated when they are consulted privately.

The private centers that have up to 35% of their beds occupied by patients with dengue are Gynaecology and Obstetrics, Otorhinolaryngology, Abreu Clinic, Plaza de la Salud, Abel González, and the UCE Medical Centre. The Independencia, Alcántara y González, and Rodríguez Santo clinics also have high occupancy rates. In Santiago, Unión Médica, Corominas and the Hospital Metropolitano de Santiago (Homs).

Public centres
The public hospitals with the highest number of patients under 18 admitted with the viral disease transmitted by the bite of the Aedes aegypti are the Robert Reid Cabral and the Hugo Mendoza. Also known as the yellow fever mosquito, Aedes aegypti is a mosquito that can spread dengue fever, chikungunya, Zika fever, Mayaro, and yellow fever viruses, and other disease agents. The mosquito can be recognized by black and white markings on its legs and a marking in the form of a lyre on the upper surface of its thorax.

State hospitals
Data released by Robert Reid Cabral indicates that by mid-afternoon on Friday, 63 children with symptoms of dengue fever were admitted. The hospital reported that it has 13 new patients. Three patients are in intensive care. The emergency room is full of patients with fever and other symptoms.

The Hugo Mendoza Hospital has 60 admissions and one in intensive care. The Hospital General de la Plaza de la Salud has 23 minors admitted; six were waiting for beds in the emergency room.

Other viruses
It is not only dengue impacting the Dominican health system but also respiratory infections.

In that order, the authorities call the population to go to vaccination centers to be immunized against the influenza virus.

Personnel from different institutions participated in the fumigation work, elimination of mosquito breeding sites, and orientation to the citizens to stop the epidemic outbreak of dengue affecting the country in the second stage of interventions at a national level, which will continue this Sunday, informed the Ministry of Public Health.

In addition, the operations included the distribution of water tank lids, chlorine, and educational material to sensitize the population on the importance of keeping their environment clean and preventing the formation of water accumulations that serve as breeding grounds for the mosquito that transmits the disease.

The authorities focused on the sectors that have registered the highest incidence of dengue fever in different provinces of the country, including Santo Domingo, where members of the Military Commission of the Ministry of Public Works (Comipol) disinsected the facilities of the Cristo Redentor National Cemetery, applying larvicide in some 320 tombs and where they eliminated 37 mosquito breeding sites.

According to the latest figures provided by the health authorities, so far this year, 13 deaths have been confirmed due to dengue, and there are almost 14,100 suspected cases of the disease in the country.

Family members say they do not believe the number of cases has decreased. On the contrary, they say that they know of more and more children with symptoms; they also say that spaces and beds in hospitals are scarce.

Johanna Santos, the grandmother of a nine-month-old baby, was waiting for news about her grandson outside the Hugo Mendoza Pediatric Hospital in Santo Domingo Norte after being admitted for several days with suspected dengue fever.

“Don’t pay any attention to the fact that dengue is decreasing. Dengue is ending; it is not decreasing at all. That is a lie,” said the lady. She insisted that there were no more beds available at the hospital due to the number of children hospitalized.

According to a hospital spokesman, yesterday morning, 82 patients remained in the center, which was at maximum capacity.

No beds

During the last few weeks, the number of patients in the hospitals continues to be alarming, while several health centers are at maximum capacity, and the lack of beds to attend to the infants is evident, according to parents.

Yoleidy Suarez, mother of a two-year-old boy admitted to the Robert Reid Cabral Children’s Hospital with dengue fever, indicated that although her little boy has received good care, she says that in the observation area, there are no beds.

“Upstairs (in internment) everything is fine, but downstairs, in observation, there are three and four children in a single bed,” Suarez said.

This information was corroborated by other people such as Maritza Rodriguez, aunt of a 14-year-old boy with the same disease, who assured that the emergency area has remained full.

Outside the Hugo Mendoza Hospital, several parents were waiting for news of their relatives admitted or attended by the Emergency Department. They indicated that the wards of the health center were also full of parents with their children.

“You can’t even get in here,” exclaimed a mother who came with her little girl who has sickle cell disease (sickle cell patient), referring to the fact that the place was overcrowded and that she would have to go to another health center.

Robert Reid

At the Robert Reid Cabral Hospital, in the morning hours, 33 patients had been admitted with symptoms of dengue fever.

According to a spokesman for the health center, 69 patients were still in the ward with a possible diagnosis of the disease, while eight were confirmed.

In the Intensive Care Unit (ICU), the center kept a total of four children hospitalized, all of whom were stable.

Alarming symptoms

Among the warning signs for parents coming to children’s hospitals are fever, vomiting, headache, and body aches, among other symptoms.

In addition to these febrile symptoms, children come to the centers with signs of respiratory viruses such as pneumonia or bronchopneumonia.

Dr. Griselys Alcántara pointed out that patients infected by the virus transmitted by the bite of the Aedes aegypti mosquito need special treatment and constant supervision.

“A person affected by dengue requires 24-hour supervision, due to the fact that it is an unpredictable disease that does not represent a danger now, and after half an hour it worsens,” Alcántara said.

At the Unión Médica del Norte clinic, where she directs the intensive care area, they maintain surveillance of patients with shifts of up to 24 hours.

Margarita Santana, a pediatric infectious disease specialist at the Unión Médica, added that the treatment for this virus is “totally exhausting.”

“The truth is that I don’t think there is a pediatrician in the public or private sector who is not exhausted, due to the great demand,” she said.

In addition to the large number of suspected cases of dengue, which so far this year exceeds 14,000, there are also patients with other conditions that present themselves in the emergency room.

Statistics show that this center is attending about 300 children with febrile processes in the pediatric area, of which an average of 18 cases are positive for the disease. To date, the Unión Médica has treated 854 probable dengue fever patients.

Baby worsened due to lack of timely care.
At the door of the Emergency Room of the Hugo Mendoza Hospital, Kelcy Zabala was accompanied by her parents on her way to the cafeteria to have a quick snack since her nine-month-old baby has been in the Intensive Care Unit for two days with a positive diagnosis of dengue.

The new mother said that her situation worsened because she took him to a private clinic in Santo Domingo East, and the answer she received was to treat him with acetaminophen at home because the clinic was full. “They bounced us from the clinic, and the baby got worse,” she said.

This was the reason why they went to Hugo Mendoza, where they already had to give him a platelet transfusion because of the low level he presented.

“Here the treatment has been very good,” she added.

This Thursday, the emergency room of the health center looked more evident than on previous occasions, with only about twenty children waiting, when in the past days, there were more than 70. In the case of Robert Reid, this Thursday, there were 67 children admitted and four in intensive care.

Tests do not need an indication.
Diario Libre visited branches of private clinical laboratories to observe the demand for serological and molecular tests for dengue diagnosis.

“It is not necessary to have an indication. For antigen tests it is recommended that the patient has at least three days of fever. The PCR tests are more specialized tests that are normally done if requested by the physician,” responded a collaborator of the Amadita Laboratory.

This is the opinion of the international expert Javier Marin, director for Latin America of Healthcare of Llorente y Cuenca (LLYC) when he was interviewed during a visit to the editorial office of Listin Diario.

The specialist emphasized that the control of health conditions affecting the population is not only the responsibility of the State and that service companies, clinics, pharmaceutical companies, laboratories, and diagnostic centers must play a more empowering role in the health care of the population.

Marín was in the country participating as a speaker at the congress “Innovation, Trends and Challenges: where we must move,” held last weekend by the Association of Representatives, Agents and Pharmaceutical Producers, Inc (ARAPF).

He understands that companies must stop considering only suppliers and start getting more involved in society’s health care.

Effective communication

With dengue, Marín said that if companies get involved and work directly with the State, there would be better results in prevention and response and that effective communication is fundamental because, many times, the aggravation of cases of a particular disease occurs mainly because people confuse the symptoms and arrive late to the health system.

He explained that in the activity organized by ARAPF, he explained how communication can contribute to improving the reasoning of companies’ impact in improving health in each country.

He said that the sustainability of health systems must be considered.

He said that sometimes it is thought that this sustainability is the responsibility of the State, without understanding that the companies involved in the sector cannot be seen only as suppliers and that the individual himself assumes a more empowered role in health care.

He pointed out that at LLYC, they study the challenges facing healthcare systems. He said that governments must establish processes to monitor what is happening and, above all, to know what the population is feeling, to analyze volumes of data, and to take immediate action.

He emphasized that social networks are of great importance in monitoring because people express themselves without filters, and they make it possible to understand what is happening in some regions of the country and about specific health conditions, including what is happening with the high incidence of non-communicable diseases.

The denunciation was made by the Technical Cabinet, whose spokesperson was the former Minister of Health, Rafael Sánchez Cárdenas, who expressed that the Government manipulates the epidemiological bulletins, added to an absence of orientation campaign to deal with the disease and a notorious insensitivity of its officials.

“President, this is not about some methodological error, at the same time we share the criterion that these facts are totally dishonest and that they call into question the touted transparency,” expressed Sánchez Cárdenas, in the company of other PLD leaders.

Measles is a highly infectious disease that is prevented by vaccines and has not been present in the Dominican Republic since 2001. In Canada, there are eight cases; Chile has one case of measles, and the United States has 29 confirmed cases.

The Vice Minister of Collective Health, Dr. Eladio Perez, read the epidemiological alert issued for the Dominican Republic. The country was declared free of the disease in 2010.

However, they are maintaining and intensifying surveillance to avoid the arrival of the disease affecting children in the country.

Mario Lama, vice minister of Collective Health and executive director of the National Health Service, respectively.

Greater Santo Domingo has 350 beds for dengue patients, primarily children. Dr. Lama said the Hugo Mendoza and Robert Reid Cabral hospitals have the highest bed demand.

In the last 24 hours, 100 patients were admitted, said Dr. Lama; the reduction is about 16%, especially in the previous 72 hours.

Those admitted
In the Metropolitan region, 315 people were admitted yesterday with suspected dengue fever; of those with PCR test, 39 have tested positive for the disease. It was announced that seven more intensive care beds would be opened in the mother and child area of the Marcelino Velez Santana hospital in the next few hours.

30 to 50 additional beds are also expected to be opened in the Mario Tolentino Dipp hospital.

Pressure for beds
The National Association of Private Clinics has been collaborating to habilitate more beds to attend to patients with dengue. Minister Daniel Rivera offered the information. However, the public network is trying to reserve beds for patients with other diseases.

The country currently has several circulating viruses, including respiratory syncytial, rhinovirus, influenza, and adenovirus. Health authorities perform PCR tests to detect dengue in less time.

Tests

The Ministry of Health said that, through the Doctor Defilló National Laboratory, specialized PCR tests are being performed to detect dengue in the shortest possible time and quickly diagnose the disease. The data are by the standards required for notifiable diseases, and PCR tests are performed for a faster diagnosis.