Executive Director of the Caribbean Public Health Agency (CARPHA) Dr. James Hospedales has argued that the number of confirmed Zika cases is just the "tip of the iceberg" and is not a true reflection of the reality of those potentially infected with the virus.
Using a graphic titled "Lab confirmation of Zika: iceberg phenomenon", the executive painted a grim image in which the submerged (largest) portion of the iceberg represents the hidden mass of the disease, which includes subclinical cases, carriers and undiagnosed cases.
The tip of the iceberg, the smallest area, represents the number of confirmed Zika cases; this is followed by the percentage of persons tested, those eligible for testing, persons who came for medical attention and those who are symptomatic. The largest area of the chart showed persons who are infected with Zika.
"As is seen in the iceberg phenomenon, only a small percentage of all the infected persons end up being laboratory confirmed positive cases. The iceberg phenomenon is important and provides valuable information for public health decision making.
"It gives an indication of the magnitude of the infection so that action can be taken to reach those who cannot be seen and are 'under the water'. Often times when the figures of confirmed laboratory cases of diseases such as chikungunya and Zika are reported by officials to the media, we normally get a surprising reaction from the public. Comments like; 'those figures can't be true because my whole village had Zika' are not uncommon," said Hospedales.
Reports say 58 countries/territories currently have active Zika transmission. That includes one country in Africa (Cape Verde), eight in the Pacific Islands and 48 in North, Central and South America.
The number of confirmed Zika cases in New Providence is now 11. The first case of Zika was reported on August 10.
Chief Medical Officer (CMO) Dr. Glen Beneby said the government plans to set aside an estimated $2.5 million every month to fight the Zika virus, which would add up to almost $30 million per year.
"The reported figures are often laboratory confirmed positive cases. These cases do not represent everyone who have been infected. The figures are only what is described as the 'tip of the iceberg' as demonstrated in the diagram...," said Hospedales.
"In the context of the Zika outbreak, the reported cases are the persons who have been infected with Zika, were symptomatic and then sought medical attention. They were the ones who were eligible for testing and then got tested," he said.
Currently, those being tested for Zika in The Bahamas have to wait approximately two to three weeks for results. The test blood samples are sent to CARPHA, in Port-of-Spain, Trinidad and Tobago.
The government is upgrading a lab intended to be used to test for the virus in The Bahamas and would cost $50,000 to $100,000 in modifications.
Beneby said once the upgrades are complete, it should cut the wait time by 50 percent.
Xian Smith, Guardian Business Reporter
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