Knowledge —both on the part of medical personnel and the population— marks, on many occasions, the difference between life and death of a patient. Right in knowledge we can find the answer to a question that guided the analyzes of a new meeting of the First Secretary of the Central Committee of the Communist Party and President of the Republic, Miguel Díaz-Canel Bermúdez, with experts and scientists for health issues.
"Can death from dengue be avoided?" Dr. Osvaldo Castro Peraza, a specialist at the Pedro Kourí Institute of Tropical Medicine (IPK), asked before the auditorium, referring to the clinical management carried out in Cuba for adult patients who become ill with the virus.
"Yes, it can. Death from dengue can be avoided," the specialist replied. The key to this, he assured, is in compliance with four basic elements that define the treatment of this disease.
The first, he explained, lies in the fact that all the medical and nursing staff who care for these patients must be trained and trained in clinical management. The main medicine, the main technology that we have today to treat dengue is knowledge; there is no medicine, no miracle drug, no vaccine, that can help us prevent or cure dengue, he stressed.
He also considered essential education for the population, not only in what we have been doing for many years, which is vector control, but also in regard to patients and their families having basic knowledge about the symptoms and signs of alarm that can be decisive to treat the disease in a timely manner and, consequently, go to the health services promptly.
The life of a dengue patient is not saved in intensive care, he insisted, we take very complicated patients to these; dengue patients are saved from the first days and primary care and secondary care services, which are responsible for monitoring and evaluating cases, play an important role in this.
The third aspect, he confirmed, is to have a case classification —which we have in Cuba— based on symptoms and signs, which includes warning signs, as well as having care guides and flow charts.Last but not least, he highlighted everything associated with the reorganization of medical services, that is, he said, the organization of care at three levels.
The meeting evaluated, among other topics, the current epidemiological situation in the country, with special emphasis on the behavior of dengue. Photo: Revolution Studios.
Together with these elements, Castro Peraza placed special emphasis on the idea that dengue is a single disease and should be managed as such. There are many cases at the moment, he explained, that do not even bleed and, nevertheless, come to therapy in serious condition.
This is related to the fact —he detailed— “the main pathophysiological event that aggravates a dengue patient is plasma extravasation, which is nothing more than the liquid of the blood that escapes out of the blood vessels and reduces blood volume, producing circulatory failure.
When this phenomenon begins, which is expressed clinically with warning signs, the disease becomes serious, he assured. In this sense, he drew attention to symptoms such as abdominal pain, vomiting, fluid accumulation, mucosal bleeding, fainting and others that express that the critical phase and the period of aggravation have begun.
During his explanation, the outstanding specialist also referred to a group of experiences accumulated by the IPK researchers, during three of the dengue epidemics experienced in the country, from which they have been able to modify action behaviors for the benefit of care for the sick. "Treating a patient well not only prevents death, but also severity," he stressed.
In this regard, President Díaz-Canel commented on the importance for the timely treatment of the sick, not only the skill of the doctors and the preparation of the health personnel in charge of caring for them, but also the promptness with which people attend consultations. in the presence of symptoms associated with the virus.
At the meeting —which was also chaired by the member of the Political Bureau and Prime Minister, Manuel Marrero Cruz— special attention was devoted to the particularities of dengue treatment in pediatric ages.
Given the risks that this disease entails for children and adolescents, greater than what it can mean for adults, doctor of sciences Eric Martínez Torres, an outstanding IPK specialist, stated that the main epidemiological criterion that must be followed for its treatment, is to consider as a possible case of dengue any child, coming from or residing in an area with dengue transmission, who presents an acute febrile illness.
"Every child, when there is transmission and has a fever, has dengue until the contrary is proven, that must be thought about to avoid delays," he emphasized.
The Minister of Public Health reported that transmission of the virus is currently confirmed in all provinces. Photo: Revolution Studios.We have the protocols to deal with dengue cases, and if they are dealt with in a timely manner, we can avoid complications in patients, based on all the experience that exists in the country. This is how the First Secretary of the Central Committee of the Communist Party commented when referring, during the meeting of the Government's working group for the attention and prevention of the epidemiological situation, to the fruitful exchange held minutes before with the experts and scientists for Health issues.
Here, the fundamental problem to face dengue -he pointed out- is to eliminate the transmitting agent, which is the mosquito, and that begins by identifying where the foci are and eliminating them.
His reflections took place after the information offered by the Minister of Public Health, José Angel Portal Miranda, on the epidemiological situation that dengue has caused in recent months.
"At the end of the last week, number 36 of the year, transmission of the virus is confirmed in all provinces," Portal Miranda updated. Only Artemisa remained without confirmed transmission, but in the course of the last seven days, it was confirmed in two health areas of the municipality of San Antonio de los Baños.
The head also commented that in the last four weeks there has been a decrease in the speed of transmission of the virus, with very similar incidence rates. This is the result, he affirmed, of the intensive actions that have been developed in the municipalities with the highest risk.Despite this reality, he said, the incidence rate of suspected cases increased in general in the country compared to the previous week.
This was mainly caused by the behavior of this indicator in eight territories: the special municipality of Isla de la Juventud, as well as the provinces of Santiago de Cuba, Las Tunas, Mayabeque, Sancti Spíritus, Ciego de Ávila, Artemisa and Granma.
Hence the emphasis placed by the Minister of Public Health, in reviewing the effectiveness of the actions that are being carried out, because despite the complexity that these months imply for the disease, the actions have to lead to a decrease in transmission, one week compared to the previous one.
In this meeting, in which the highest political and governmental authorities of all the provinces and the special municipality of Isla de la Juventud also participated via videoconference, Portal Miranda also referred to the favorable behavior that COVID-19 manifests in Cuba currently.
That reality, he valued, cannot lead us to trust. For this reason, its insistence on complying with the measures planned for personal protection and that of the different population groups, as well as advancing in the booster vaccination process, key aspects to maintain the control that has been achieved over the epidemic.